Abstract:<b><i>Introduction:</i></b> Early diagnosis of dementia is important; however, the diagnostic criteria for the preclinical stage of dementia, including biomarkers and pathophysiological markers, are not suitable for application in patients in real-world clinical settings. One potential noninvasive method to predict the risk of dementia conversion is the neuropsychological test. Therefore, in this study, we examined the results of various assessments, such as comprehensive neuropsycholog… Show more
“…Baseline global test measures such as MMSE and MOCA have also been found useful in predictive modeling in a hospital-based study from Thailand; however our study suggests that domainspecific measures are more predictive in comparison to total ACE score [51]. Higher CDR and IADL at baseline has been associated with a greater risk of MCI conversion as has been shown in other studies [23,[52][53][54][55]. The CDR and IADL repeated measure ANOVA comparing conversion groups showed a decline between and within each group from baseline and final follow-up.…”
<b><i>Introduction:</i></b> The study aimed to explore longitudinal cognitive outcomes and to ascertain predictors of conversion to dementia in a hospital-based mild cognitive impairment (MCI) cohort classified according to the neuropsychological phenotype at baseline. <b><i>Materials and Methods:</i></b> Subjects aged >55 years who had a clinical diagnosis of MCI at initial visit between 2010 and 2018, with at least one formal neuropsychological assessment at baseline and follow-up of a minimum of 2 years were included. The prospective study was completed based on evaluation at last follow-up to gauge conversion to dementia, quantification of performance on activities of daily living and when available, longitudinal neuropsychological test scores. <b><i>Results:</i></b> Ninety-five patients with MCI met the inclusion criteria with a mean age of 68.4 ± 6.4 years at baseline and a mean duration of follow-up for 6.4 ± 3.2 years. The cumulative conversion rate to dementia was 22.2% (21/95) and the annualized conversion rate was 3.3% per year of follow-up. The majority of subjects who had converted had multidomain MCI (66%). Only white matter changes on MRI brain revealed correlation with baseline neuropsychology tests. The multivariate logistic regression analysis revealed the utility of lower baseline list recognition (adjusted odds ratio: 0.735 [95% confidence interval: 0.589–0.916]; <i>p</i> 0.006), lower immediate logical memory (0.885 [0.790–0.990]; <i>p</i> 0.03), and high perseverative error scores on set shifting (3.116 [1.425–6.817]; <i>p</i> 0.004) as predictors of conversion. A model score of +2.615 could predict conversion with sensitivity of 72% and specificity of 98% over 6.4 years follow-up. <b><i>Conclusion:</i></b> There was a higher risk of conversion associated with multidomain MCI. Logistic regression-based estimations of dementia risk utilizing domain-based neuropsychology test scores in MCI have high specificity for diagnosis at baseline.
“…Baseline global test measures such as MMSE and MOCA have also been found useful in predictive modeling in a hospital-based study from Thailand; however our study suggests that domainspecific measures are more predictive in comparison to total ACE score [51]. Higher CDR and IADL at baseline has been associated with a greater risk of MCI conversion as has been shown in other studies [23,[52][53][54][55]. The CDR and IADL repeated measure ANOVA comparing conversion groups showed a decline between and within each group from baseline and final follow-up.…”
<b><i>Introduction:</i></b> The study aimed to explore longitudinal cognitive outcomes and to ascertain predictors of conversion to dementia in a hospital-based mild cognitive impairment (MCI) cohort classified according to the neuropsychological phenotype at baseline. <b><i>Materials and Methods:</i></b> Subjects aged >55 years who had a clinical diagnosis of MCI at initial visit between 2010 and 2018, with at least one formal neuropsychological assessment at baseline and follow-up of a minimum of 2 years were included. The prospective study was completed based on evaluation at last follow-up to gauge conversion to dementia, quantification of performance on activities of daily living and when available, longitudinal neuropsychological test scores. <b><i>Results:</i></b> Ninety-five patients with MCI met the inclusion criteria with a mean age of 68.4 ± 6.4 years at baseline and a mean duration of follow-up for 6.4 ± 3.2 years. The cumulative conversion rate to dementia was 22.2% (21/95) and the annualized conversion rate was 3.3% per year of follow-up. The majority of subjects who had converted had multidomain MCI (66%). Only white matter changes on MRI brain revealed correlation with baseline neuropsychology tests. The multivariate logistic regression analysis revealed the utility of lower baseline list recognition (adjusted odds ratio: 0.735 [95% confidence interval: 0.589–0.916]; <i>p</i> 0.006), lower immediate logical memory (0.885 [0.790–0.990]; <i>p</i> 0.03), and high perseverative error scores on set shifting (3.116 [1.425–6.817]; <i>p</i> 0.004) as predictors of conversion. A model score of +2.615 could predict conversion with sensitivity of 72% and specificity of 98% over 6.4 years follow-up. <b><i>Conclusion:</i></b> There was a higher risk of conversion associated with multidomain MCI. Logistic regression-based estimations of dementia risk utilizing domain-based neuropsychology test scores in MCI have high specificity for diagnosis at baseline.
Purpose
The purpose of this article was to describe the validity and reliability of the Fun and Social Engagement Evaluation (FUSE) developed to evaluate and measure social engagement displayed by nursing home residents during Bingocize. The FUSE combines health care worker observation and a resident self-report measure to produce a score that represents a resident's total engagement.
Method
To describe validity, trained health care workers who implement Bingocize were surveyed about the items on the FUSE. Visual inspection of bar graphs of responses to survey questions were used to determine content validity.
To assess reliability of the FUSE, nursing home residents were evaluated by trained research assistants. Test–retest reliability of the participant scores 1 week apart was determined with the bivariate correlation (Pearson product–moment correlation coefficient).
Results
For validity, the majority of survey respondents indicated that the behaviors were representative of nursing home residents during Bingocize. For reliability, there was moderate–strong test–retest reliability over 1 week (
r
= .60). Interrater reliability between two raters observing eight participants across two sessions was significant, κ = .68 (95% CI [.504,.848]),
p
< .0001.
Conclusion
Results offer evidence that the FUSE is a valid and reliable method for determining social engagement during Bingocize.
Objective This study aimed to explore the characteristics and factors related to changes in cognitive function in vulnerable individuals with cognitive impairment during the coronavirus disease 2019 (COVID-19) pandemic.Methods Among patients who visited a local university hospital with subjective cognitive complaints, those who had been tested for cognitive function at least once after the onset of COVID-19 and tested regularly at least three times within the last 5 years were included (1st, the initial screening; 2nd, the test immediately before the COVID-19 pandemic; 3rd, the most recent test after the pandemic). Finally, 108 patients were included in this study. They were divided into groups according to whether the Clinical Dementia Rating (CDR) was maintained/improved and deteriorated. We investigated the characteristics of the changes in cognitive function and related factors during COVID-19.Results When comparing CDR changes before and after COVID-19, there was no significant difference between the two groups (p=0.317). Alternatively, the main effect of the time when the test was conducted was significant (p<0.001). There was also a significant difference in the interaction between the groups and time. When the effect of the interaction was analyzed, the CDR score of the maintained/ improved group significantly decreased before COVID-19 (1st–2nd) (p=0.045). After COVID-19 (2nd–3rd), the CDR score of the deteriorated group was significantly higher than that of the maintained/improved group (p<0.001). Mini-Mental State Examination recall memory and changes in activity during COVID-19 were significantly associated with CDR deterioration.Conclusion Memory dysfunction and decreased activity during the COVID-19 pandemic are strongly related to the deterioration of cognitive impairment.
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