Clinical evaluation of brief cognitive assessment measures for patients with severe dementia

Dixon, Jasmine S.; Saddington, Deborah G.; Shiles, Celia; Sreevalsan, Kavya P.; Munro, Cynthia A.; Rosenberg, Paul B.

doi:10.1017/s1041610217000151

Cited by 7 publications

(6 citation statements)

References 12 publications

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“…The MMSE is an international standard for evaluating intelligence state and cognitive impairment in patients with cognitive disorders ( Predictors, 2017 ; Dixon et al, 2017b ). The cataract group exhibited a significantly lower MMSE score (27·65 ± 1·47) than the control group (29·58 ± 0·86) ( P < 0·001, Cohen's d = 1·60) ( Fig.…”

Section: Resultsmentioning

confidence: 99%

“…These patients exhibited significantly decreased visual function and underwent phacoemulsification with IOL implantation. We measured changes in brain function and structure before and after cataract surgery using functional magnetic resonance imaging (fMRI), a well-established neuroimaging technology that not only evaluates grey matter (GM) variation but also detects functional changes in the brain by monitoring blood oxygen level-dependent signals ( Tambini et al, 2017 ), and the Mini-Mental State Examination (MMSE), a classic measurement of cognitive impairment ( Predictors, 2017 ; Dixon et al, 2017a ). We demonstrate that patients with ARC display impaired brain function and structure, but these changes can be fully reversed by visual acuity restoration.…”

Section: Introductionmentioning

confidence: 99%

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Visual Restoration after Cataract Surgery Promotes Functional and Structural Brain Recovery

et al. 2018

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BackgroundVisual function and brain function decline concurrently with aging. Notably, cataract patients often present with accelerated age-related decreases in brain function, but the underlying mechanisms are still unclear. Optical structures of the anterior segment of the eyes, such as the lens and cornea, can be readily reconstructed to improve refraction and vision quality. However, the effects of visual restoration on human brain function and structure remain largely unexplored.MethodsA prospective, controlled clinical trial was conducted. Twenty-six patients with bilateral age-related cataracts (ARCs) who underwent phacoemulsification and intraocular lens implantation and 26 healthy controls without ARC, matched for age, sex, and education, were recruited. Visual functions (including visual acuity, visual evoke potential, and contrast sensitivity), the Mini-Mental State Examination and functional magnetic resonance imaging (including the fractional amplitude of low-frequency fluctuations and grey matter volume variation) were assessed for all the participants and reexamined for ARC patients after cataract surgery. This trial was registered with ClinicalTrials.gov (NCT02644720).FindingsCompared with the healthy controls, the ARC patients presented decreased brain functionality as well as structural alterations in visual and cognitive-related brain areas preoperatively. Three months postoperatively, significant functional improvements were observed in the visual and cognitive-related brain areas of the patients. Six months postoperatively, the patients' grey matter volumes in these areas were significantly increased. Notably, both the function and structure in the visual and cognitive-related brain areas of the patients improved significantly and became comparable to those of the healthy controls 6 months postoperatively.InterpretationWe demonstrated that ocular reconstruction can functionally and structurally reverse cataract-induced brain changes. The integrity of the eye is essential for maintaining the structure and function of the brain within and beyond the primary visual pathway.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Visual Restoration after Cataract Surgery Promotes Functional and Structural Brain Recovery

et al. 2018

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“…There was minimal risk of harm to the participants, as no known safety risks are associated with the devices used in the study and all comply [37]. While not identical, the MMSE and BIMS measures are highly correlated [38].…”

Section: Participant Selectionmentioning

confidence: 99%

Long-Term, All-Day Exposure to Circadian-Effective Light Improves Sleep, Mood, and Behavior in Persons with Dementia

Figueiro

Şahin

Kalsher

et al. 2020

ADR

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Background: Persons with Alzheimer's disease and related dementias (ADRD) frequently experience sleep-wake (circadian) cycle disturbances that lead them to remain awake at night, causing stress and fatigue for families and caregivers. Light therapy shows promise as a nonpharmacological treatment for regulating sleep in this population. Objective: We investigated the long-term impact of a circadian-effective lighting intervention on sleep, mood, and behavior problems in persons with ADRD. Methods: This 25-week clinical trial administered an all-day lighting intervention to 47 patients with ADRD in 9 senior-care facilities, employing wrist-worn actigraphy measures and standardized measures of sleep quality, mood, and behavior. Results: The intervention significantly improved Pittsburgh Sleep Quality Index scores, from an estimated mean ± SEM of 11.89 ± 0.53 at baseline to 5.36 ± 0.63 at the end of the intervention. Additional improvements were noted for sleep efficiency data from actigraph measurements. The intervention significantly reduced Cornell Scale for Depression in Dementia scores (mean ± SEM of 11.36 ± 0.74 at baseline and 4.18 ± 0.88 at the end of the intervention) and Cohen-Mansfield Agitation Inventory scores (mean ± SEM of 47.10 ± 1.98 at baseline and 35.33 ± 2.23 at the end of the intervention). Conclusion: A regular circadian-effective daytime lighting intervention can improve sleep at night and reduce depression and agitation in patients with dementia living in controlled environments. More importantly, the positive effects of the tailored lighting intervention on these outcomes appear to be cumulative over time.

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“…SIB-8: a cognitive assessment tool [ 52 ] for moderate to severe dementia [ 40 , 41 , 46 , 48 , 50 , 81 , 82 ].…”

Section: Methodsmentioning

confidence: 99%

Electroconvulsive therapy for the acute management of severe agitation in dementia (ECT-AD): A modified study protocol

Lapid,

Merrill,

Mueller

et al. 2024

PLoS ONE

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Objective This study began as a single-blind randomized controlled trial (RCT) to investigate the efficacy and safety of electroconvulsive therapy (ECT) for severe treatment-refractory agitation in advanced dementia. The aims are to assess agitation reduction using the Cohen-Mansfield Agitation Inventory (CMAI), evaluate tolerability and safety outcomes, and explore the long-term stability of agitation reduction and global functioning. Due to challenges encountered during implementation, including recruitment obstacles and operational difficulties, the study design was modified to an open-label format and other protocol amendments were implemented. Methods Initially, the RCT randomized participants 1:1 to either ECT plus usual care or simulated ECT plus usual care (S-ECT) groups. As patients were enrolled, data were collected from both ECT and simulated ECT (S-ECT) patients. The study now continues in an open-label study design where all patients receive actual ECT, reducing the targeted sample size from 200 to 50 participants. Results Study is ongoing and open to enrollment. Conclusion The transition of the ECT-AD study design from an RCT to open-label design exemplifies adaptive research methodologies in response to real-world challenges. Data from both the RCT and open-label phases of the study will provide a unique perspective on the role of ECT in managing severe treatment-refractory agitation in dementia, potentially influencing future clinical practices and research approaches.

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Clinical evaluation of brief cognitive assessment measures for patients with severe dementia

Abstract: Brief cognitive tests designed for severe dementia such as the SIB-8 and sMMSE have been evaluated in this project to be shorter in administration duration and highly correlated with gold standard instruments: the SIB and MMSE.

Cited by 7 publications

References 12 publications

Visual Restoration after Cataract Surgery Promotes Functional and Structural Brain Recovery

Visual Restoration after Cataract Surgery Promotes Functional and Structural Brain Recovery

Long-Term, All-Day Exposure to Circadian-Effective Light Improves Sleep, Mood, and Behavior in Persons with Dementia

Electroconvulsive therapy for the acute management of severe agitation in dementia (ECT-AD): A modified study protocol

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