Enhancing Cognitive Screening in Geriatric Care

Lichtenberg, Peter A.; Johnson, Amanda; Erlanger, David; Kaushik, Tanya; Maddens, Michael; Imam, Khaled; Barth, Jeffrey T.; Webbe, Frank M.

doi:10.4018/jhisi.2006070103

Cited by 9 publications

(23 citation statements)

References 7 publications

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“…Five studies reported results for more than two groups of participants: three included healthy controls, MCI and early dementia, 71,76,86 and two included healthy controls, early dementia and early dementia/MCI combined. 70,74 In total, 10 studies 68,69,71,72,75,76,78,79,85,86 evaluated the use of automated computerised tests to detect MCI alone, seven studies 70,71,74,76,80,81,86 reported results for early dementia, three studies 70,74,77 reported results for combined MCI/early dementia and one study 83 reported results for human immunodeficiency virus (HIV)-associated neurocognitive disorder (HAND).…”

Section: Included Studiesmentioning

confidence: 99%

“…Although only one study 77 was judged to be at low risk of bias across the four domains, the studies were considered to be of good quality. Patient selection issues were the most likely to introduce bias.…”

Section: Study Quality Assessmentmentioning

confidence: 99%

“…Even though all of the tests were self-administered, a practice session was offered to participants in five studies [69][70][71]79,86 to make sure that patients were familiar with the software and platform for the index test. Nine studies 68,69,71,72,75,[77][78][79][80] reported that support staff were present in the room to address any questions from participants about the software or platform. …”

Section: Index Test Detailsmentioning

confidence: 99%

“…In total, 16 studies [68][69][70][71][72][74][75][76][77][78][79][80][81]83,85,86 were included in the diagnostic accuracy review.…”

Section: Included Studiesmentioning

confidence: 99%

“…[68][69][70][77][78][79][80]85 The studies were judged to be at high risk for this criterion because a case-control study design was used. Regarding the index test criteria for risk of bias, seven studies 70,71,74,76,78,83,85 were judged to be at unclear risk.…”

Section: Study Quality Assessmentmentioning

confidence: 99%

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Automated tests for diagnosing and monitoring cognitive impairment: a diagnostic accuracy review

Aslam

Bates

Dündar

et al. 2016

Health Technol Assess

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BackgroundCognitive impairment is a growing public health concern, and is one of the most distinctive characteristics of all dementias. The timely recognition of dementia syndromes can be beneficial, as some causes of dementia are treatable and are fully or partially reversible. Several automated cognitive assessment tools for assessing mild cognitive impairment (MCI) and early dementia are now available. Proponents of these tests cite as benefits the tests’ repeatability and robustness and the saving of clinicians’ time. However, the use of these tools to diagnose and/or monitor progressive cognitive impairment or response to treatment has not yet been evaluated.ObjectivesThe aim of this review was to determine whether or not automated computerised tests could accurately identify patients with progressive cognitive impairment in MCI and dementia and, if so, to investigate their role in monitoring disease progression and/or response to treatment.Data sourcesFive electronic databases (MEDLINE, EMBASE, The Cochrane Library, ISI Web of Science and PsycINFO), plus ProQuest, were searched from 2005 to August 2015. The bibliographies of retrieved citations were also examined. Trial and research registers were searched for ongoing studies and reviews. A second search was run to identify individual test costs and acquisition costs for the various tools identified in the review.Review methodsTwo reviewers independently screened all titles and abstracts to identify potentially relevant studies for inclusion in the review. Full-text copies were assessed independently by two reviewers. Data were extracted and assessed for risk of bias by one reviewer and independently checked for accuracy by a second. The results of the data extraction and quality assessment for each study are presented in structured tables and as a narrative summary.ResultsThe electronic searching of databases, including ProQuest, resulted in 13,542 unique citations. The titles and abstracts of these were screened and 399 articles were shortlisted for full-text assessment. Sixteen studies were included in the diagnostic accuracy review. No studies were eligible for inclusion in the review of tools for monitoring progressive disease. Eleven automated computerised tests were assessed in the 16 included studies. The overall quality of the studies was good; however, the wide range of tests assessed and the non-standardised reporting of diagnostic accuracy outcomes meant that meaningful synthesis or statistical analysis was not possible.LimitationsThe main limitation of this review is the substantial heterogeneity of the tests assessed in the included studies. As a result, no meta-analyses could be undertaken.ConclusionThe quantity of information available is insufficient to be able to make recommendations on the clinical use of the computerised tests for diagnosing and monitoring MCI and early dementia progression. The value of these tests also depends on the costs of acquisition, training, administration and scoring.Future workResearch is required to establish stable cut-off points for automated computerised tests that are used to diagnose patients with MCI or early dementia. Additionally, the costs associated with acquiring and using these tests in clinical practice should be estimated.Study registrationThe study is registered as PROSPERO CRD42015025410.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Included Studiesmentioning

confidence: 99%

Section: Study Quality Assessmentmentioning

confidence: 99%

Section: Index Test Detailsmentioning

confidence: 99%

“…In total, 16 studies [68][69][70][71][72][74][75][76][77][78][79][80][81]83,85,86 were included in the diagnostic accuracy review.…”

Section: Included Studiesmentioning

confidence: 99%

Section: Study Quality Assessmentmentioning

confidence: 99%

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Automated tests for diagnosing and monitoring cognitive impairment: a diagnostic accuracy review

Aslam

Bates

Dündar

et al. 2016

Health Technol Assess

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A systematic review of the diagnostic accuracy of automated tests for cognitive impairment

Aslam

Bates

Dündar

et al. 2018

Int J Geriat Psychiatry

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ObjectiveThe aim of this review is to determine whether automated computerised tests accurately identify patients with progressive cognitive impairment and, if so, to investigate their role in monitoring disease progression and/or response to treatment.MethodsSix electronic databases (Medline, Embase, Cochrane, Institute for Scientific Information, PsycINFO, and ProQuest) were searched from January 2005 to August 2015 to identify papers for inclusion. Studies assessing the diagnostic accuracy of automated computerised tests for mild cognitive impairment (MCI) and early dementia against a reference standard were included. Where possible, sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratios were calculated. The Quality Assessment of Diagnostic Accuracy Studies tool was used to assess risk of bias.ResultsSixteen studies assessing 11 diagnostic tools for MCI and early dementia were included. No studies were eligible for inclusion in the review of tools for monitoring progressive disease and response to treatment. The overall quality of the studies was good. However, the wide range of tests assessed and the non‐standardised reporting of diagnostic accuracy outcomes meant that statistical analysis was not possible.ConclusionSome tests have shown promising results for identifying MCI and early dementia. However, concerns over small sample sizes, lack of replicability of studies, and lack of evidence available make it difficult to make recommendations on the clinical use of the computerised tests for diagnosing, monitoring progression, and treatment response for MCI and early dementia. Research is required to establish stable cut‐off points for automated computerised tests used to diagnose patients with MCI or early dementia.

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Sleep and self-care correlates before and after implantation of a left-ventricular assist device (LVAD)

et al. 2018

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The impact of sleep on LVAD patients' self-care behaviors is unknown. This study examined the patterns and changes of patients sleep quality (SQ), daytime sleepiness (DS), instrumental activities of daily living (IADL), and self-care capability (SCC) before and after LVAD. In addition, the relationships among these variables were explored. This observational study consisted of 38 subjects from two VAD Centers in Michigan. The subjects completed self-reported demographics and psychometrically sound SQ, DS, IADL, and SCC questionnaires before LVAD implant and at 1, 3, and 6 months after implant. Data were analyzed using descriptive statistics, linear mixed models, and partial least square models. Subjects (mean age, 56.3 ± 10.3 years) were predominantly white (63%), male (68%), married (60%), and living with caregivers (92%). Over 70% had axial flow LVADs implanted as bridge-to-transplant (55%). Subjects' SQ was poor throughout the study period, along with high normal-to-excessive levels of DS. Problems with IADL before implant were significantly reduced at 1 through 6 months after implant. SCC ranged from "good" to "excellent" before and after implant. Significant relationships between SQ and IADL (β = 0.43, p < 0.01) and DS and SCC (β = - 0.62, p < 0.01) were found. In conclusion, poor SQ and high degrees of DS were prevalent before and up to 6 months after LVAD implant. The data inferred that the improvement in IADL was associated with an improvement in SQ. Research is needed to clarify the negative impact of DS on SCC and explain the contributions of caregivers on patients' SCC over time.

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Enhancing Cognitive Screening in Geriatric Care

Cited by 9 publications

References 7 publications

Automated tests for diagnosing and monitoring cognitive impairment: a diagnostic accuracy review

Automated tests for diagnosing and monitoring cognitive impairment: a diagnostic accuracy review

A systematic review of the diagnostic accuracy of automated tests for cognitive impairment

Sleep and self-care correlates before and after implantation of a left-ventricular assist device (LVAD)

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