Evaluation of Cognitive Impairment in Older Adults

Galvin, James E.; Roe, Catherine M.; Morris, John C.

doi:10.1001/archneur.64.5.718

Cited by 58 publications

(30 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The AD8 AUC of the present study was much lower than those reported in other studies that assessed the utility of the AD8 in discriminating cognitively normal from demented (including “very mild” and “uncertain dementia”) participants (AUC=.77 – .94) which may relate to the greater degree of deficits in their impaired groups, compared to our mildly impaired PD sample (Galvin et al, 2010; Galvin et al, 2005; Galvin, Roe, Coats, & Morris, 2007a; Galvin, Roe, & Morris, 2007b; Galvin et al, 2006). In addition, Carpenter et al (2011) found the AD8 yielded an AUC of .82 for discriminating cognitively impaired from cognitively intact individuals over age 65 presenting to the emergency room.…”

Section: Discussioncontrasting

confidence: 88%

Use of the Montreal Cognitive Assessment and Alzheimer's Disease‐8 as cognitive screening measures in Parkinson's disease

Brown

Bernstein

McClintock

et al. 2015

Int J Geriat Psychiatry

View full text Add to dashboard Cite

Objective to examine the sensitivity and specificity of the Montreal Cognitive Assessment (MoCA), a brief cognitive screening measure previously validated for use in Parkinson disease (PD), and Alzheimer’s Disease-8 (AD8), an eight-item informant report used to screen for dementia, but not yet validated for use in PD, to identify cognitive impairment in a sample of 111 patients with PD. Methods cognitive impairment was determined based on a battery of neuropsychological measures, excluding the MoCA and AD8. Classification rates of both the MoCA and AD8 in identifying cognitive impairment were examined using logistic regression and receiver operator characteristic (ROC) analysis. Optimal cutoff scores were determined to maximize sensitivity and specificity. Results the MoCA correctly classified 78.4% of participants (p<.001) and ROC analysis yielded an area under the curve (AUC) of .82. A MoCA cutoff score of <25 yielded optimal sensitivity (.77) and specificity (.79) for identifying PD patients with cognitive impairment. Similar analyses for the AD8 were statistically nonsignificant, although the classification rate was 70.5%, with an AUC of .50. Conclusions these results provide additional support for the MoCA, but not the AD8, in identifying cognitive impairment in patients with PD.

show abstract

Section: Discussioncontrasting

confidence: 88%

Use of the Montreal Cognitive Assessment and Alzheimer's Disease‐8 as cognitive screening measures in Parkinson's disease

Brown

Bernstein

McClintock

et al. 2015

Int J Geriat Psychiatry

View full text Add to dashboard Cite

show abstract

“…These findings are supported by others, who have demonstrated an association in CN individuals between subject-reported cognitive concerns and incidence of MCI and AD dementia [60, 61], although this has not been consistent across all studies [62]. Further strengthening the importance of self and informant-reported cognitive concerns for AD are studies of CN elderly demonstrating associations of such cognitive concerns with underlying brain atrophy similar to that of MCI [63, 64] and elevated cortical amyloid burden [65]. Taken in aggregate, these prior studies of self and informant-reported cognitive and functional symptoms appear to parallel the findings of the current study of apathy, wherein CN individuals reported greater severity of apathy over time compared to informant or clinician report of apathy, while individuals with MCI at baseline reported lower apathy severity compared to informants and clinicians.…”

Section: Discussionmentioning

confidence: 65%

The Apathy Evaluation Scale: A Comparison of Subject, Informant, and Clinician Report in Cognitively Normal Elderly and Mild Cognitive Impairment

Guercio

Donovan

Munro

et al. 2015

JAD

View full text Add to dashboard Cite

Background Apathy is a common neuropsychiatric symptom in Alzheimer’s disease (AD) dementia and mild cognitive impairment (MCI). Detecting apathy accurately may facilitate earlier diagnosis of AD. The Apathy Evaluation Scale (AES) is a promising tool for measurement of apathy in prodromal and possibly preclinical AD. Objective To compare the three AES sub-scales—subject-reported (AES-S), informant-reported (AES-I), and clinician-reported (AES-C)—over time in individuals at risk for AD due to MCI and advanced age (cognitively normal [CN] elderly). Methods Mixed effects longitudinal models were used to assess predictors of score for each AES sub-scale. Cox proportional hazards models were used to assess which AES sub-scales predict progression from MCI to AD dementia. Results Fifty seven MCI and 18 CN subjects (ages 53–86) were followed for 1.4±1.2 years and 0.7±0.7 years, respectively. Across the three mixed effects longitudinal models, the common findings were associations between greater apathy and greater years in study, a baseline diagnosis of MCI (compared to CN), and male sex. CN elderly self-reported greater apathy compared to that reported by informants and clinicians, while individuals with MCI under-reported their apathy compared to informants and clinicians. Of the three sub-scales, the clinician-reported AES (AES-C) best predicted transition from MCI to AD dementia. Conclusion In a sample of CN elderly and elderly with MCI, apathy increased over time, particularly in men and those with MCI. Self-reported AES scores may be more sensitive than informant and clinician-report when subjects are CN, but less reliable if subjects have MCI. Moreover, the clinician-reported AES sub-scale predicted progression from MCI to AD dementia.

show abstract

“…23 The AD8 and Dementia=(MC) 2 are two very brief informant-based screening tools that detect early dementia and mild cognitive impairment (Table 1). 24, 25 We prospectively administered these screening tools at the time of admission to a cohort of non-delirious adult medical inpatients who were subsequently followed for the development of delirium during their hospitalization.…”

Section: Introductionmentioning

confidence: 99%

A Prospective Comparison of Informant-based and Performance-based Dementia Screening Tools to Predict In-Hospital Delirium

Zeng

Josephson²,

Fukuda³

et al. 2015

Alzheimer Disease &Amp; Associated Disorders

View full text Add to dashboard Cite

Dementia is an important risk factor for delirium, but the optimal strategy for incorporating cognitive impairment into delirium risk assessment at the time of hospital admission is unknown. We compared two informant-based screening tools for dementia and mild cognitive impairment (AD8 and D=(MC)2) to the Mini Mental State Exam (MMSE) and Mini-cog in predicting hospital-acquired delirium. This prospective cohort study at an academic medical center consisted of 162 medical inpatients over age 50 without delirium upon admission. Each participant was evaluated using the MMSE, Mini-cog, AD8, and D=(MC)2 upon admission and was assessed daily for delirium. An MMSE ≤ 24 carried a 5.5 (95% CI 2.7 – 11.1) relative risk for delirium, whereas cognitive impairment detected by the Mini-cog, D=(MC)2 or AD8 carried a 2-fold risk. Adding the D=(MC)2 to the MMSE increased the sensitivity for predicting delirium from 52% (32 – 73) for the MMSE alone to 65% (46 – 85) if either test was positive. If both were positive, specificity was maximized at 97% (94 – 100) but sensitivity was 17% (2 – 33). The MMSE and Mini-cog identify a large proportion of patients at risk for hospital-acquired delirium, but the combination of performance- and an informant-based screens may maximize specificity and sensitivity.

show abstract

Evaluation of Cognitive Impairment in Older Adults

Cited by 58 publications

References 42 publications

Use of the Montreal Cognitive Assessment and Alzheimer's Disease‐8 as cognitive screening measures in Parkinson's disease

Use of the Montreal Cognitive Assessment and Alzheimer's Disease‐8 as cognitive screening measures in Parkinson's disease

The Apathy Evaluation Scale: A Comparison of Subject, Informant, and Clinician Report in Cognitively Normal Elderly and Mild Cognitive Impairment

A Prospective Comparison of Informant-based and Performance-based Dementia Screening Tools to Predict In-Hospital Delirium

Contact Info

Product

Resources

About