Operating Characteristics of Brief Screens for Dementia in a Multicultural Population

Wilder, David E.; Cross, Peter; Chen, Jiming; Gurland, Barry J.; Lantigua, Rafael; Teresi, Jeanne A.; Bolívar, M; Encarnación, Priscilla

doi:10.1097/00019442-199500320-00002

Cited by 35 publications

(21 citation statements)

References 25 publications

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“…24 This study demonstrated the limitations of using the MMSE in isolation when discriminating between demented and nondemented patients in a general population.…”

Section: Analysis Of Evidence Does the Presence Of Mild Cognitive Immentioning

confidence: 80%

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Practice parameter: Early detection of dementia: Mild cognitive impairment (an evidence-based review) [RETIRED]

et al. 2001

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Article abstract-Objective: The goal of this project was to determine whether screening different groups of elderly individuals in a general or specialty practice would be beneficial in detecting dementia. Background: Epidemiologic studies of aging and dementia have demonstrated that the use of research criteria for the classification of dementia has yielded three groups of subjects: those who are demented, those who are not demented, and a third group of individuals who cannot be classified as normal or demented but who are cognitively (usually memory) impaired. Methods: The authors conducted computerized literature searches and generated a set of abstracts based on text and index words selected to reflect the key issues to be addressed. Articles were abstracted to determine whether there were sufficient data to recommend the screening of asymptomatic individuals. Other research studies were evaluated to determine whether there was value in identifying individuals who were memory-impaired beyond what one would expect for age but who were not demented. Finally, screening instruments and evaluation techniques for the identification of cognitive impairment were reviewed. Results: There were insufficient data to make any recommendations regarding cognitive screening of asymptomatic individuals. Persons with memory impairment who were not demented were characterized in the literature as having mild cognitive impairment. These subjects were at increased risk for developing dementia or AD when compared with similarly aged individuals in the general population. Recommendations: There were sufficient data to recommend the evaluation and clinical monitoring of persons with mild cognitive impairment due to their increased risk for developing dementia (Guideline). Screening instruments, e.g., Mini-Mental State Examination, were found to be useful to the clinician for assessing the degree of cognitive impairment (Guideline), as were neuropsychologic batteries (Guideline), brief focused cognitive instruments (Option), and certain structured informant interviews (Option). Increasing attention is being paid to persons with mild cognitive impairment for whom treatment options are being evaluated that may alter the rate of progression to dementia.

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“…24 This study demonstrated the limitations of using the MMSE in isolation when discriminating between demented and nondemented patients in a general population.…”

Section: Analysis Of Evidence Does the Presence Of Mild Cognitive Immentioning

confidence: 80%

“…24 When the sensitivity was set to 90% (by using ROC curves) the tests all demonstrated rather poor specificity for detecting dementia (results ranging from 44 to 62%).…”

Section: Practice Recommendationmentioning

confidence: 99%

Practice parameter: Early detection of dementia: Mild cognitive impairment (an evidence-based review) [RETIRED]

et al. 2001

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“…To recruit subjects a presentation was given by the principal investigator and an assistant during the lunch hour in the community dining room at the facility. Potential subjects were screened for cognitive impairment with the Mini-Mental State Exam and those with scores of ≥ 17 (includes the mildly impaired) were included in the study (Wilder et al, 1995). After an initial presentation describing the memory improvement program was made, 23 individuals signed up for the course.…”

Section: Design and Methodsmentioning

confidence: 99%

Memory Improvement in Assisted Living Elders

McDougall

2000

Issues in Mental Health Nursing

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The Cognitive Behavioral Model of Everyday Memory (CBMEM), an eight-session cognitive enhancement program, entitled "MEMORIES, MEMORIES, Can We Improve Ours?" was tested with older adults living in an assisted living facility in the Middle West. The aims of this quasiexperimental study were: to improve everyday memory, memory self-efficacy, and metamemory. A total of 19 older adults (14 female, 5 male) with an average age of 83 years and an average MMSE score of 26 participated. At pretest there were 16 individuals in the experimental and 3 individuals in the comparison group. There were no differences between experimental and comparison groups on the study variables. The experimental group was post tested at one week after completing the intervention. At posttest memory self-efficacy scores significantly increased in the experimental group (M 1 = 52.13, M 2 = 68.50). Total memory performance scores were not significantly different at posttest; however the prospective memory items of asking for an appointment (M 1 =.56, M 2 =1.25), asking for a belonging M 1 =.62, M 2 =.88), and delivering a message (M 1 =1.00, M 2 =1.19) significantly improved.There is growing demand from residents of assisted living and their family members to allow these residents to "age in place," rather than moving them from assisted living to nursing home settings. Yet, the average assisted living resident, 84 years of age and requiring help with ADLs and IADLs, today looks like the average nursing home resident of ten years ago (Furner, Rudberg, & Cassel, 1995; Morton, 1995). About 15 percent exhibit daily incontinence, and 63 percent need medication reminders. Elders in long-term care facilities are at-risk for decreasing cognitive ability and are particularly vulnerable to the devastating effects of depression (Hayslip, Kennelly, & Maloy, 1990). McDougall and Balyer (1998) described this phenomenon as mental frailty. Studies by the Assisted Living Facilities Association of America found that 30 to 40 percent of assisted living residents had Alzheimer's disease or other dementing illnesses. A survey of 33 assisted living facilities in Massachusetts by Stocker and Silverstein (1996) determined that 50 percent of the discharges to nursing homes were for cognitive decline and 60 percent were for functional decline.Older adults are fearful of losing memory ability, and studies indicate that declining memory is one of the most widespread complaints about aging (Bolla, Lindgreen, Bonaccorsy, & Bleecker, 1991;Grut, Jorm, & Fratiglioni, 1993). This fear is based on the reality that memory declines with age (Rinn, 1988). A complicating factor, however, in the relationship between perceived memory loss and actual memory performance is depression (Dellefield & McDougall,1996;Lichtenberg, Ross, Millis, & Manning, 1995;Nussbaum & Sauer, 1993). The confounding effects of depression have particular relevance for episodic remembering in very old adults (Backman, Hassing, Forsell, & Viitanen, 1996 Long-term care residents have major depressive ...

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“…The most consistent across ethnoracial groups was the Comprehensive Assessment and Referral Evaluation cognitive screen ( Golden et al, 1983;Teresi et al, 1984;Wilder et al, 1995), which was therefore selected as this study's cognitive screen.…”

Section: Minimizing Ethnoracial Biasesmentioning

confidence: 99%