scholarly journals Triple Test Plus Rapid Cognitive Screening Test: A Combination of Clinical Signs and A Tool for Cognitive Assessment in Older Adults

Diagnostics ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. 97 ◽  
Author(s):  
Saadet Koc Okudur ◽  
Ozge Dokuzlar ◽  
Derya Kaya ◽  
Pinar Soysal ◽  
Ahmet Turan Isik
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Clinical Signs ◽  
Diagnostic Value ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Head Turning ◽  
Predictive Values ◽  
Triple Test ◽  
Cognitive Screen

Less time-consuming, easy-to-apply and more reliable cognitive screening tests are essential for use in primary care. The aim of this study was to investigate the diagnostic value of the Turkish version of the Rapid Cognitive Screen (RCS-T) and Triple Test individually and the combination of RCS-T with each sign and Triple Test to screen elderly patients for cognitive impairment (CI). A total of 357 outpatients aged 60 or older, who underwent comprehensive geriatric assessment, were included in the study. Presence or absence of attended alone sign (AAS), head-turning sign, and applause sign was investigated. The mean age of the patients was 74.29 ± 7.46. Of those, 61 patients (28 men, 33 women) had Alzheimer’s disease (AD), 59 patients had mild cognitive impairment (MCI) (29 men, 30 women), and 237 (80 men, 157 women) were cognitively robust. The sensitivity of the combination of RCS-T and negative for AAS for CI, AD and MCI is 0.79, 0.86 and 0.61, respectively; the specificity was 0.92, 0.93 and 0.92, respectively; and the positive and negative predictive values revealed good diagnostic accuracy. The combination of RCS-T and negative for AAS is a simple, effective and rapid way to identify possible CI in older adults.

Simple diagnostic signs in those with cognitive impairment–anything to improve detection of cognitive disorders

2017 ◽  
Vol 29 (11) ◽  
pp. 1761-1761
Author(s):  
Michael C. Woodward
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Disorders ◽  
Diagnostic Value ◽  
Screening Tests ◽  
Cognitively Impaired ◽  
Head Turning ◽  
Clock Drawing Test ◽  
Intensive Training ◽  
Drawing Test ◽  
Diagnostic Signs

With now over 50 million people worldwide with dementia (Prince et al., 2013), there are almost certainly well over 100 million people with cognitive concerns and many of these will attend their health professional keen to know what is going on. We need those without intensive training in this field to be more confident and correct in their diagnosis when such a concerned person turns up. Many simple diagnostic tests have been proposed and some assessed – these include the walk and talk (divided attention) test (those who stop when asked a question while walking may be cognitively impaired) (Lamoth et al., 2011), the clock drawing test (Brodaty and Moore, 1997), the “handbag” sign (those clutching their personal possessions are more likely to be cognitively impaired) and the “hippopotamus sign” (calling the rhinoceros, in those tests that include this, a hippopotamus). Simple screening tests have been extensively validated and are important to the clinician in formulating a diagnosis (Lorentz et al., 2002). The “head-turning” and the “attended with/alone” signs are frequently observed, and many clinicians assessing such individuals would be well aware of them and probably even unknowingly factor them into their diagnosis. In this issue, Pinar Soysal and colleagues (Soysal et al., 2017) have evaluated these signs and, in those older people attending with cognitive concerns, found they had quite good diagnostic value. They were not very specific but showed good sensitivity and negative predictive value. Indeed, at the recent Alzheimer's Association International Conference in London there were several posters evaluating “soft but simple” signs although not all performed as expected – one group found gait actually sped up in those with cognitive impairment that were asked a question.

Cognitive Impairment in Euthymic Older Adults With Bipolar Disorder: A Controlled Study Using Cognitive Screening Tests

2014 ◽  
Vol 22 (4) ◽  
pp. 389-397 ◽  
Author(s):  
Ivan Aprahamian ◽  
Rodolfo B. Ladeira ◽  
Breno S. Diniz ◽  
Orestes V. Forlenza ◽  
Paula V. Nunes
Keyword(s):  
Older Adults ◽  
Bipolar Disorder ◽  
Cognitive Impairment ◽  
Screening Tests ◽  
Controlled Study ◽  
Cognitive Screening

scholarly journals Using Cognitive Screening Tests in Audiology

2016 ◽  
Vol 25 (4) ◽  
pp. 319-331 ◽  
Author(s):  
Jing Shen ◽  
Melinda C. Anderson ◽  
Kathryn H. Arehart ◽  
Pamela E. Souza
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Health Care Professionals ◽  
The United States ◽  
Medical Intervention ◽  
Cognitive Status ◽  
Screening Tests ◽  
Cognitive Screening

Purpose The population of the United States is aging. Those older adults are living longer than ever and have an increased desire for social participation. As a result, audiologists are likely to see an increased demand for service by older clients whose communication difficulty is caused by a combination of hearing loss and cognitive impairment. For these individuals, early detection of mild cognitive impairment is critical for providing timely medical intervention and social support. Method This tutorial provides information about cognition of older adults, mild cognitive impairment, and cognitive screening tests, with the purpose of assisting audiologists in identifying and appropriately referring potential cases of cognitive impairment. Results Topics addressed also include how to administer cognitive screening tests on individuals with hearing loss, how to use test results in audiology practice, and the potential of using cognitive screening tests for evaluating the benefit of clinical interventions. Conclusions As health care professionals who serve the aging population, audiologists are likely to encounter cases of undiagnosed cognitive impairment. In order to provide timely referral for medical assistance as well as an optimized individual outcome of audiologic interventions, audiologists should be trained to recognize an abnormality in older clients' cognitive status.

Exploring the Association between Multimorbidity and Cognitive Impairment in Older Adults Living in the Community: A Review of the Literature

2021 ◽  
pp. 108482232110304
Author(s):  
Grace F. Wittenberg ◽  
Michelle A. McKay ◽  
Melissa O’Connor
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Assessment Tool ◽  
Adult Population ◽  
Home Health ◽  
Adverse Outcomes ◽  
Community Dwelling ◽  
Cognitive Screening ◽  
Review Of The Literature ◽  
Increased Risk

Two-thirds of older adults have multimorbidity (MM), or co-occurrence of two or more medical conditions. Mild cognitive impairment (CI) is found in almost 20% of older adults and can lead to further cognitive decline and increased mortality. Older adults with MM are the primary users of home health care services and are at high risk for CI development; however, there is no validated cognitive screening tool used to assess the level of CI in home health users. Given the prevalence of MM and CI in the home health setting, we conducted a review of the literature to understand this association. Due to the absence of literature on CI in home health users, the review focused on the association of MM and CI in community-dwelling older adults. Search terms included home health, older adults, cognitive impairment, and multimorbidity and were applied to the databases PubMed, CINAHL, and PsychInfo leading to eight studies eligible for review. Results show CI is associated with MM in older adults of increasing age, among minorities, and in older adults with lower levels of education. Heart disease was the most prevalent disease associated with increased CI. Sleep disorders, hypertension, arthritis, and hyperlipidemia were also significantly associated with increased CI. The presence of MM and CI was associated with increased risk for death among older adults. Further research and attention are needed regarding the use and development of a validated cognitive assessment tool for home health users to decrease adverse outcomes in the older adult population.

scholarly journals A Modified CAIDE Risk Score as a Screening Tool for Cognitive Impairment in Older Adults

2021 ◽  
pp. 1-14
Author(s):  
Magdalena I. Tolea ◽  
Jaeyeong Heo ◽  
Stephanie Chrisphonte ◽  
James E. Galvin
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Cognitive Impairment ◽  
Risk Score ◽  
Clinical Sample ◽  
Community Sample ◽  
Community Dwelling ◽  
Cognitive Testing ◽  
Risk Scores ◽  
Predictive Values

Background: Although an efficacious dementia-risk score system, Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) was derived using midlife risk factors in a population with low educational attainment that does not reflect today’s US population, and requires laboratory biomarkers, which are not always available. Objective: Develop and validate a modified CAIDE (mCAIDE) system and test its ability to predict presence, severity, and etiology of cognitive impairment in older adults. Methods: Population consisted of 449 participants in dementia research (N = 230; community sample; 67.9±10.0 years old, 29.6%male, 13.7±4.1 years education) or receiving dementia clinical services (N = 219; clinical sample; 74.3±9.8 years old, 50.2%male, 15.5±2.6 years education). The mCAIDE, which includes self-reported and performance-based rather than blood-derived measures, was developed in the community sample and tested in the independent clinical sample. Validity against Framingham, Hachinski, and CAIDE risk scores was assessed. Results: Higher mCAIDE quartiles were associated with lower performance on global and domain-specific cognitive tests. Each one-point increase in mCAIDE increased the odds of mild cognitive impairment (MCI) by up to 65%, those of AD by 69%, and those for non-AD dementia by >  85%, with highest scores in cases with vascular etiologies. Being in the highest mCAIDE risk group improved ability to discriminate dementia from MCI and controls and MCI from controls, with a cut-off of ≥7 points offering the highest sensitivity, specificity, and positive and negative predictive values. Conclusion: mCAIDE is a robust indicator of cognitive impairment in community-dwelling seniors, which can discriminate well between dementia severity including MCI versus controls. The mCAIDE may be a valuable tool for case ascertainment in research studies, helping flag primary care patients for cognitive testing, and identify those in need of lifestyle interventions for symptomatic control.

scholarly journals The Clock Drawing Test: Performance differences between the free-drawn and incomplete-copy versions in patients with MCI and dementia

2016 ◽  
Vol 10 (3) ◽  
pp. 227-231 ◽  
Author(s):  
Bárbara Costa Beber ◽  
Renata Kochhann ◽  
Bruna Matias ◽  
Márcia Lorena Fagundes Chaves
Keyword(s):  
Cognitive Impairment ◽  
Test Performance ◽  
Diagnostic Value ◽  
Control Group ◽  
Cognitive Screening ◽  
Scoring Method ◽  
Clock Drawing Test ◽  
Clock Drawing ◽  
Healthy Elderly ◽  
Drawing Test

ABSTRACT Background: The Clock Drawing Test (CDT) is a brief cognitive screening tool for dementia. Several different presentation formats and scoring methods for the CDT are available in the literature. Objective: In this study we aimed to compare performance on the free-drawn and "incomplete-copy" versions of the CDT using the same short scoring method in Mild Cognitive Impairment (MCI) and dementia patients, and healthy elderly participants. Methods: 90 participants (controlled for age, sex and education) subdivided into control group (n=20), MCI group (n=30) and dementia group (n=40) (Alzheimer's disease - AD=20; Vascular Dementia - VD=20) were recruited for this study. The participants performed the two CDT versions at different times and a blinded neuropsychologist scored the CDTs using the same scoring system. Results: The scores on the free-drawn version were significantly lower than the incomplete-copy version for all groups. The dementia group had significantly lower scores on the incomplete-copy version of the CDT than the control group. MCI patients did not differ significantly from the dementia or control groups. Performance on the free-drawn copy differed significantly among all groups. Conclusion: The free-drawn CDT version is more cognitively demanding and sensitive for detecting mild/early cognitive impairment. Further evaluation of the diagnostic value (accuracy) of the free-drawn CDT in Brazilian MCI patients is needed.

Utility of a Computerised Cognitive Screen in MCI and Depression in an Older Population

2010 ◽  
Vol 16 (1) ◽  
pp. 14-26 ◽  
Author(s):  
Rachell Kingsbury ◽  
Nancy A. Pachana ◽  
Michael Humphreys ◽  
Gerry Tehan ◽  
Gerard J.A. Byrne
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Operating Characteristic ◽  
Memory Loss ◽  
Partial Support ◽  
Community Based ◽  
Symptoms Of Depression ◽  
Clinically Significant ◽  
Cognitive Screen

AbstractThe current study investigated the ability of CogniScreen to differentiate older adults with mild cognitive impairment (MCI) from those reporting symptoms of depression. Participants included 140 community-based adults (30 MCI, 15 self-rated depressed, and 95 typical older adults) aged 50–89 years. Intergroup comparisons performed using receiver operating characteristic (ROC) analyses suggest tasks within CogniScreen are sensitive to clinically significant memory loss. Data provided partial support for some CogniScreen tasks to also differentiate individuals with MCI from those who are depressed. Results suggest CogniScreen may be potentially useful in screening older adults for early cognitive decline.

Attended With and Head-Turning Sign can be clinical markers of cognitive impairment in older adults

2017 ◽  
Vol 29 (11) ◽  
pp. 1763-1769 ◽  
Author(s):  
Pinar Soysal ◽  
Cansu Usarel ◽  
Gul Ispirli ◽  
Ahmet Turan Isik
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Predictive Value ◽  
Cognitive Assessment ◽  
Screening Methods ◽  
Operating Characteristics ◽  
Head Turning ◽  
Sensitivity Specificity

ABSTRACTBackground:Comprehensive neurocognitive assessment may not be performed in clinical practice, as it takes too much time and requires special training. Development of easily applicable, time-saving, and cost effective screening methods has allowed identifying the individuals that require further evaluation. The aim of present study was to assess the diagnostic value of the Attended With (AW) and Head-Turning Sign (HTS) for screening cognitive impairment (CI).Methods:Comprehensive geriatric assessment was performed in 529 elderly outpatients, and the presence or absence of AW and HTS was investigated in them all.Results:Of the 529 patients, of whom the mean age was 75.67 ± 8.29 years, 126 patients were considered as CI (102 dementia, 24 mild CI). The patients with positive AW had significantly lower scores on Mini-Mental State Examination, Cognitive State Test, and Montreal Cognitive Assessment, and activities of daily living compared to AW (−) patients (p < 0.001). Similar significant findings were obtained in the patients with positive and negative HTS (p < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of AW in detecting CI were 92%, 37%, 31.4%, and 93.7%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of HTS were 80%, 64%, 41.8%, and 91.5%, respectively. The area under the receiver-operating characteristics curve was 0.90 for AW and 0.82 for HTS.Conclusion:AW and HTS are fast, simple, effective, and sensitive methods for detecting CI. Therefore, they can be used for older adults attending the primary care settings with memory loss. Those with positive AW or HTS can be referred to the relevant centers for detailed cognitive assessment.

Cognitive screening tools for identification of dementia in illiterate and low-educated older adults, a systematic review and meta-analysis

2017 ◽  
Vol 29 (6) ◽  
pp. 897-929 ◽  
Author(s):  
Stella-Maria Paddick ◽  
William K. Gray ◽  
Jackie McGuire ◽  
Jenny Richardson ◽  
Catherine Dotchin ◽  
...  
Keyword(s):  
Older Adults ◽  
Validation Studies ◽  
Meta Analysis ◽  
Significant Proportion ◽  
Educational Background ◽  
Screening Tools ◽  
Screening Tests ◽  
Cognitive Screening ◽  
Low Literacy ◽  
Prevalence Studies

ABSTRACTBackground:The majority of older adults with dementia live in low- and middle-income countries (LMICs). Illiteracy and low educational background are common in older LMIC populations, particularly in rural areas, and cognitive screening tools developed for this setting must reflect this. This study aimed to review published validation studies of cognitive screening tools for dementia in low-literacy settings in order to determine the most appropriate tools for use.Method:A systematic search of major databases was conducted according to PRISMA guidelines. Validation studies of brief cognitive screening tests including illiterate participants or those with elementary education were eligible. Studies were quality assessed using the QUADAS-2 tool. Good or fair quality studies were included in a bivariate random-effects meta-analysis and a hierarchical summary receiver operating characteristic (HSROC) curve constructed.Results:Forty-five eligible studies were quality assessed. A significant proportion utilized a case–control design, resulting in spectrum bias. The area under the ROC (AUROC) curve was 0.937 for community/low prevalence studies, 0.881 for clinic based/higher prevalence studies, and 0.869 for illiterate populations. For the Mini-Mental State Examination (MMSE) (and adaptations), the AUROC curve was 0.853.Conclusion:Numerous tools for assessment of cognitive impairment in low-literacy settings have been developed, and tools developed for use in high-income countries have also been validated in low-literacy settings. Most tools have been inadequately validated, with only MMSE, cognitive abilities screening instrument (CASI), Eurotest, and Fototest having more than one published good or fair quality study in an illiterate or low-literate setting. At present no screening test can be recommended.

scholarly journals Effects of experience-based frequency learning on posterior probability judgments

2021 ◽  
Author(s):  
Bonnie A. Armstrong
Keyword(s):  
Older Adults ◽  
Posterior Probability ◽  
Natural Frequencies ◽  
Screening Tests ◽  
Conditional Probabilities ◽  
Medical Decisions ◽  
Predictive Values ◽  
Probability Judgments ◽  
Medical Tests ◽  
Probability Estimates

Aging is associated with an increase in the frequency of medical screening tests. Bayesian inference is used to estimate posterior probabilities of medical tests such as positive or negative predictive values (PPVs or NPVs). Both laypeople and experts are typically poor at estimating PPVs and NPVs when relevant probabilities are communicated descriptively. Decision making research has revealed dissociations between described and experience-based judgments. This study examined the accuracy of posterior probability estimates of 80 younger and 81 older adults when statistical information was presented through description or experience. Results show that both younger and older adults can make more accurate posterior probability estimates if they experience probabilities compared to when probabilities are described as either natural frequencies or conditional probabilities. Results also indicate that most people prefer to rely on physicians to make their medical decisions regardless of how confident they are in their judgments of probabilities.

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