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Ferruzzi GJ, Campanile A, Visco V, Loria F, Mone P, Masarone D, Dattilo G, Agnelli G, Moncada A, Falco L, Mancusi C, Fucile I, Mazzeo P, Stabile E, Citro R, Molloy W, Ravera A, Illario M, Gatto C, Carrizzo A, Santulli G, Iaccarino G, Vecchione C, Ciccarelli M. Subclinical left ventricular dysfunction assessed by global longitudinal strain correlates with mild cognitive impairment in hypertensive patients. Hypertens Res 2025; 48:1768-1778. [PMID: 40097616 PMCID: PMC12055581 DOI: 10.1038/s41440-025-02182-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2024] [Revised: 02/18/2025] [Accepted: 03/02/2025] [Indexed: 03/19/2025]
Abstract
Prevention of dementia represents a public health priority. Hypertension is a risk factor for mild cognitive impairment (MCI), a precursor to progressive dementia. A great effort is underway to develop accurate and sensitive tools to detect the MCI condition in hypertensive patients. To investigate the potential association of subclinical left ventricular dysfunction expressed by the global longitudinal strain (GLS) with the MCI, defined by the Italian version of the quick mild cognitive impairment (Qmci-I). This multi-centric study included 180 consecutive hypertensive patients without medical diseases and/or drugs with known significant effects on cognition but with a not negligible comorbidity burden to avoid a possible "hyper-normality bias". The study cohort was classified into two main groups concerning the median value of the GLS. A weighted logistic regression model was employed after an inverse probability of treatment weighting (IPTW) analysis to characterize a potential association between GLS and MCI. Almost 41,1% of the whole study population was female. The mean age was 65,6 ± 7,2. 39 patients (21,7%) showed MCI. After IPTW, the GLS was significantly associated with the study endpoint (OR, 1,22; 95% CI: 1,07-1,39, P = 0.003). Our results highlight that the GLS is a potential predictor of MCI and, therefore, a valuable tool for establishing preventive strategies to arrest the progression toward a cognitive decline in hypertensive patients.
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Affiliation(s)
- Germano Junior Ferruzzi
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy
| | - Alfonso Campanile
- Cardiovascular and Thoracic Department, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Valeria Visco
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy
| | - Francesco Loria
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy
| | - Pasquale Mone
- Department of Medicine and Health Sciences "Vincenzo Tiberio", University of Molise, Campobasso, Italy
- Albert Einstein College of Medicine, New York, NY, USA
- Casa di Cura Montevergine, GVM Care and Research, Mercogliano, Italy
| | | | - Giuseppe Dattilo
- Department of Biomedical And Dental Sciences and Morphofunctional Imaging, Section of Cardiology, University of Messina, Messina, Italy
| | - Graziella Agnelli
- Department of Biomedical And Dental Sciences and Morphofunctional Imaging, Section of Cardiology, University of Messina, Messina, Italy
| | - Alice Moncada
- Department of Biomedical And Dental Sciences and Morphofunctional Imaging, Section of Cardiology, University of Messina, Messina, Italy
| | - Luigi Falco
- Heart Failure Unit, AORN Colli, Naples, Italy
| | - Costantino Mancusi
- Department of Advanced Biomedical Sciences, Federico II University of Naples, 80138, Naples, Italy
| | - Ilaria Fucile
- Department of Advanced Biomedical Sciences, Federico II University of Naples, 80138, Naples, Italy
| | - Pietro Mazzeo
- Division of Cardiology, Cardiovascular Department, Azienda Ospedaliera Regionale "San Carlo", Potenza, Italy
| | - Eugenio Stabile
- Division of Cardiology, Cardiovascular Department, Azienda Ospedaliera Regionale "San Carlo", Potenza, Italy
| | - Rodolfo Citro
- Cardiovascular and Thoracic Department, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - William Molloy
- Centre for Gerontology and Rehabilitation, University College Cork, St Finbarr's Hospital, Cork City, Ireland
- Department of Geriatric Medicine, Mercy University Hospital, Cork City, Ireland
| | - Amelia Ravera
- Cardiovascular and Thoracic Department, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
| | - Maddalena Illario
- Public Health Department, University Federico II of Naples, Naples, Italy
| | - Cristina Gatto
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy
| | - Albino Carrizzo
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy
- Vascular Pathophysiology Unit, IRCCS Neuromed, Pozzilli, Italy
| | - Gaetano Santulli
- Department of Advanced Biomedical Sciences, Federico II University of Naples, 80138, Naples, Italy
- International Translational Research and Medical Education (ITME) Consortium, Department of Advanced Biomedical Sciences, "Federico II" University, Naples, Italy
| | - Guido Iaccarino
- Department of Clinical Medicine and Surgery, "Federico II" University, Naples, Italy
| | - Carmine Vecchione
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy
- Cardiovascular and Thoracic Department, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy
- Vascular Pathophysiology Unit, IRCCS Neuromed, Pozzilli, Italy
| | - Michele Ciccarelli
- Department of Medicine, Surgery and Dentistry, University of Salerno, Baronissi, Salerno, Italy.
- Cardiovascular and Thoracic Department, University Hospital "San Giovanni di Dio e Ruggi d'Aragona", Salerno, Italy.
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De Luca V, Donnoli C, Formosa V, Carnevale E, Bisogno M, Patumi L, Leonardini L, Obbia P, Palummeri E, Ruatta M, Basso AM, Minichini M, Adamo D, Bruzzese D, Mercurio L, Virgolesi M, Toccoli S, Sforzin S, Denisi F, Borgioli M, Dell’Acqua M, Cacciapuoti V, Iaccarino G, Liotta G, Illario M. Preliminary results of a multidimensional approach to screen for frailty in community-dwelling older adults of eight Italian regions: the SUNFRAIL+ study. Front Public Health 2025; 13:1543724. [PMID: 40302770 PMCID: PMC12039670 DOI: 10.3389/fpubh.2025.1543724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2024] [Accepted: 03/26/2025] [Indexed: 05/02/2025] Open
Abstract
Background Frailty syndrome in older adults is an age-related decline in many physiological systems, that results in a reduced response to minor stressors, and leading to an increased risk of falls, hospitalization, disability and death. Frailty can be prevented, reversed or mitigated by early screening for frailty risk in community-dwelling older adults, allowing for preventive interventions on clinical and social determinants. Objectives The present article reports the preliminary results of the SUNFRAIL+ study multidimensional cascade assessment in a group of community-dwelling older adults of 8 Italian regions aimed to stratify the population according to the needs of care at the first administration, integrated with the quality of life (QoL) assessment to evaluate the impact of early, integrated care. Methods The SUNFRAIL+ study performed a multidimensional assessment of community-dwelling older adults by linking elements of the SUNFRAIL frailty assessment tool with an in-depth assessment of biopsychosocial domains of frailty, through validated questionnaires and physical tests. Results The sample consisted of 743 participants (279 males and 464 females). The mean score of the multidimensional assessment with the SUNFRAIL tool was 2.31 (SD ± 0.7) with the cut-off point of frailty set at 3. The analysis revealed a significant difference in SUNFRAIL scores between the age groups. The results confirmed that individuals with higher frailty scores are significantly more likely to experience falls. Significant and conceptually valid correlations were found between physical and cognitive tests and QoL scores. Frailty is significantly associated with a lower physical and mental quality of life. The results indicated that older age and lower education levels are associated with higher frailty scores. Conclusion The study demonstrates important different correlation levels, firstly between the assessment of frailty by SUNFRAIL and the perceived QoL; secondarily among all SUNFRAIL spheres and their second test sets that more objectively evaluate each frailty domain. The study demonstrates that the SUNFRAIL+ approach accurately assesses frailty status owing to its strong correlation with the SF-12 quality of life assessment.
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Affiliation(s)
- Vincenzo De Luca
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Clara Donnoli
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Valeria Formosa
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Edoardo Carnevale
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Michele Bisogno
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Lola Patumi
- Programma Mattone Internazionale Salute, ULSS 4 Veneto Orientale Local Health Agency, San Donà di Piave, Italy
| | - Lisa Leonardini
- Programma Mattone Internazionale Salute, ULSS 4 Veneto Orientale Local Health Agency, San Donà di Piave, Italy
| | - Paola Obbia
- Directorate of Health Professions, Local Health Agency Cuneo 1, Cuneo, Italy
| | | | - Manuela Ruatta
- Directorate of Health Professions, Local Health Agency Cuneo 1, Cuneo, Italy
| | | | - Marcello Minichini
- Department of Primary Care and District Activities, Ligurian Social Health Agency 4, Genoa, Italy
| | - Daniela Adamo
- Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University of Naples, Naples, Italy
| | - Dario Bruzzese
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Lorenzo Mercurio
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Michele Virgolesi
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Stefano Toccoli
- Department of Primary Care, Provincial Health Authority of Trento, Trento, Italy
| | - Simona Sforzin
- Department of Primary Care, Provincial Health Authority of Trento, Trento, Italy
| | | | - Moira Borgioli
- Design, Development, Training and Research Unit, North-West Local Health Authority, Pisa, Italy
| | - Marino Dell’Acqua
- Socio-Health Department, Insubria Health Protection Agency, Varese, Italy
| | | | - Guido Iaccarino
- Department of Clinical Medicine and Surgery, Federico II University of Naples, Naples, Italy
| | - Giuseppe Liotta
- Department of Biomedicine and Prevention, Tor Vergata University of Rome, Rome, Italy
| | - Maddalena Illario
- Department of Public Health, Federico II University of Naples, Naples, Italy
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Manser P, de Bruin ED. Diagnostic accuracy, reliability, and construct validity of the German quick mild cognitive impairment screen. BMC Geriatr 2024; 24:613. [PMID: 39026157 PMCID: PMC11256646 DOI: 10.1186/s12877-024-05219-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 07/12/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Early detection of cognitive impairment is among the top research priorities aimed at reducing the global burden of dementia. Currently used screening tools have high sensitivity but lack specificity at their original cut-off, while decreasing the cut-off was repeatedly shown to improve specificity, but at the cost of lower sensitivity. In 2012, a new screening tool was introduced that aims to overcome these limitations - the Quick mild cognitive impairment screen (Qmci). The original English Qmci has been rigorously validated and demonstrated high diagnostic accuracy with both good sensitivity and specificity. We aimed to determine the optimal cut-off value for the German Qmci, and evaluate its diagnostic accuracy, reliability (internal consistency) and construct validity. METHODS We retrospectively analyzed data from healthy older adults (HOA; n = 43) and individuals who have a clinical diagnosis of 'mild neurocognitive disorder' (mNCD; n = 37) with a biomarker supported characterization of the etiology of mNCD of three studies of the 'Brain-IT' project. Using Youden's Index, we calculated the optimal cut-off score to distinguish between HOA and mNCD. Receiver operating characteristic (ROC) curve analysis was performed to evaluate diagnostic accuracy based on the area under the curve (AUC). Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated. Reliability (internal consistency) was analyzed by calculating Cronbach's α. Construct validity was assessed by analyzing convergent validity between Qmci-G subdomain scores and reference assessments measuring the same neurocognitive domain. RESULTS The optimal cut-off score for the Qmci-G was ≤ 67 (AUC = 0.96). This provided a sensitivity of 91.9% and a specificity of 90.7%. The PPV and NPV were 89.5% and 92.9%, respectively. Cronbach's α of the Qmci-G was 0.71 (CI95% [0.65 to 0.78]). The Qmci-G demonstrated good construct validity for subtests measuring learning and memory. Subtests that measure executive functioning and/or visuo-spatial skills showed mixed findings and/or did not correlate as strongly as expected with reference assessments. CONCLUSION Our findings corroborate the existing evidence of the Qmci's good diagnostic accuracy, reliability, and construct validity. Additionally, the Qmci shows potential in resolving the limitations of commonly used screening tools, such as the Montreal Cognitive Assessment. To verify these findings for the Qmci-G, testing in clinical environments and/or primary health care and direct comparisons with standard screening tools utilized in these settings are warranted.
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Affiliation(s)
- Patrick Manser
- Motor Control and Learning Group - Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland.
| | - Eling D de Bruin
- Motor Control and Learning Group - Institute of Human Movement Sciences and Sport, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
- Department of Health, OST - Eastern Swiss University of Applied Sciences, St. Gallen, Switzerland
- Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Stockholm, Sweden
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Giombi F, Canali L, Zuppardo J, Pace GM, Pirola F, Ferreli F, Mercante G, Spriano G, Cerasuolo M, Malvezzi L. Psychiatric Burden in Chronic Sinonasal Diseases: A Single-Center Cross-Sectional Observational Study. Cureus 2024; 16:e57471. [PMID: 38699136 PMCID: PMC11065418 DOI: 10.7759/cureus.57471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Chronic rhinosinusitis (CRS) and nasal septum deviation (SD) are two widely diffused clinical conditions in otorhinolaryngology clinical practice. Albeit nasal symptoms are the most commonly referred by patients affected by both conditions, recent evidence has explored the impairment of nasal function beyond its local implication. Indeed, the prevalence of psychiatric disorders, specifically anxiety and depression, was found higher in patients suffering from SD or CRS than in the general population. The aim of this study was to evaluate the psychiatric burden of these conditions in terms of anxiety and depression and to assess its relationship with clinical phenotype and age. METHODS Monocentric cross-sectional observational study. Consecutive patients affected by CRS with or without nasal polyps or by SD were considered eligible. At referral, each patient underwent nasal endoscopy for clinical diagnosis and had to fill in the Hospital Anxiety and Depression Scale (HADS), the Sinonasal Outcome Test-22 (SNOT-22), and the Visual Analogue Scale (VAS) for global nasal symptoms. The population was grouped according to disease and age. RESULTS One hundred fifty patients were enrolled. We observed a statistically significant difference in mean HADS score between patients affected by CRS with nasal polyps and those suffering from CRS without nasal polyps or SD both in the overall population and by age groups. Nevertheless, there was no significant difference in the HADS score between younger patients affected by CRS and SD. The mean HADS score was significantly higher in younger patients affected by SD compared to older. Furthermore, we observed an inverse correlation between age and HADS score in each disease group, statistically significant for SD. On the contrary, in the overall population, HADS score and patient-related outcomes (PROs) were directly correlated. Conclusions: In the era of personalized medicine, our work remarks on the critical impact of anxiety and depression on the quality of life (QoL) of patients affected by sinonasal conditions. According to our results, age affects patient-reported outcomes (PROs) and should, therefore, be enhanced in the therapeutic decision process.
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Affiliation(s)
- Francesco Giombi
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
| | - Luca Canali
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
| | - Jessica Zuppardo
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
| | - Gian Marco Pace
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
| | - Francesca Pirola
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
| | - Fabio Ferreli
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
| | - Giuseppe Spriano
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
| | - Michele Cerasuolo
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
- Otorhinolaryngology Head and Neck Surgery Unit, Casa di Cura Humanitas San Pio X, Milan, ITA
| | - Luca Malvezzi
- Department of Biomedical Sciences, Humanitas University, Milan, ITA
- Otorhinolaryngology Unit, Humanitas Research Hospital, Milan, ITA
- Otorhinolaryngology Head and Neck Surgery Unit, Casa di Cura Humanitas San Pio X, Milan, ITA
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De Luca V, Femminella GD, Leonardini L, Patumi L, Palummeri E, Roba I, Aronni W, Toccoli S, Sforzin S, Denisi F, Basso AM, Ruatta M, Obbia P, Rizzo A, Borgioli M, Eccher C, Farina R, Conforti D, Mercurio L, Salvatore E, Gentile M, Bocchino M, Sanduzzi Zamparelli A, Viceconte G, Gentile I, Ruosi C, Ferrara N, Fabbrocini G, Colao A, Triassi M, Iaccarino G, Liotta G, Illario M. Digital Health Service for Identification of Frailty Risk Factors in Community-Dwelling Older Adults: The SUNFRAIL+ Study Protocol. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3861. [PMID: 36900872 PMCID: PMC10001419 DOI: 10.3390/ijerph20053861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/13/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
This article reports the study protocol of a nationwide multicentric study in seven Italian regions aimed at assessing the effectiveness of a digitally supported approach for the early screening of frailty risk factors in community-dwelling older adults. SUNFRAIL+ is a prospective observational cohort study aimed at carrying out a multidimensional assessment of community-dwelling older adults through an IT platform, which allows to connect the items of the SUNFRAIL frailty assessment tool with a cascading multidimensional in-depth assessment of the bio-psycho-social domains of frailty. Seven centers in seven Italian regions will administer the SUNFRAIL questionnaire to 100 older adults. According to the answers provided by older adults, they will be subjected to one or more validated in-depth scale tests in order to perform further diagnostic or dimensional evaluations. The study aims to contribute to the implementation and validation of a multiprofessional and multistakeholder service model for the screening of frailty in community-dwelling older adult population.
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Affiliation(s)
- Vincenzo De Luca
- Dipartimento di Sanità Pubblica, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Grazia Daniela Femminella
- Dipartimento di Scienze Mediche Traslazionali, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Lisa Leonardini
- Programma Mattone Internazionale Salute, Azienda ULSS 4 Veneto Orientale, 30027 San Donà di Piave, Italy
| | - Lola Patumi
- Programma Mattone Internazionale Salute, Azienda ULSS 4 Veneto Orientale, 30027 San Donà di Piave, Italy
| | - Ernesto Palummeri
- A.li.sa. (Azienda Ligure Sanitaria), Regione Liguria, 16121 Genova, Italy
| | - Isabella Roba
- A.li.sa. (Azienda Ligure Sanitaria), Regione Liguria, 16121 Genova, Italy
| | - Walter Aronni
- Dipartimento di Cure Primarie e Attività Distrettuali, Azienda Sociosanitaria Ligure 4, 16043 Chiavari, Italy
| | - Stefano Toccoli
- Dipartimento Cure Primarie, Azienda Provinciale per i Servizi Sanitari di Trento, 38123 Trento, Italy
| | - Simona Sforzin
- Dipartimento Cure Primarie, Azienda Provinciale per i Servizi Sanitari di Trento, 38123 Trento, Italy
| | | | - Anna Maddalena Basso
- Direzione Professioni Sanitarie, Azienda Sanitaria Locale Cuneo 1, 12100 Cuneo, Italy
| | - Manuela Ruatta
- Rete Della Cronicità e Fragilità, Azienda Sanitaria Locale Cuneo 1, 12100 Cuneo, Italy
| | - Paola Obbia
- Dipartimento di Scienze Della Sanità Pubblica e Pediatriche, Università Degli Studi di Torino, 10126 Torino, Italy
| | - Alessio Rizzo
- Settore Sistemi Organizzativi e Risorse Umane Della Direzione Sanità e Welfare, Regione Piemonte, 10144 Torino, Italy
| | - Moira Borgioli
- Unità Operativa Complessa Progettazione, Sviluppo, Formazione e Ricerca, Azienda Unità Sanitaria Locale Nord-Ovest, 56121 Pisa, Italy
| | - Claudio Eccher
- eHealth Unit, Fondazione Bruno Kessler, 38123 Trento, Italy
| | - Riccardo Farina
- Dipartimento Salute e Politiche Sociali, Provincia Autonoma di Trento, 38122 Trento, Italy
| | - Diego Conforti
- Dipartimento Salute e Politiche Sociali, Provincia Autonoma di Trento, 38122 Trento, Italy
| | - Lorenzo Mercurio
- Dipartimento di Sanità Pubblica, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Elena Salvatore
- Dipartimento di Scienze Biomediche Avanzate, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Maurizio Gentile
- Dipartimento di Medicina Clinica e Chirurgia, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Marialuisa Bocchino
- Dipartimento di Medicina Clinica e Chirurgia, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | | | - Giulio Viceconte
- Dipartimento di Medicina Clinica e Chirurgia, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Ivan Gentile
- Dipartimento di Medicina Clinica e Chirurgia, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Carlo Ruosi
- Dipartimento di Sanità Pubblica, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Nicola Ferrara
- Dipartimento di Scienze Mediche Traslazionali, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Gabriella Fabbrocini
- Dipartimento di Sanità Pubblica, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Annamaria Colao
- Dipartimento di Medicina Clinica e Chirurgia, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Maria Triassi
- Dipartimento di Sanità Pubblica, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Guido Iaccarino
- Dipartimento di Scienze Biomediche Avanzate, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
| | - Giuseppe Liotta
- Dipartimento di Biomedicina e Prevenzione, Università Degli Studi di Roma Tor Vergata, 00133 Roma, Italy
| | - Maddalena Illario
- Dipartimento di Sanità Pubblica, Università Degli Studi di Napoli Federico II, 80131 Napoli, Italy
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Pirola F, Giombi F, Ferreli F, Costantino A, Mercante G, Paoletti G, Heffler E, Canonica GW, Settimi S, De Corso E, Spriano G, Malvezzi L. Cross-Cultural Validation of the Short Version of the Questionnaire of Olfactory Disorders-Negative Statements into Italian: Towards Personalized Patient Care. J Pers Med 2022; 12:jpm12122010. [PMID: 36556231 PMCID: PMC9782898 DOI: 10.3390/jpm12122010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/21/2022] [Accepted: 12/02/2022] [Indexed: 12/07/2022] Open
Abstract
Given the high burden of olfactory dysfunction worldwide, recently increased due to the COVID-19 pandemic, it is mandatory to adopt a specific questionnaire to assess the impact of olfactory impairment on quality of life, to be used in clinical practice. The aim of this study is to adapt and validate the short version of the Questionnaire of Olfactory Disorders-Negative Statements (svQOD-NS) for Italian. In the pilot phase, the Italian version of the questionnaire (ITA-svQOD-NS) was produced following recommended guidelines. It was then given to 50 healthy subjects and 50 patients (affected by either nasal polyposis or septal deviation), and results were compared to those of other widely used questionnaires. Test-retest reliability was assessed on a sample of 25 patients. All 50 patients repeated the questionnaires at one and nine months after surgery. The internal consistency of ITA-svQOD-NS measured with Cronbach α was excellent (α = 0.92). The intraclass correlation coefficient for test-retest reliability was also optimal (0.93; 95%CI: 0.90-0.96). Concurrent validity tested with the Pearson coefficient was significant with all other tests administered; also, concerning responsiveness, statistically significant differences were obtained between pre- and post-operative conditions. ITA-svQOD-NS showed high internal consistency, test-retest reliability, and significant correlation with all most-used clinical questionnaires; thus, it can be efficiently applied to assess olfaction-related QoL in the Italian population.
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Affiliation(s)
- Francesca Pirola
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Francesco Giombi
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Fabio Ferreli
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Andrea Costantino
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Giuseppe Mercante
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Giovanni Paoletti
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Enrico Heffler
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Giorgio Walter Canonica
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
- Personalized Medicine, Asthma and Allergy, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
| | - Stefano Settimi
- Department of Head and Neck and Sensory Organs, Catholic University of the Sacred Hearth, 00168 Rome, Italy
| | - Eugenio De Corso
- Unit of Otorhinolaryngology-Head and Neck Surgery, A. Gemelli Hospital Foundation IRCCS, 00168 Rome, Italy
| | - Giuseppe Spriano
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Luca Malvezzi
- Otorhinolaryngology Head & Neck Surgery Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
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7
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Iaccarino G. Editorial: Highlights in Hypertension: 2021. Front Cardiovasc Med 2022; 9:926949. [PMID: 35783858 PMCID: PMC9241515 DOI: 10.3389/fcvm.2022.926949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 05/04/2022] [Indexed: 11/18/2022] Open
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Comparison of the Greek Version of the Quick Mild Cognitive Impairment Screen and Montreal Cognitive Assessment in Older Adults. Healthcare (Basel) 2022; 10:healthcare10050906. [PMID: 35628043 PMCID: PMC9141789 DOI: 10.3390/healthcare10050906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/01/2022] [Accepted: 05/06/2022] [Indexed: 02/04/2023] Open
Abstract
Objective: Cognitive screening instruments (CSIs) are essential for everyday practice. The Quick Mild Cognitive Impairment (Qmci) screen, a short instrument designed to identify mild cognitive impairment, was recently translated into Greek (Qmci-Gr). The present study compared its diagnostic value against the Montreal Cognitive Assessment (MoCA) screen and examined its optimal cutoffs. Method: We recruited consecutive patients aged ≥55 years that presented with cognitive complaints from two outpatient clinics in Greece. The Qmci-Gr and MoCA were completed by all patients. Furthermore, they were assessed independently with a comprehensive flexible neuropsychological battery to establish a diagnostic classification. Results: In the current study, we assessed a total of 145 patients, with a median age of 70 years; 44 were classified as having Subjective Memory Complaints (SMC) but normal cognition, 32 with MCI and 69 with dementia. The Qmci-Gr had a higher accuracy compared to the MoCA in discriminating MCI from dementia, area under the curve (AUC) of 0.81 versus 0.75, respectively; however, this finding was marginally significant (p = 0.08). Its accuracy was marginally higher for distinguishing SMC from dementia, AUC of 0.94 versus 0.89 (p = 0.03). However, Qmci-Gr presented a lower accuracy than MoCa in differentiating SMC from MCI, AUC of 0.76 versus 0.94 (p = 0.006). Conclusions: The Qmci-Gr has comparable diagnostic accuracy to the MoCA regarding MCI and dementia groups. Further research, with larger and more diverse samples, may be necessary to ensure generalizability.
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Illario M, De Luca V, Onorato G, Tramontano G, Carriazo AM, Roller-Wirnsberger RE, Apostolo J, Eklund P, Goswami N, Iaccarino G, Triassi M, Farrell J, Bousquet J. Interactions Between EIP on AHA Reference Sites and Action Groups to Foster Digital Innovation of Health and Care in European Regions. Clin Interv Aging 2022; 17:343-358. [PMID: 35400996 PMCID: PMC8985824 DOI: 10.2147/cia.s323723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 02/22/2022] [Indexed: 11/23/2022] Open
Abstract
The article describes some of the achievements of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA), after eight years in operation. These results were achieved thanks to the collaborative work of the action groups (AGs) and reference sites (RSs). RS regional ecosystems include key organisations committed to investing in innovation to foster active and healthy ageing. The AGs are groups of professionals committed to sharing their knowledge and skills in active and healthy ageing. This article reports on the approach used by the EIP on AHA to bring together experts and regions in identifying and addressing these challenges. Synergies between AGs offered substantial support to RSs, allowing regional health and care priorities and challenges to be identified and pursued through AG commitments. Building upon the experiences of the EIP on AHA, the Reference Sites Collaborative Network has set up a number of thematic action groups that bring together multidisciplinary experts from across Europe to address the main health and social care challenges at regional, national and European level.
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Affiliation(s)
- Maddalena Illario
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, Naples, Italy
- Executive Board, EIP on AHA Reference Sites Collaborative Network, Brussels, Belgium
- Research & Development Unit, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
- Correspondence: Maddalena Illario, Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, Via Sergio Pansini n.5, Naples, 80131, Italy, Tel +39 0817464211, Fax +39 0817464212, Email
| | - Vincenzo De Luca
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Gabrielle Onorato
- Executive Board, EIP on AHA Reference Sites Collaborative Network, Brussels, Belgium
| | - Giovanni Tramontano
- Executive Board, EIP on AHA Reference Sites Collaborative Network, Brussels, Belgium
- Research & Development Unit, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - Ana Maria Carriazo
- Executive Board, EIP on AHA Reference Sites Collaborative Network, Brussels, Belgium
- Deputy Regional Ministry, Regional Ministry of Health and Families of Andalusia, Seville, Spain
| | | | - Joao Apostolo
- Health and Care Sciences Research Unit, Escola Superior de Enfermagem de Coimbra, Coimbra, Portugal
| | - Patrik Eklund
- Department of Computing Science, Umeå University, Umeå, Sweden
| | - Nandu Goswami
- Division of Physiology, Medical University of Graz, Graz, Austria
- Nandu Goswami, Division of Physiology, Medical University of Graz, Neue Stiftingtalstraße 6, Graz, 8010, Austria, Tel +43 31638573852, Fax +43 31638579005, Email
| | - Guido Iaccarino
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli Federico II, Naples, Italy
| | - Maria Triassi
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, Naples, Italy
| | - John Farrell
- Executive Board, EIP on AHA Reference Sites Collaborative Network, Brussels, Belgium
| | - Jean Bousquet
- Executive Board, EIP on AHA Reference Sites Collaborative Network, Brussels, Belgium
- MACVIA-France, Fondation partenariale FMC VIA-LR, Montpellier, France
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10
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Aiello EN, Rimoldi S, Bolognini N, Appollonio I, Arcara G. Psychometrics and diagnostics of Italian cognitive screening tests: a systematic review. Neurol Sci 2021; 43:821-845. [PMID: 34816316 DOI: 10.1007/s10072-021-05683-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 10/17/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cognitive screening tests (CSTs) are crucial to neuropsychological diagnostics, and thus need to be featured by robust psychometric and diagnostic properties. However, CSTs happen not to meet desirable statistical standards, negatively affecting their level of recommendations and applicability. This study aimed at (a) providing an up-to-date compendium of available CSTs in Italy, (b) report their psychometric and diagnostic properties, and (c) address related limitations. METHODS This review was implemented by consulting Preferred Reporting Items for Systematic Reviews and Meta-Analyses and pre-registered on the International Prospective Register of Systematic Reviews. Standardization and usability studies focusing on norms, validity, reliability, or sensitivity/specificity (and derived metrics) in adults were considered for eligibility. Quality assessment was performed by means of an ad hoc checklist collecting information on sampling, psychometrics/diagnostics, norming, and feasibility. RESULTS Sixty studies were included out of an initial N = 683. Identified CSTs (N = 40) were classified into general, domain-, and disease-specific (N = 17, 7, and 16, respectively), the latter being less statistically robust than remaining categories. Validity and reliability evidence was provided for 29 and 26 CSTs, respectively, sensitivity/specificity for 20 and norms for 33. Prevalence- and post-test-based diagnostic metrics were seldomly represented; factorial structures, ceiling/floor effects, and acceptability rarely investigated; content, face, and ecological validity never assessed. DISCUSSION Although available Italian CSTs overall met basic psychometric/diagnostic requirements, their statistical profile often proved to be poor on several properties that are desirable for clinical applications, with a few exceptions among general and domain-specific ones.
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Affiliation(s)
- Edoardo Nicolò Aiello
- PhD Program in Neuroscience, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.
| | - Sara Rimoldi
- Department of Psychology, University of Milano-Bicocca, Milano, Italy
| | - Nadia Bolognini
- Department of Psychology, University of Milano-Bicocca, Milano, Italy.,Neuropsychological Laboratory, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Ildebrando Appollonio
- Neurology Section, School of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
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11
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Comparison of the Accuracy of Short Cognitive Screens Among Adults With Cognitive Complaints in Turkey. Alzheimer Dis Assoc Disord 2021; 34:350-356. [PMID: 32530832 DOI: 10.1097/wad.0000000000000391] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Cutoff values of cognitive screen tests vary according to age and educational levels. OBJECTIVE The objective of this study was to compare the accuracy and determine cutoffs for 3 short cognitive screening instruments: the Mini-Mental State Examination, Montreal Cognitive Assessment (MoCA), and Quick Mild Cognitive Impairment Screen-Turkish version (Qmci-TR), in older adults with low literacy in Turkey. METHODS In all 321 patients, 133 with subjective cognitive complaints (SCC), 88 amnestic-type mild cognitive impairment (aMCI), and 100 with probable Alzheimer disease (AD) with a median of 5 years education were included. Education and age-specific cutoffs were determined. RESULTS For the overall population, the Qmci-TR was more accurate than the MoCA in distinguishing between aMCI and AD (area under the curve=0.83 vs. 0.76, P=0.004) and the Qmci-TR and Mini-Mental State Examination were superior to the MoCA in discriminating SCC from aMCI and AD. All instruments had similar accuracy among those with low literacy (primary school and lower educational level or illiterate). CONCLUSIONS To distinguish between SCC, aMCI, and AD in a sample of older Turkish adults, the Qmci-TR may be preferable. In very low literacy, the choice of the instrument appears less important.
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12
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Rezaei M, Shariati B, Molloy DW, O’Caoimh R, Rashedi V. The Persian Version of the Quick Mild Cognitive Impairment Screen (Q mci-Pr): Psychometric Properties among Middle-Aged and Older Iranian Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:8582. [PMID: 34444331 PMCID: PMC8393250 DOI: 10.3390/ijerph18168582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 08/03/2021] [Accepted: 08/11/2021] [Indexed: 01/15/2023]
Abstract
Brief cognitive screening instruments are used to identify patients presenting with cognitive symptoms that warrant further assessment. This study aimed to evaluate the reliability and validity of the Persian version of the Quick Mild Cognitive Impairment (Qmci-Pr) among middle-aged and older Iranian adults. Consecutive patients aged ≥55 years and caregivers attending with them as normal controls (NCs) were recruited from geriatric outpatient clinics and a hospital in Tehran, Iran. All patients completed the Qmci-Pr before completing an independent detailed neuropsychological assessment and staging using the Clinical Dementia Rating (CDR) Scale. NCs underwent the same assessment. In all, 92 participants with a median age of 70 years (±13) were available. Of these, 20 participants were NCs, 24 had subjective memory complaints (SMC), 24 had mild cognitive impairment (MCI), and 24 had Alzheimer's disease (AD). The Qmci-Pr had good accuracy in differentiating SMC and NC from MCI (area under the curve (AUC): 0.80 (0.69-0.91)) and in identifying cognitive impairment (MCI and mild AD) (AUC: 0.87 (0.80-0.95)) with a sensitivity of 88% and specificity of 80%, at an optimal cut-off of <53/100. The Qmci-Pr is an accurate short cognitive screening impairment for separating NC and patients with SMC from MCI and identifying cognitive impairment. Further research with larger samples and comparison with other widely used instruments such as the Montreal Cognitive Assessment is needed. Given its established brevity, the Qmci-Pr is a useful screen for Iranian adults across the spectrum of cognitive decline.
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Affiliation(s)
- Mohammad Rezaei
- Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Hamadan 6517838687, Iran;
| | - Behnam Shariati
- Mental Health Research Center, Department of Psychiatry, School of Medicine, Iran University of Medical Sciences, Tehran 1449614535, Iran;
| | - David William Molloy
- Department of Geriatric Medicine, Mercy University Hospital, T12 WE28 Cork, Ireland; (D.W.M.); (R.O.)
| | - Rónán O’Caoimh
- Department of Geriatric Medicine, Mercy University Hospital, T12 WE28 Cork, Ireland; (D.W.M.); (R.O.)
| | - Vahid Rashedi
- School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran 1445613111, Iran
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13
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Messinis L, O'Donovan MR, Molloy DW, Mougias A, Nasios G, Papathanasopoulos P, Ntoskou A, O'Caoimh R. Comparison of the Greek Version of the Quick Mild Cognitive Impairment Screen and Standardised Mini-Mental State Examination. Arch Clin Neuropsychol 2021; 36:578-586. [PMID: 32783063 DOI: 10.1093/arclin/acaa062] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 04/27/2020] [Accepted: 07/16/2020] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Short cognitive screening instruments (CSIs) are widely used to stratify patients presenting with cognitive symptoms. The Quick Mild Cognitive Impairment (Qmci) screen is a new, brief (<5mins) CSI designed to identify mild cognitive impairment (MCI), which can be used across the spectrum of cognitive decline. Here we present the translation of the Qmci into Greek (Qmci-Gr) and its validation against the widely-used Standardised Mini-Mental State Examination (SMMSE). METHODS Consecutive patients aged ≥55 years presenting with cognitive complaints were recruited from two outpatient clinics in Greece. All patients completed the Qmci-Gr and SMMSE and underwent an independent detailed neuropsychological assessment to determine a diagnostic classification. RESULTS In total, 140 patients, median age 75 years, were included; 30 with mild dementia (median SMMSE 23/30), 76 with MCI and 34 with subjective memory complaints (SMC) but normal cognition. The Qmci-Gr had similar accuracy in differentiating SMC from cognitive impairment (MCI & mild dementia) compared with SMMSE, area under the curve (AUC) of 0.84 versus 0.79, respectively; while accuracy was higher for the Qmci-Gr, this finding was not significantly different, (p = .19). Similarly, the Qmci-Gr had similar accuracy in separating SMC from MCI, AUC of 0.79 versus 0.73 (p = .23). CONCLUSIONS The Qmci-Gr compared favorably with the SMMSE. Further research with larger samples and comparison with other instruments such as the Montreal Cognitive Assessment is needed to confirm these findings but given its established brevity, it may be a better choice in busy clinical practice in Greece.
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Affiliation(s)
- Lambros Messinis
- Neuropsychology Section, Departments of Neurology and Psychiatry, University Hospital of Patras and University of Patras Medical School, Patras, Greece
| | - Mark R O'Donovan
- Department of Geriatric Medicine, Mercy University Hospital, Cork, Ireland.,Health Research Board, Clinical Research Facility Cork, University College Cork, Mercy University Hospital, Grenville Place, Cork, Ireland
| | - D William Molloy
- Department of Geriatric Medicine, Mercy University Hospital, Cork, Ireland
| | - Antonis Mougias
- Alzheimer Center, Greek Psychogeriatric Association "Nestor", Athens, Greece
| | - Grigorios Nasios
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | | | - Aikaterini Ntoskou
- Rehabilitation Unit for patients with Spinal Cord Injury, "Demetrios and Vera Sfikas" Department of Medicine, University of Patras Medical School, Patras, Greece
| | - Rónán O'Caoimh
- Department of Geriatric Medicine, Mercy University Hospital, Cork, Ireland
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De Luca V, Tramontano G, Riccio L, Trama U, Buono P, Losasso M, Bracale UM, Annuzzi G, Zampetti R, Cacciatore F, Vallefuoco G, Lombardi A, Marro A, Melone MAB, Ponsiglione C, Chiusano ML, Bracale G, Cafiero G, Crudeli A, Vecchione C, Taglialatela M, Tramontano D, Iaccarino G, Triassi M, Roller-Wirnsberger R, Bousquet J, Illario M. "One Health" Approach for Health Innovation and Active Aging in Campania (Italy). Front Public Health 2021; 9:658959. [PMID: 34046390 PMCID: PMC8144456 DOI: 10.3389/fpubh.2021.658959] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 03/18/2021] [Indexed: 12/23/2022] Open
Abstract
This article describes how innovations are exploited in Campania (Italy) to improve health outcomes, quality of life, and sustainability of social and healthcare services. Campania's strategy for digitalization of health and care and for healthy aging is based on a person-centered, life-course, “One Health” approach, where demographic change is considered capable of stimulating a growth dynamic linked to the opportunities of combining the “Silver Economy” with local assets and the specific health needs of the population. The end-users (citizens, patients, and professionals) contribute to the co-creation of products and services, being involved in the identification of unmet needs and test-bed activity. The Campania Reference Site of the European Innovation Partnership on Active and Healthy Aging is a flexible regional ecosystem to address the challenge of an aging population with a life-course approach. The good practices, developed in the context of research and innovation projects and innovative procurements by local stakeholders and collaborations with international networks, have been allowing the transfer of innovative solutions, knowledge, and skills to the stakeholders of such a multi-sectoral ecosystem for health.
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Affiliation(s)
- Vincenzo De Luca
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli "Federico II, " Naples, Italy
| | - Giovanni Tramontano
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - Luigi Riccio
- Direzione Generale per la Tutela della Salute e il Coordinamento del Servizio Sanitario Regionale, Naples, Italy
| | - Ugo Trama
- Direzione Generale per la Tutela della Salute e il Coordinamento del Servizio Sanitario Regionale, Naples, Italy
| | - Pietro Buono
- Direzione Generale per la Tutela della Salute e il Coordinamento del Servizio Sanitario Regionale, Naples, Italy
| | - Mario Losasso
- Dipartimento di Architettura, Università degli Studi di Napoli "Federico II", Naples, Italy
| | | | - Giovanni Annuzzi
- Unità Operativa Semplice Microinfusori e tecnologie innovative, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | | | - Francesco Cacciatore
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli "Federico II, " Naples, Italy
| | | | | | - Anna Marro
- Azienda Sanitaria Locale Avellino, Avellino, Italy
| | - Mariarosa Anna Beatrice Melone
- Dipartimento di Scienze Mediche e Chirurgiche Avanzate e Centro Interuniversitario di Ricerca in Neuroscienze, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | - Cristina Ponsiglione
- Dipartimento di Ingegneria Industriale, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Maria Luisa Chiusano
- Dipartimento di Agraria, Università degli Studi di Napoli "Federico II", Naples, Italy
| | - Giancarlo Bracale
- Mediterranean Federation for Advancing Vascular Surgery, Naples, Italy
| | | | | | - Carmine Vecchione
- Dipartimento di Medicina, Chirurgia e Odontoiatria, Università degli Studi di Salerno, Salerno, Italy
| | - Maurizio Taglialatela
- Dipartimento di Neuroscienze e Scienze Riproduttive ed Odontostomatologiche, Università degli Studi di Napoli "Federico II," Naples, Italy
| | - Donatella Tramontano
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli "Federico II," Naples, Italy
| | - Guido Iaccarino
- Dipartimento di Scienze Biomediche Avanzate, Università degli Studi di Napoli "Federico II," Naples, Italy
| | - Maria Triassi
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli "Federico II, " Naples, Italy
| | | | - Jean Bousquet
- MACVIA-France, Fondation Partenariale FMC VIA-LR, Montpellier, France
| | - Maddalena Illario
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli "Federico II, " Naples, Italy
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15
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Time of isolation, education and gender influence the psychological outcome during COVID-19 lockdown in caregivers of patients with dementia. Eur Geriatr Med 2020; 11:1095-1098. [PMID: 33052535 PMCID: PMC7556578 DOI: 10.1007/s41999-020-00413-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/29/2020] [Indexed: 01/10/2023]
Abstract
Aim To evaluate the effects of the COVID-19 emergency lockdown on the psychological outcome in caregivers of patients with dementia and on the loss of welfare services in these patients. Findings Time of isolation, education and gender had a significant effect on anxiety and depression. A marked reduction of health services was observed in all patients with dementia. Message The lockdown registered a particularly negative impact on people with dementia and their caregivers. Purpose The study evaluated the effects of the COVID-19 emergency lockdown on the psychological outcome in caregivers (children or spouses) of patients with dementia and the loss of the welfare services in these patients. Methods Zung’s depression and anxiety assessment scales and the Perceived Stress Scale were administered by a telephone interview or a self-compilation directly on the online platform. Results The sample consisted of 239 participants (men = 124; women = 115) with a mean age of 54.4 years (SD = 12.1). Education was associated with significantly lower overall anxiety and depression scores while days of isolation and female gender were associated with the higher scores. A marked reduction of health services was observed in all patients. Conclusion The lockdown registered a particular impact on people with dementia and their caregivers. Many people with dementia were deprived of care services and time of isolation had a significant negative effect on anxiety and depression in caregivers.
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O'Caoimh R, Gao Y, Svendrovski A, Illario M, Iaccarino G, Yavuz BB, Kehoe PG, Molloy DW. Effect of Visit-to-Visit Blood Pressure Variability on Cognitive and Functional Decline in Mild to Moderate Alzheimer's Disease. J Alzheimers Dis 2020; 68:1499-1510. [PMID: 30909214 DOI: 10.3233/jad-180774] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Visit-to-visit blood pressure (BP) variability (VVV) is increasingly recognized as a marker of cardiovascular risk. Although implicated in cognitive decline, few studies are currently available assessing its effects on established dementia. OBJECTIVE To investigate if VVV is associated with one-year rate of decline in measures of cognition and function in patients with mild to moderate Alzheimer's disease (AD) in the Doxycycline And Rifampicin for Alzheimer's Disease study. METHODS Patients were included if ≥3 BP readings were available (n = 392). VVV was defined using different approaches including the coefficient of variation (CV) in BP readings between visits. Outcomes included rates of decline in the Standardized Alzheimer's Disease Assessment Scale-Cognitive Subscale (SADAS-cog), Standardized MMSE, Clinical Dementia Rating Scale, the Quick Mild Cognitive Impairment screen and the Lawton-Brody activities of daily living (ADL) scale. RESULTS Half of the patients (196/392) had a ≥4-point decline in the SADAS-cog over one-year. Using this cut-off, there were no statistically significant associations between any measures of VVV, for systolic or diastolic BP, with and without adjustment for potential confounders including treatment allocation, history of hypertension and use of anti-hypertensive and cognitive enhancing medications. Multiple regression models examining the association between systolic BP CV by quartile and decline over one-year likewise showed no clinically significant effects, apart from a U-shaped pattern of ADL decline of borderline clinical significance.∥Conclusions: This observational study does not support recent research showing that VVV predicts cognitive decline in AD. Further studies are needed to clarify its effects on ADL in AD.
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Affiliation(s)
- Rónán O'Caoimh
- Centre for Gerontology and Rehabilitation, University College Cork, St Finbarrs Hospital, Cork, Ireland.,Health Research Board Clinical Research Facility Galway, National University of Ireland, Galway, Geata an Eolais, University Road, Galway, Ireland
| | - Yang Gao
- Centre for Gerontology and Rehabilitation, University College Cork, St Finbarrs Hospital, Cork, Ireland
| | | | - Maddalena Illario
- Division on Health Innovation, Campania Region Health Directorate; DISMET/R&D Unit, Federico II University and Hospital, Naples, Italy
| | - Guido Iaccarino
- Department of Medicine and Surgery, University of Salerno, Baronissi, SA, Italy
| | - Burcu Balam Yavuz
- Department of Internal Medicine, Division of Geriatric Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Patrick Gavin Kehoe
- Department of Internal Medicine, Division of Geriatric Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - D William Molloy
- Centre for Gerontology and Rehabilitation, University College Cork, St Finbarrs Hospital, Cork, Ireland
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17
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Xu Y, Lin Y, Yi L, Li Z, Li X, Yu Y, Guo Y, Wang Y, Jiang H, Chen Z, Svendrovski A, Gao Y, Molloy DW, O'Caoimh R. Screening for Cognitive Frailty Using Short Cognitive Screening Instruments: Comparison of the Chinese Versions of the MoCA and Q mci Screen. Front Psychol 2020; 11:558. [PMID: 32308636 PMCID: PMC7145973 DOI: 10.3389/fpsyg.2020.00558] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 03/09/2020] [Indexed: 02/05/2023] Open
Abstract
Background Cognitive frailty describes cognitive impairment associated with physical decline. Few studies have explored whether short cognitive screens identify frailty. We examined the diagnostic accuracy of the Chinese versions of the Quick Mild Cognitive Impairment (Qmci-CN) screen and Montreal Cognitive Assessment (MoCA-CN) in identifying cognitive frailty. Methods Ninety-five participants with cognitive symptoms [47 with mild cognitive impairment (MCI), 34 with subjective cognitive disorder, and 14 with dementia] were included from two outpatient rehabilitation clinics. Energy (work intensity) and physical activity levels were recorded. Cognitive frailty was diagnosed by an interdisciplinary team using the IANA/IAGG consensus criteria, stratified on the Clinical Frailty Scale (CFS). Instruments were administered sequentially and randomly by trained assessors, blind to the diagnosis. Results The mean age of the sample was 62.6 ± 10.2 years; median CFS score was 4 ± 1 and 36 (38%) were cognitively frail. The Qmci-CN had similar accuracy in differentiating the non-frail from cognitively frail compared to the MoCA-CN, AUC 0.82 versus 0.74, respectively (p = 0.19). At its optimal cut-off (≤55/100), the Qmci-CN provided a sensitivity of 83% and specificity of 67% versus 91% and 51%, respectively, for the MoCA-CN (≤23/30). Neither was accurate in separating MCI from cognitive frailty but both accurately separated cognitive frailty from dementia. Conclusion Established short cognitive screens may be useful in identifying cognitive frailty in Chinese adults with cognitive complaints but not in separating MCI from cognitive frailty. The Qmci-CN had similar accuracy to the MoCA-CN and a shorter administration time in this small and under-powered study, necessitating the need for adequately powered studies in different healthcare settings.
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Affiliation(s)
- Yangfan Xu
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yangyang Lin
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lingrong Yi
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Rehabilitation Medicine, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Zhao Li
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Rehabilitation Medicine, Mianzhu Hospital of West China Hospital, Sichuan University, Chengdu, China
| | - Xian Li
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuying Yu
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,Department of Rehabilitation Medicine, The Second People's Hospital of Foshan, Foshan, China
| | - Yuxiao Guo
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.,UCL Division of Surgery and Interventional Science, London, United Kingdom
| | - Yuling Wang
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Haoying Jiang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China.,Department of Rehabilitation Medicine, Jilin Provincial People's Hospital, Jilin, China
| | - Zhuoming Chen
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | | | - Yang Gao
- Centre for Gerontology and Rehabilitation, University College Cork, St Finbarr's Hospital, Cork, Ireland
| | - D William Molloy
- Centre for Gerontology and Rehabilitation, University College Cork, St Finbarr's Hospital, Cork, Ireland.,Department of Geriatric Medicine, Mercy University Hospital, Cork, Ireland
| | - Rónán O'Caoimh
- Centre for Gerontology and Rehabilitation, University College Cork, St Finbarr's Hospital, Cork, Ireland.,Department of Geriatric Medicine, Mercy University Hospital, Cork, Ireland.,Clinical Sciences Institute, National University of Ireland Galway, Galway, Ireland
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Carpinelli Mazzi M, Iavarone A, Russo G, Musella C, Milan G, D’Anna F, Garofalo E, Chieffi S, Sannino M, Illario M, De Luca V, Postiglione A, Abete P. Mini-Mental State Examination: new normative values on subjects in Southern Italy. Aging Clin Exp Res 2020; 32:699-702. [PMID: 31230268 DOI: 10.1007/s40520-019-01250-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 06/11/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The aims of the present study were: (a) to obtain new normative data of the Italian version of the Mini-Mental Examination State (MMSE) (Measso et al. in Dev Neuropsychol 9:77-85, 1993) by administering the tool to a sample of normal Italian individuals more representative of the current Italian population; (b) to compare the sensitivity of this tool in detecting patients suffering from Alzheimer's disease (AD according to NIA-AA), as compared to the those reported in previous normative Italian studies. METHODS MMSE was administered to 314 normal subjects recruited among individuals (and/or their relatives) attending the Offices of General Practitioners (GP) or Memory Clinics in Campania (Italy) by convenience sampling. A group of 47 patients with AD were included into the study. The effect of demographic variables on the raw MMSE scores of normal subjects was checked by multiple linear regression assuming MMSE scores as dependent variable and age, gender and education as the independent one(s). Therefore, a simultaneous regression model was constructed to correct the raw scores according the sensitive variables. Correction grid and equivalent scores were devised to classify subject's performance. RESULTS The mean raw MMSE score was 27.78 (SD = 1.80) (range 22-30/30). There was no significant difference between scores achieved by men or women (p = 0.688). Multiple linear regression analysis showed a significant effect of age and years of school attendance on the MMSE raw score, whereas gender did not show any significant effect. The cutoff score, distinguishing between pathological and normal performances, was fixed at the fifth centile corresponding to 24.9/30, higher than the current score of 23.8/30. The new cutoff value was able to identify 44/47 patients with AD, in contrast to 38/47 subjects detected by currently used norms. CONCLUSIONS (1) A more updated and representative population sample; (2) a new cutoff threshold able to distinguish between normal and pathological performances; (3) a correction grid that reduces the risk of false-positive and false-negative values due to the influence of the main demographic factors; (4) greater sensitivity, compared to previous Italian normative studies in identifying people with dementia.
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19
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Ahn YD, Yi D, Joung H, Seo EH, Lee YH, Byun MS, Lee JH, Jeon SY, Lee JY, Sohn BK, Lee DY. Normative Data for the Logical Memory Subtest of the Wechsler Memory Scale-IV in Middle-Aged and Elderly Korean People. Psychiatry Investig 2019; 16:793-799. [PMID: 31648423 PMCID: PMC6877463 DOI: 10.30773/pi.2019.0061] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 08/09/2019] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE The purpose of this study is to identify the demographic variables that are affecting performances on the Logical Memory (LM) subtest included in the Korean version of the Wechsler Memory Scale (WMS)-IV and to provide normative data on the LM subtest for the middle-age and elderly Korean people. METHODS The participants were 435 non-demented adults aging from 50 to 90 and with the educational level ranging from 0 to 21 years. RESULTS Age and education were found to be significantly associated with performance on the LM subtest, while gender effect was not statistically significant. Therefore, we stratified the norm blocks by age and education. Age was divided into three groups: 50-59, 60-74, and 75-90 years. Education was stratified into three groups: 0-8 years, 9-12 years, and 13 years or more. CONCLUSION The normative data provided in the current study are expected to be useful in clinical and research settings to detect or define subtle changes in episodic memory in Korean adults and elderly, and can also be used for cross-cultural comparison of verbal episodic memory performance among elderly populations using different languages.
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Affiliation(s)
- Yebin D Ahn
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Dahyun Yi
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Haejung Joung
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Eun Hyun Seo
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Young Hwa Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Min Soo Byun
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Jun Ho Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - So Yeon Jeon
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jun-Young Lee
- Department of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Bo Kyung Sohn
- Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.,Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
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20
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Comparing the Diagnostic Accuracy of Two Cognitive Screening Instruments in Different Dementia Subtypes and Clinical Depression. Diagnostics (Basel) 2019; 9:diagnostics9030093. [PMID: 31398811 PMCID: PMC6787633 DOI: 10.3390/diagnostics9030093] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/06/2019] [Accepted: 08/06/2019] [Indexed: 12/23/2022] Open
Abstract
Short but accurate cognitive screening instruments are required in busy clinical practice. Although widely-used, the diagnostic accuracy of the standardised Mini-Mental State Examination (SMMSE) in different dementia subtypes remains poorly characterised. We compared the SMMSE to the Quick Mild Cognitive Impairment (Qmci) screen in patients (n = 3020) pooled from three memory clinic databases in Canada including those with mild cognitive impairment (MCI) and Alzheimer’s, vascular, mixed, frontotemporal, Lewy Body and Parkinson’s dementia, with and without co-morbid depression. Caregivers (n = 875) without cognitive symptoms were included as normal controls. The median age of patients was 77 (Interquartile = ±9) years. Both instruments accurately differentiated cognitive impairment (MCI or dementia) from controls. The SMMSE most accurately differentiated Alzheimer’s (AUC 0.94) and Lewy Body dementia (AUC 0.94) and least accurately identified MCI (AUC 0.73), vascular (AUC 0.74), and Parkinson’s dementia (AUC 0.81). The Qmci had statistically similar or greater accuracy in distinguishing all dementia subtypes but particularly MCI (AUC 0.85). Co-morbid depression affected accuracy in those with MCI. The SMMSE and Qmci have good-excellent accuracy in established dementia. The SMMSE is less suitable in MCI, vascular and Parkinson’s dementia, where alternatives including the Qmci screen may be used. The influence of co-morbid depression on scores merits further investigation.
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21
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Validity of the Japanese Version of the Quick Mild Cognitive Impairment Screen. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16060917. [PMID: 30875774 PMCID: PMC6466607 DOI: 10.3390/ijerph16060917] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 02/28/2019] [Accepted: 03/08/2019] [Indexed: 01/04/2023]
Abstract
Early detection of dementia provides opportunities for interventions that could delay or prevent its progression. We developed the Japanese version of the Quick Mild Cognitive Impairment (Qmci-J) screen, which is a performance-based, easy-to-use, valid and reliable short cognitive screening instrument, and then we examined its validity. Community-dwelling adults aged 65–84 in Niigata prefecture, Japan, were concurrently administered the Qmci-J and the Japanese version of the standardized Mini-Mental State Examination (sMMSE-J). Mild cognitive impairment (MCI) and dementia were categorized using established and age-adjusted sMMSE-J cut-offs. The sample (n = 526) included 52 (9.9%) participants with suspected dementia, 123 (23.4%) with suspected MCI and 351 with likely normal cognition. The Qmci-J showed moderate positive correlation with the sMMSE-J (r = 0.49, p < 0.001) and moderate discrimination for predicting suspected cognitive impairment (MCI/dementia) based on sMMSE-J cut-offs, area under curve: 0.74, (95%CI: 0.70–0.79), improving to 0.76 (95%CI: 0.72 to 0.81) after adjusting for age. At a cut-off of 60/61/100, the Qmci-J had a 73% sensitivity, 68% specificity, 53% positive predictive value, and 83% negative predictive value for cognitive impairment. Normative data are presented, excluding those with any sMMSE-J < 27. Though further research is required, the Qmci-J screen may be a useful screening tool to identify older adults at risk of cognitive impairment.
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22
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De Luca V, Tramontano G, Del Giudice C, Grimaldi I, Romano R, Liguori I, Carpinelli Mazzi M, Di Carluccio N, Riccio PA, Speranza P, Iavarone A, Abete P, Postiglione A, Cataldi M, Vallone C, Giallauria F, Cittadini A, Triggiani M, Savastano S, Menditto E, Leonardini L, Colao A, Triassi M, Iaccarino G, Postiglione A, Coscioni E, Illario M. Innovative Approaches to Active and Healthy Ageing: Campania Experience to Improve the Adoption of Innovative Good Practices. Transl Med UniSa 2019; 19:116-123. [PMID: 31360676 PMCID: PMC6581492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The demographic projections on the European population predict that people aged over 60 will increase by about two million/year in the next decades. Since 2012, the Campania Reference Site of the European Innovation Partnership on Active and Healthy Ageing supports the innovation of the Regional Health System, to face up demographic changes and sustainability. Campania Reference Site provides the opportunity to connect loco-regional stakeholders in social and health care services (universities, healthcare providers, social services, local communities and municipalities), with international organizations, in order to adopt and scale up innovative solutions and approaches. This paper describes the building process of Campania Reference Site and the main results achieved, that have been allowing it to become a hub for open innovation in the field of active and healthy aging at regional, national and international level.
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Affiliation(s)
- V De Luca
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy,
| | - G Tramontano
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - C Del Giudice
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - I Grimaldi
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - R Romano
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - I Liguori
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - M Carpinelli Mazzi
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
| | | | - PA Riccio
- Associazione Progetto Alfa Onlus, Marigliano NA, Italy
| | - P Speranza
- Unità Operativa Complessa Gestione Affari Generali, Azienda Ospedaliera Universitaria Federico II, Naples, Italy
| | - A Iavarone
- Unità Operativa Complessa di Neurologia, Azienda Ospedaliera Specialistica Dei Colli - Monaldi-Cotugno-CTO, Naples, Italy
| | - P Abete
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - A Postiglione
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - M Cataldi
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università degli Studi di Napoli Federico II, Naples, Italy
| | - C Vallone
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, Naples, Italy
| | - F Giallauria
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - A Cittadini
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy
| | - M Triggiani
- Dipartimento di Medicina, Chirurgia ed Odontoiatria, Università degli Studi di Salerno, Salerno, Italy
| | - S Savastano
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - E Menditto
- Dipartimento di Farmacia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - L Leonardini
- Progetto Mattone Internazionale Salute, Ministero della Salute, Rome, Italy
| | - A Colao
- Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy
| | - M Triassi
- Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, Naples, Italy
| | - G Iaccarino
- Dipartimento di Scienze biomediche avanzate, Università degli Studi di Napoli Federico II, Naples, Italy
| | - A Postiglione
- Direzione Generale per la Tutela della Salute e il Coordinamento del Sistema Sanitario Regionale (DG04), Regione Campania, Naples, Italy
| | - E Coscioni
- Struttura Dipartimentale di Chirurgia dell’Aorta Ascendente e Toracica, Azienda Ospedaliera Universitaria Ospedali Riuniti San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy
| | - M Illario
- Unità Operativa Semplice Ricerca e Sviluppo, Azienda Ospedaliera Universitaria Federico II, Naples, Italy,Dipartimento di Scienze Mediche Traslazionali, Università degli Studi di Napoli Federico II, Naples, Italy,Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Naples, Italy,Consorzio Farmacie Servizi (COFASER), Sarno SA, Italy,Associazione Progetto Alfa Onlus, Marigliano NA, Italy,Unità Operativa Complessa Gestione Affari Generali, Azienda Ospedaliera Universitaria Federico II, Naples, Italy,Unità Operativa Complessa di Neurologia, Azienda Ospedaliera Specialistica Dei Colli - Monaldi-Cotugno-CTO, Naples, Italy,Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, Università degli Studi di Napoli Federico II, Naples, Italy,Dipartimento di Sanità Pubblica, Università degli Studi di Napoli Federico II, Naples, Italy,Dipartimento di Medicina, Chirurgia ed Odontoiatria, Università degli Studi di Salerno, Salerno, Italy,Dipartimento di Farmacia, Università degli Studi di Napoli Federico II, Naples, Italy,Progetto Mattone Internazionale Salute, Ministero della Salute, Rome, Italy,Dipartimento di Scienze biomediche avanzate, Università degli Studi di Napoli Federico II, Naples, Italy,Direzione Generale per la Tutela della Salute e il Coordinamento del Sistema Sanitario Regionale (DG04), Regione Campania, Naples, Italy,Struttura Dipartimentale di Chirurgia dell’Aorta Ascendente e Toracica, Azienda Ospedaliera Universitaria Ospedali Riuniti San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy,Unità Operativa Dipartimentale Promozione e potenziamento di programmi Health Innovation (DG04), Regione Campania, Naples, Italy
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23
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Machado dos Santos P, O’Caoimh R, Svendrovski A, Casanovas C, Orfila Pernas F, Illario M, Molloy W, Paul C. The RAPid COmmunity COGnitive screening Programme (RAPCOG): Developing the Portuguese version of the Quick Mild Cognitive Impairment (Q mci-P) screen as part of the EIP on AHA Twinning Scheme. Transl Med UniSa 2019; 19:82-89. [PMID: 31360671 PMCID: PMC6581493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
As populations age and the prevalence of cognitive impairment increases, healthcare professionals and researchers require short, validated cognitive screening instruments (CSIs). As part the EIP-on-AHA Twinning Support Scheme (2016), four reference sites developed the RAPid COmmunity COGnitive screening Programme (RAPCOG) twinning project to validate translated versions of the Quick Mild Cognitive Impairment (Qmci) screen that could be adapted quickly for use with future eHealth screening and assessment programmes. Here we present the cultural adaption and translation of the Qmci-Portuguese (Qmci-P) screen as part of RAPCOG and explore its subsequent validation against two commonly-used CSIs (MMSE-P and MoCA-P) with 93 participants aged ≥65, attending ten day care centres or resident in two long-term care institutions; median age 74 (+/-15), 66% female. The Qmci-P's internal consistency was high (Cronbach's Alpha 0.82), compared with the MoCA (0.79) and SMMSE (0.54). Qmci-P screen scores moderately correlated with the SMMSE (r=0.61, 95% CI:0.45-0.72, p<0.001) and MoCA (r=0.63, 95% CI:0.36-0.80, p<0.001). The Qmci-P screen demonstrates high internal consistency and concurrent validity against more established CSIs and given its brevity (3-5mins), may be preferable for use in community settings. This project shows the potential of the EIP-on-AHA Twinning initiative to promote the scaling-up of innovative good practices.
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Affiliation(s)
- P Machado dos Santos
- Center for Health Technology and Services Research/ICBAS, Institute of Biomedical Sciences Abel Salazar – University of Porto, Porto, Portugal
| | - R O’Caoimh
- Health Research Board, Clinical Research Facility Galway, National University of Ireland, Galway, Ireland,Centre for Gerontology and Rehabilitation, University College Cork, St Finbarr’s Hospital, Douglas Road, Cork City, Ireland,Dr. Rónán O’Caoimh,
| | - A Svendrovski
- UZIK Consulting Inc., 86 Gerrard St E, Unit 12D, Toronto, ON, M5B 2J1 Canada
| | - C Casanovas
- Institut Universitari d’Investigació en Atenció Primaria Jordi Gol (IDIAP JGol), Barcelona, Spain
| | - F Orfila Pernas
- Institut Universitari d’Investigació en Atenció Primaria Jordi Gol (IDIAP JGol), Barcelona, Spain
| | - M Illario
- Division on Health Innovation, Campania Region Health Directorate; DISMET/R&D Unit, Federico II University & Hospital, Naples, Italy
| | - W Molloy
- Centre for Gerontology and Rehabilitation, University College Cork, St Finbarr’s Hospital, Douglas Road, Cork City, Ireland
| | - C Paul
- Center for Health Technology and Services Research/ICBAS, Institute of Biomedical Sciences Abel Salazar – University of Porto, Porto, Portugal
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An Approach to Prevent Frailty in Community Dwelling Older Adults: a pilot study performed in Campania region in the framework of the PERSSILAA project. Transl Med UniSa 2019; 19:42-48. [PMID: 31360666 PMCID: PMC6581496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We developed and tested an innovative physical training method in older adults that embeds the gym program into everyday life in the most conservative way possible. Physical training was included in the activities of local parishes where older women from Southern Italy spend most of their free time and was delivered by trained physical therapists with the support of an ICT tool known as CoCo. 113 older women (aged 72.0 [69.0-75.0] years) noncompliant to conventional exercise programs participated to the study. 57 of them underwent the final anthropometric assessment and 50 the final physical tests. In study completers handgrip strength and physical performance evaluated with the chair-stand, the two minutes step and the chair-sit and -reach tests significantly improved. Quality of life as evaluated with the EuroQol-5dimension (EQ-5D) questionnaire improved as well. In conclusion, a training program designed to minimally impact on life habits of older people is effective in improving fitness in patients noncompliant to other to physical exercise programs.
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