Community screening for visual impairment in older people. Community screening for visual impairment in the elderly

Association of Being Accompanied at Medical Consultation and Having Memory Complaints With Cognitive Impairment in Elderly Brazilian Outpatients

BACKGROUND

The usefulness of both the presence of a companion at the medical consultation and patient's cognitive complaints as selection strategies for performing a dementia evaluation is still unclear.

OBJECTIVES

To estimate the association of elderly patients being accompanied during medical visits and patient's memory complaint with objective cognitive impairment.

METHODS

We included elderly outpatients awaiting medical consultations in 3 non-neurological medical specialties. Demographic and Mini-Mental State Examination were collected. Patients' memory complaints were evaluated with a single question to both patients and companions.

RESULTS

Five hundred ninety-three elderly patients were included in the study with 64.6% female and median (interquartile range) age 73 (68-78), 4 (2-6) years of education. Of these, 242 patients were accompanied and 62.6% presented memory complaints. The median (interquartile range) Mini-Mental State Examination scores were significantly lower in patients accompanied and in those with memory complaints. In a logistic regression model, age, education, memory complaint, and presence of companion were associated with cognitive impairment. In the model including only accompanied patients, only age and companion memory complaints were associated with objective cognitive impairment.

CONCLUSIONS

The presence of a companion during a clinical consultation and patients' memory complaints are both synergistically associated with objective cognitive impairment.

Evaluation of Mini-Mental State Examination scores according to different age and education strata, and sex, in a large Brazilian healthy sample

Until better measures have been accepted for wider use, the Mini-Mental State Examination (MMSE) will continue to be utilized. In this context, knowledge on characteristics and determinants of its distribution for the Brazilian population are particularly valuable. The present study aimed to evaluate, based on multivariate analysis, the independent effect of age, educational level and sex, and their interactions, on MMSE scores in a healthy sample.

METHODS

Demographic data and scores on the MMSE of 1,553 healthy individuals were analyzed. The sample was grouped according to age and education.

RESULTS

The sample was composed of 963 females (62%), mean age ±SD was 49.6±20.7yrs (range 20 to 92 yrs). The mean years of education ±SD was 8.9±5.5yrs (range 0 to 28 yrs). The mean score ±SD on the MMSE was 27.3±2.7(range 15 to 30). A significant effect of the interaction between education and sex (p=0.011), and also between education and age was observed (p=0.003). An independent effect of education (p<0.001) and age (p<0.001) was found. Participants from the higher educated group presented higher MMSE scores than the other groups. Younger adults presented higher MMSE scores than the other age groups.

CONCLUSIONS

We observed an effect of education and age on MMSE scores. Younger individuals and higher educated participants presented higher scores.

How many items from a word list can Alzheimer's disease patients and normal controls recall? Do they recall in a similar way?

The serial position effect occurs when individuals are asked to recall a list of information that exceeds normal attention span. Alzheimer's disease (AD) patients show lower scores on word span recall tests when compared to healthy aging subjects, younger individuals or depressed patients.

Factorial Structure of the Quality of Life Questionnaire in a Spanish Sample of Visually Disabled Adults1

Abstract. This study presents a new Spanish version of the Quality of Life Questionnaire (QOL.Q; Schalock & Keith, 1993a ) for use with adults with visual disability. The QOL.Q was originally developed in English and designed to measure four dimensions of quality of life in populations with mental retardation. The purpose of this paper is to study some psychometric properties of the Spanish translation for a population with visual disabilities. Confirmatory factor analysis (CFA) has been used to check whether the factorial structure of the Spanish version of the questionnaire was similar to the original version. The questionnaire was applied to a sample of 364 adults with visual disability. As the results indicated that the data was not appropriate for the aforementioned structure, an Exploratory factor analysis was carried out with the aim of determining which factorial structure would be most appropriate. As a result, the Spanish version of the questionnaire consists of 24 items assigned to three subscales: Competence (8), Satisfaction (10), and Self-determination (6). A new CFA permitted the testing of the appropriate fit between the responses and the new proposed model. Psychometric analyses of these subscales seem to indicate good measurement properties of the new scale.