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Zempel H. Genetic and sporadic forms of tauopathies-TAU as a disease driver for the majority of patients but the minority of tauopathies. Cytoskeleton (Hoboken) 2024; 81:66-70. [PMID: 37795931 DOI: 10.1002/cm.21793] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 09/18/2023] [Accepted: 09/19/2023] [Indexed: 10/06/2023]
Abstract
Ageing-associated tauopathies like frontotemporal dementia (FTD), variants thereof (like progressive supranuclear palsy (PSP), pick diseases (PiD), corticobasal degeneration (CBD)), and of course the most prevalent form of dementia, Alzheimer Disease (AD), are widely recognized forms of tauopathies. The list of tauopathies is expanding. We now include: (i) tauopathies where the disease cause or trigger is clearly either physical, such as in Traumatic Brain Injury (TBI) or Chronic Traumatic Encephalopathy (CTE), and (ii) genetic diseases that result in tauopathy but have pathogenic genetic variants in genes not related to TAU. Examples of the latter are myotonic dystrophy Type 1 and Type 2 (DM1, DM2, due to pathogenic genetic variants in the genes DMPK and CNBP, respectively), Niemann-Pick Disease Type C (NPD, due to mutations in NPC1 or NPC2), Kufs Disease (CLN6), Christianson Syndrome (SLC9A6), familial forms of Parkinson Disease (PD), and many others. In terms of affected brain regions and cell types, intracellular distribution of TAU pathology/aggregates, age of disease onset, velocity of disease progression and spreading of TAU pathology, there is, however, little in common in most of these disease entities. Here, I reason that TAU/MAPT is causative for the minority of tauopathies (e.g., MAPT-related FTD/PSP and Vacuolar Tauopathy (VCP)) and a critical mediator for others, like shown by overwhelming evidence for AD. However, TAU may also be a mere bystander or even protective in other settings. Improved understanding of rare tauopathies is necessary to develop specific treatments, but also to improve our understanding of the pathomechanistic role of TAU and to identify diseases that may profit from TAU-based therapies.
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Affiliation(s)
- Hans Zempel
- Institute of Human Genetics, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
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Alkeridy WA, Al Khalifah RA, Mohammedin AS, Khallaf R, Muayqil T, Bucks RS. The Arabic Translation and Cross-Cultural Adaptation of the Bristol Activity of Daily Living Scale. J Alzheimers Dis 2022; 86:1123-1130. [PMID: 35147542 DOI: 10.3233/jad-215489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There are few Arabic language functional scales for patients with dementia. The Bristol Activity of Daily Living Scale (BADLS) was designed and validated for use in patients with dementia. OBJECTIVE Our study aimed to translate, cross-culturally adapt, and validate the BADLS to the Arabic language for people with neurocognitive decline and dementia. METHODS The original BADLS scale was translated to the Arabic language followed by face validity assessment through a pilot testing in five Arabic countries. The Arabic BADLS was assessed in a sample of 139 participants and their caregivers for concurrent and convergent validity. RESULTS The Arabic BADLS had excellent internal consistency, Cronbach's alpha 0.95 (95% CI 0.93-0.96). Likewise, the Arabic BADLS had strong convergent validity with the Montreal Cognitive Assessment (r = -0.82, p < 0.001). CONCLUSION The Arabic BADLS is a valid scale that can used to assess the functional performance of people living with dementia.
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Affiliation(s)
- Walid A Alkeridy
- Department of Medicine, College of Medicine, King Saud University, Riyadh, Saudi Arabia.,Department of Medicine, Geriatric Division, University of British Columbia, Vancouver, Canada
| | | | - Ahmed S Mohammedin
- Imam Abdulrahman Bin Faisal University, Dammam, Medicine Department Geriatrics Division, Dammam, Saudi Arabia.,Ain Shams University, Geriatrics Department, Cairo, Egypt
| | - Roaa Khallaf
- King Fahad Specialist Hospital Dammam, Department of Medicine, Neurology Division, Dammam, Saudi Arabia
| | - Taim Muayqil
- Neurology Unit, Department of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Romola S Bucks
- School of Psychological Science & School of Population and Global Health, University of Western Australia, Perth, Australia
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Li C, Peng W, Li M, Li X, Yang T, Yan H, Wang Z, Jia X, Hu Z, Wang Y. Exploring the relationship between depression and different multimorbidity patterns among older people covered by long-term care insurance in Shanghai, China. Psychogeriatrics 2022; 22:99-107. [PMID: 34743400 PMCID: PMC9297888 DOI: 10.1111/psyg.12783] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/30/2021] [Accepted: 10/18/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Depression is common in patients with multimorbidity, but little is known about the relationship between depression and multimorbidity. The purpose of our research was to investigate multimorbidity patterns and their association with depression in a sample of older people covered by long-term care insurance in Shanghai, China. METHOD This was a population-based cross-sectional study, with 1871 participants aged ≥60 years old who are covered by Shanghai long-term care insurance. Multimorbidity was defined as the presence of two or more chronic diseases at the same time. We collected information on chronic conditions using a self-reported medical history, and we used the 30-item Geriatric Depression Scale (GDS-30) to evaluate depressive symptoms. Patterns of multimorbidity were identified with exploratory factor analysis, using oblimin rotation. Logistic regression was used to estimate the relationship between multimorbidity patterns and depressive symptoms. RESULTS Among the participants, the prevalence of multimorbidity was 64.7%, and the prevalence of depression was 64.6%. Hypertension, cardiovascular disease, cerebrovascular disease (CVD), and cataracts showed strong associations with depression when co-occurring with other conditions. Three patterns of multimorbidity were identified: a musculoskeletal pattern, cardiometabolic pattern, and degenerative disease pattern. Among these, the cardiometabolic (adjusted odds ratio (AOR) 1.223; 95% confidence interval (CI) 1.102, 1.357) and degenerative disease (AOR 1.185; 95% CI 1.071, 1.311) patterns were associated with a higher risk of depressive symptoms. CONCLUSION Two of three multimorbidity patterns were found to be associated with depression. Physical and psychological dimensions require greater attention in the care of older adults who are covered by long-term care insurance.
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Affiliation(s)
- Cancan Li
- School of Health Service Management, Anhui Medical University, Hefei, China
| | - Wenjia Peng
- Epidemiology and Health Statistics, School of Public Health, Bengbu Medical College, Bengbu, China
| | - Mengying Li
- School of Public Health, Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Xinghui Li
- School of Public Health, Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Tingting Yang
- School of Public Health, Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
| | - Huosheng Yan
- School of Health Service Management, Anhui Medical University, Hefei, China
| | - Zijing Wang
- School of Health Service Management, Anhui Medical University, Hefei, China
| | - Xianjie Jia
- Epidemiology and Health Statistics, School of Public Health, Bengbu Medical College, Bengbu, China
| | - Zhi Hu
- School of Health Service Management, Anhui Medical University, Hefei, China
| | - Ying Wang
- School of Public Health, Key Laboratory of Public Health Safety, NHC Key Laboratory of Health Technology Assessment, Fudan University, Shanghai, China
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Gianella S, Saloner R, Curtin G, Little SJ, Heaton A, Montoya JL, Letendre SL, Marquine MJ, Jeste DV, Moore DJ. A Cross-Sectional Study to Evaluate the Effects of Age and Duration of HIV Infection on Anxiety and Depression in Cisgender Men. AIDS Behav 2022; 26:196-203. [PMID: 34287757 PMCID: PMC8294268 DOI: 10.1007/s10461-021-03373-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2021] [Indexed: 11/27/2022]
Abstract
This observational cross-sectional study of 152 people with HIV (PWH) examined the effects of age and estimated duration of HIV infection (EDI) on depressive and anxiety symptoms. All participants were cisgender men and completed the Profile of Moods State (POMS), a self-report inventory of current (i.e., past week) mood states. Overall, study results confirmed higher levels of anxiety and depression in PWH compared to individuals without HIV. Age group (< 50 or ≥ 50 years) moderated the effect of EDI (< 3 or ≥ 3 years) on mood disturbance. Specifically, younger PWH with early diagnosed infection exhibited the highest levels of depression and anxiety, whereas depression and anxiety were attenuated in older PWH with early infection such that their POMS scores did not significantly differ from the HIV-negative and chronically HIV-infected groups. Despite the small sample size and other important limitations in our study design, our preliminary findings confirm previous observations that older people may have some adaptive ability to better handle the acute psychological stressors associated with recent HIV infection.
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Affiliation(s)
- Sara Gianella
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Drive MC 0679, La Jolla, CA, 92093-0679, USA.
| | - Rowan Saloner
- Department of Psychiatry, University of California San Diego, La Jolla, USA
| | - Genevieve Curtin
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Drive MC 0679, La Jolla, CA, 92093-0679, USA
| | - Susan J Little
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Drive MC 0679, La Jolla, CA, 92093-0679, USA
| | - Anne Heaton
- Department of Psychiatry, University of California San Diego, La Jolla, USA
| | - Jessica L Montoya
- Department of Psychiatry, University of California San Diego, La Jolla, USA
| | - Scott L Letendre
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, 9500 Gilman Drive MC 0679, La Jolla, CA, 92093-0679, USA
- Department of Psychiatry, University of California San Diego, La Jolla, USA
| | - María J Marquine
- Division of Geriatrics, Gerontology and Palliative Care, University of California, La Jolla, USA
| | - Dilip V Jeste
- Department of Psychiatry, University of California San Diego, La Jolla, USA
- Sam and Rose Stein Institute for Research on Aging, University of California San Diego, La Jolla, USA
- Department of Neurosciences, University of California San Diego, La Jolla, USA
| | - David J Moore
- Department of Psychiatry, University of California San Diego, La Jolla, USA
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Chan HJ, Yanshree, Roy J, Tipoe GL, Fung ML, Lim LW. Therapeutic Potential of Human Stem Cell Implantation in Alzheimer's Disease. Int J Mol Sci 2021; 22:10151. [PMID: 34576314 PMCID: PMC8471075 DOI: 10.3390/ijms221810151] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 12/27/2022] Open
Abstract
Alzheimer's disease (AD) is a progressive debilitating neurodegenerative disease and the most common form of dementia in the older population. At present, there is no definitive effective treatment for AD. Therefore, researchers are now looking at stem cell therapy as a possible treatment for AD, but whether stem cells are safe and effective in humans is still not clear. In this narrative review, we discuss both preclinical studies and clinical trials on the therapeutic potential of human stem cells in AD. Preclinical studies have successfully differentiated stem cells into neurons in vitro, indicating the potential viability of stem cell therapy in neurodegenerative diseases. Preclinical studies have also shown that stem cell therapy is safe and effective in improving cognitive performance in animal models, as demonstrated in the Morris water maze test and novel object recognition test. Although few clinical trials have been completed and many trials are still in phase I and II, the initial results confirm the outcomes of the preclinical studies. However, limitations like rejection, tumorigenicity, and ethical issues are still barriers to the advancement of stem cell therapy. In conclusion, the use of stem cells in the treatment of AD shows promise in terms of effectiveness and safety.
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Affiliation(s)
| | | | | | | | | | - Lee Wei Lim
- School of Biomedical, Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China; (H.J.C.); (Y.); (J.R.); (G.L.T.); (M.-L.F.)
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Tak P, Rohilla J, Jhanwar S. Comparison of two screening instruments to detect dementia in Indian elderly subjects in a clinical setting. J Family Med Prim Care 2021; 10:657-661. [PMID: 34041057 PMCID: PMC8138394 DOI: 10.4103/jfmpc.jfmpc_1050_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/09/2020] [Accepted: 09/22/2020] [Indexed: 11/18/2022] Open
Abstract
Objective: Cognitive screening in elderly patients receiving treatment for chronic medical conditions in a busy outpatient clinical setting is crucial to detect dementia at an earlier stage. Although Hindi Mini-Mental State Examination (HMSE) is an established screening tool for the geriatric population in India, but cannot be administered with the informant. Our study aims to compare two screening instruments, Informant based - Eight-item Interview to Differentiate Aging and Dementia (AD8) and HMSE among elderly patients attending medical outpatient service (OPD) in a tertiary care hospital. Method: A total of 776 subjects aged ≥65 years and receiving treatment from medicine OPD in a tertiary care hospital were screened for dementia using AD8 and HMSE. The clinical diagnosis was established after detailed clinical assessment using ICD-10 criterion. Sensitivity and specificity were calculated for both screening tools and ROC curves were plotted considering ICD-10 diagnosis as the gold standard. Results: Comparison of receiver operating characteristic (ROC) curves showed that HMSE (AUC = 0.77) were better than AD8 (AUC = 0.61) in detecting dementia. Although increasing the cut-off value of AD8 from a recommended score of ≥2 to ≥3 improved sensitivity from 35% to 48.9%, high false-positive rate limited its utility as a cognitive screening tool. Conclusion: Although AD8 is easy to use and quickly administered with either patient or informant, it does not seem to be a suitable cognitive screening test for Indian elderly with chronic medical disorders. HMSE at a cut-off score of ≤23 is able to find out dementia among geriatric patients in a busy medical setting.
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Affiliation(s)
- Pinki Tak
- Department of Medicine, Jawaharlal Nehru Medical College, Ajmer, Rajasthan, India
| | - Jitendra Rohilla
- Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Shubham Jhanwar
- Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Waheed W, Mirza N, Waheed MW, Malik A, Panagioti M. Developing and implementing guidelines on culturally adapting the Addenbrooke's cognitive examination version III (ACE-III): a qualitative illustration. BMC Psychiatry 2020; 20:492. [PMID: 33023520 PMCID: PMC7539399 DOI: 10.1186/s12888-020-02893-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 09/24/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Cognitive tests currently used in healthcare and research settings do not account for bias in performance that arises due to cultural context. At present there are no universally accepted steps or minimum criteria for culturally adapting cognitive tests. We propose a methodology for developing specific guidelines to culturally adapt a specific cognitive test and used this to develop guidelines for the ACE-III. We then demonstrated their implementation by using them to produce an ACE-III Urdu for a British South Asian population. METHODS This was a several stage qualitative study. We combined information from our systematic review on the translation and cultural adaptation of the ACE-III with feedback from previous ACE-III adaptors. This identified steps for cultural adaptation. We formatted these into question-by-question guidelines. These guidelines, along with feedback from focus groups with potential users were used to develop ACE-III Urdu questions. Clinical experts reviewed these questions to finalise an ACE-III Urdu. RESULTS Our systematic review found 32 adaptations and we received feedback from seven adaptors to develop the guidelines. With these guidelines and two focus groups with 12 participants a sample ACE-III Urdu was developed. A consensus meeting of two psychiatrists with a South Asian background and familiarity with cognitive tests and cultural adaptation finalised the ACE-III Urdu. CONCLUSIONS We developed a set of guidelines for culturally adapting the ACE-III that can be used by future adaptors for their own language or cultural context. We demonstrated how guidelines on cultural adaptation can be developed for any cognitive test and how they can be used to adapt it.
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Affiliation(s)
- Waquas Waheed
- grid.5379.80000000121662407Centre for Primary Care and Health Services Research, The University of Manchester, Suite 8, 5th Floor, Williamson Building Oxford Road, Manchester, M13 9PL UK
| | - Nadine Mirza
- Centre for Primary Care and Health Services Research, The University of Manchester, Suite 8, 5th Floor, Williamson Building Oxford Road, Manchester, M13 9PL, UK.
| | | | - Abid Malik
- grid.507603.70000 0004 0430 6955Greater Manchester Mental Health NHS Foundation Trust, Salford, UK
| | - Maria Panagioti
- grid.5379.80000000121662407Centre for Primary Care and Health Services Research, The University of Manchester, Suite 8, 5th Floor, Williamson Building Oxford Road, Manchester, M13 9PL UK
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Rong J, Chen G, Wang X, Ge Y, Meng N, Xie T, Ding H. Correlation Between Depressive Symptoms And Quality Of Life, And Associated Factors For Depressive Symptoms Among Rural Elderly In Anhui, China. Clin Interv Aging 2019; 14:1901-1910. [PMID: 31806946 PMCID: PMC6839580 DOI: 10.2147/cia.s225141] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 10/18/2019] [Indexed: 01/20/2023] Open
Abstract
Purpose We aimed to assess the current status of depressive symptoms and quality of life (QoL) among rural elderly in central China (Anhui Province) and explore their correlation and associated factors for depressive symptoms. Methods A multi-stage random sampling method was used to obtain 3349 participants (aged ≥60): 1206 poor and 2143 non-poor. The 30-item Geriatric Depression Scale (GDS-30) and five-dimensional European quality of health scale (EQ-5D) were employed to evaluate depressive symptoms and QoL, respectively. Results The prevalence of depressive symptoms was 52.9%, and that in the poor group (62.3%) was significantly higher than the non-poor group (47.6%). The GDS-30 score was 12.40 ± 7.089, and the poor group scored significantly higher (14.045 ± 6.929) than the non-poor group (11.472 ± 7.011). The EQ-5D score was 0.713 ± 0.186, and the poor group (0.668 ± 0.192) scored significantly lower than the non-poor group (0.738 ± 0.178). There was a significant negative correlation between depressive symptoms and QoL (r = −0.400, P-value <0.05). The following factors were associated with depressive symptoms: poverty, low EQ-5D score, female gender, older age, illiteracy, unemployed, chronic diseases, and hospitalization in previous year. Conclusion Rural elderly in central China have a high prevalence of depressive symptoms and low QoL. Poverty was associated with a higher prevalence of depressive symptoms and lower QoL.
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Affiliation(s)
- Jian Rong
- Department of Health Services Management, School of Health Management, Anhui Medical University, Hefei 230032, People's Republic of China
| | - Guimei Chen
- Department of Health Services Management, School of Health Management, Anhui Medical University, Hefei 230032, People's Republic of China
| | - Xueqin Wang
- Department of Medical Engineering, The Second Hospital of Anhui Medical University, Hefei 230601, People's Republic of China
| | - Yanhong Ge
- Department of Health Services Management, School of Health Management, Anhui Medical University, Hefei 230032, People's Republic of China
| | - Nana Meng
- Department of Health Services Management, School of Health Management, Anhui Medical University, Hefei 230032, People's Republic of China
| | - Tingting Xie
- Department of Health Services Management, School of Health Management, Anhui Medical University, Hefei 230032, People's Republic of China
| | - Hong Ding
- Department of Health Services Management, School of Health Management, Anhui Medical University, Hefei 230032, People's Republic of China
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Mirza N, Panagioti M, Waheed W. Cultural validation of the Addenbrooke's Cognitive Examination Version III Urdu for the British Urdu-speaking population: a qualitative assessment using cognitive interviewing. BMJ Open 2018; 8:e021057. [PMID: 30552243 PMCID: PMC6303692 DOI: 10.1136/bmjopen-2017-021057] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Our research determined whether the Addenbrooke's Cognitive Examination Version III (ACE-III) Urdu eliminated cultural bias through a qualitative assessment of its understanding and acceptability within the British Urdu-speaking population, employing cognitive interviews. METHOD We aimed to recruit 25 participants fluent in speaking and writing Urdu, over the age of 60 years, able to give informed consent and who did not have a history of cognitive impairment. Participants were administered the ACE-III Urdu, and cognitive interviews were conducted, which involve obtaining verbal data on the individual's perception of the assessment overall, their understanding of the mental processes behind how they interpreted questions within the assessment and how they produced appropriate responses. This allows us to gauge the participants' overall thoughts on the Urdu ACE-III before applying question-formatted prompts to every ACE-III Urdu item. RESULTS We recruited 25 participants, 12 women (48%), ranging from ages 60 years to 85 years (M=69.12, SD=6.57), all from Greater Manchester. Participants came from varied socioeconomic backgrounds, with 22 identifying as Pakistani, one as British Pakistani and two as East African. Across 19 ACE-III Urdu items, 7 required changes based on participant feedback: item 5a: fluency; items 6, 18 and 19: memory; items 12 and 13: language; and item 17: visuospatial abilities.The need for some of these changes was realised after 21 participants, due to persistently reoccurring issues, and these were applied before the last four participants. Overall, the ACE-III Urdu was considered easy and straightforward by all 25 participants, who understood items and felt the ACE-III Urdu was appropriate, not just for them, but for British Urdu speakers in general. CONCLUSION Our cognitive interviews determined the ACE-III Urdu was acceptable, especially with regards to cultural context, but further changes were made to ensure understanding. Therefore, we adapted the ACE-III Urdu in accordance with feedback, resulting in our finalised version being culturally validated.
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Affiliation(s)
- Nadine Mirza
- Centre for Primary Care, The University of Manchester, Manchester, UK
| | - Maria Panagioti
- Centre for Primary Care, The University of Manchester, Manchester, UK
| | - Waquas Waheed
- Centre for Primary Care, The University of Manchester, Manchester, UK
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Abstract
BACKGROUND In Turkey, individuals with schizophrenia usually live with their families. Therefore, families are main caregivers and face psychological, financial and social problems. AIM The aim of this study is to understand the personal burdens and coping strategies, and social support affecting the families that provide care to the individuals with schizophrenia. METHODS In-depth interviews were conducted with 31 members of 12 families. RESULTS Four themes were formed: learning and accepting the disorder, caregiving, social dimensions and service dimensions. Families have a problem with accepting this order and caregiving affects their quality of life both financially and socially. As schizophrenia is one of the reasons for being isolated from community, families prefer hiding it. Although families are satisfied with community-based systems, they need long-term solution, training and financial aid. CONCLUSIONS To reduce the burden, family therapies, education and psychological support should be provided for families, and job opportunities, long-term caregiving services and psychological support should be provided for individuals with schizophrenia.
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Affiliation(s)
- Seda Attepe Özden
- 1 Department of Social Work, Faculty of Health Sciences, Baskent University, Ankara, Turkey
| | - Tarık Tuncay
- 2 Department of Social Work, Hacettepe University, Ankara, Turkey
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Abstract
Background Patients with Alzheimer’s disease frequently elicit neuropsychiatric symptoms as well as cognitive deficits. Above all, depression is one of the most common neuropsychiatric symptoms in Alzheimer’s disease but antidepressant drugs have not shown significant beneficial effects on it. Moreover, electroconvulsive therapy has not ensured its safety for potential severe adverse events although it does show beneficial clinical effect. Transcranial direct current stimulation can be the safe alternative of neuromodulation, which applies weak direct electrical current to the brain. Although transcranial direct current stimulation has plausible evidence for its effect on depression in young adult patients, no study has explored it in older subjects with depression in Alzheimer’s disease. Therefore, we present a study protocol designed to evaluate the safety and clinical effect of transcranial direct current stimulation on depression in Alzheimer’s disease in subjects aged over 65 years. Method This is a two-arm, parallel-design, randomized controlled trial, in which patients and assessors will be blinded. Subjects will be randomized to either an active or a sham transcranial direct current stimulation group. Participants in both groups will be evaluated at baseline, immediately, and 2 weeks after the intervention. Discussion This study investigates the safety and effect of transcranial direct current stimulation that may bring a significant impact on both depression and cognition in patients with Alzheimer’s disease, and may be useful to enhance their quality of life. Trial registration ClinicalTrials.gov, NCT02351388. Registered on 27 January 2015. Last updated on 30 May 2016. Electronic supplementary material The online version of this article (doi:10.1186/s13063-017-2019-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Zui Narita
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, Japan.
| | - Yuma Yokoi
- Department of Psychiatry, National Center Hospital, National Center of Neurology and Psychiatry, 4-1-1, Ogawahigashi, Kodaira, Tokyo, Japan
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Radford K, Mack HA, Draper B, Chalkley S, Delbaere K, Daylight G, Cumming RG, Bennett H, Broe GA. Comparison of Three Cognitive Screening Tools in Older Urban and Regional Aboriginal Australians. Dement Geriatr Cogn Disord 2016; 40:22-32. [PMID: 25896073 DOI: 10.1159/000377673] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/03/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Validated cognitive screening tools for use in urban and regional Aboriginal populations in Australia are lacking. METHODS In a cross-sectional community-based study, 235 participants were assessed on the Mini-Mental State Examination (MMSE), the Rowland Universal Dementia Assessment Scale (RUDAS) and an urban modification of the Kimberley Indigenous Cognitive Assessment (mKICA). Performance on these cognitive screening tools was compared to dementia diagnosis by clinical consensus. RESULTS All tests were culturally acceptable with good psychometric properties. Receiver operating characteristic curve analyses revealed that the MMSE and mKICA were the most accurate. CONCLUSION The MMSE is an effective cognitive screening tool in urban Aboriginal populations. The mKICA is a good alternative when illiteracy, language or cultural considerations deem it appropriate. The RUDAS also has adequate validity in this population.
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Affiliation(s)
- Kylie Radford
- Neuroscience Research Australia, University of New South Wales, Sydney, N.S.W., Australia
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Cong L, Dou P, Chen D, Cai L. Depression and Associated Factors in the Elderly Cadres in Fuzhou, China: A Community-based Study. INT J GERONTOL 2015. [DOI: 10.1016/j.ijge.2015.02.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Abstract
OBJECTIVES Little is known about the factors associated with depression among elderly Nigerians despite research evidence suggesting that some correlates of depression may be important in early detection, treatment and prognosis. This study aimed to determine the correlates of depression among a community based elderly population. METHODS The study population made up of 350 consenting participants was selected using multistage stratified random sampling technique. Face-to-face interviews were conducted among the participants using a research instrument consisting of two parts: a self-designed questionnaire to elicit their socio-demographic profile, level of social support as well as their health status and the 30-item Geriatric Depression Scale to diagnose depression using cut-off score ≥11. Both the English and Yoruba versions of the study instruments were used depending on the level of education of the participants. RESULTS Depression was found to be associated with being younger old (χ(2) = 6.19, p = 0.045), prolonged stay in current residence (χ(2) = 6.62, p = 0.01), living in less developed area of the community and not having children (χ(2) = 0.03, p = 0.01), while higher social support (χ(2) = 4.19, p = 0.041) seems protective. However, only low social support (odds ratio [OR] = 0.573; 95% confidence interval [CI], 0.330-0.994; p = 0.048), living in less developed area (OR = 5.342; 95% CI = 1.027, 27.776; p = 0.046) and prolonged stay in current residence (OR = 0.407; 95% CI = 0.205, 0.806; p = 0.01) independently predicted depression in participants. CONCLUSION To enhance early detection and treatment of depressive disorders in the elderly, physicians should be alert to the diagnosis of depression in late life, especially among the younger old, elderly not having children, those with low social support as well as prolonged stay in a residence and living in less developed parts of the community. Further research is needed to shed light on the intriguing link between depression and associated factors in geriatric population.
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Sadanand S, Shivakumar P, Girish N, Loganathan S, Bagepally BS, Kota LN, Reddy NN, Sivakumar PT, Bharath S, Varghese M. Identifying elders with neuropsychiatric problems in a clinical setting. J Neurosci Rural Pract 2013; 4:S24-30. [PMID: 24174794 PMCID: PMC3808056 DOI: 10.4103/0976-3147.116438] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Multiple health problems among the elderly necessitate a comprehensive enquiry to detect problems early and also initiate treatment. We utilized available validated instruments to comprehensively identify older persons with neuro-psychiatric problems including dementia and comorbid medical ailments in the screening desk of the geriatric clinic. MATERIALS AND METHODS Individuals aged 60 years and above seeking outpatient care at NIMHANS during a 2-year period (October 2008-September 2010) participated. We used General Health Questionnaire (12-item), AD8, questions to identify psychoses and neurological problems and a checklist of common medical ailments. A probable clinical diagnosis was made at the end by medical personnel based on ICD-10. RESULTS A total of 5,260 individuals were screened and more than one-third (36.7%) were women. About 50% had psychological distress (≥2 on GHQ-12), 20.1% had probable cognitive impairment (≥2 on AD8) and about 17% had symptoms suggestive of psychoses (≥1 on Psychoses screener). More than 65% had either a neurological or neurosurgical problems (≥1 on Neurological screener) and headache was the commonest complaint. At probable diagnosis, more than 50% had a neurological problem and over 30% had psychiatric disorders. Of these the most common psychiatric illnesses were psychotic disorders (22.0%), mood disorders (21.4%) and dementia (14.4%). The most common medical comorbidity included hypertension (36.4%), visual impairment (31.8%) and joint pains (30.5%). Nearly 80% had one or more medical comorbidity in addition to psychiatric illness. The overall set of instruments took about 15-20 minutes. It systematically and comprehensively guided in evaluating the elderly for neuropsychiatric problems and hence was collated to constitute the Instruments for Comprehensive Evaluation of the Elderly (ICE-E). CONCLUSIONS ICE-E was brief, easy to administer and improved decision making even by personnel from a non-medical background. The instrument aided in systematically detecting neuro-psychiatric problems among the elderly (including psychological distress and cognitive changes) and other medical comorbidities.
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Affiliation(s)
- Shilpa Sadanand
- Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Prafulla Shivakumar
- Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - N Girish
- Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Santosh Loganathan
- Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Lakshmi Narayanan Kota
- Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Nalini Narayana Reddy
- Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences, Bangalore, India
| | | | - Srikala Bharath
- Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences, Bangalore, India
| | - Mathew Varghese
- Geriatric Clinic and Services, National Institute of Mental Health and Neurosciences, Bangalore, India
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Verghese J, Noone ML, Johnson B, Ambrose AF, Wang C, Buschke H, Pradeep VG, Abdul Salam K, Shaji KS, Mathuranath PS. Picture-based memory impairment screen for dementia. J Am Geriatr Soc 2012; 60:2116-20. [PMID: 23039180 DOI: 10.1111/j.1532-5415.2012.04191.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVES To develop and validate a picture-based memory impairment screen (PMIS) for the detection of dementia. DESIGN Cross-sectional. SETTING Outpatient clinics, Baby Memorial Hospital, Kozhikode city in the southern Indian state of Kerala. PARTICIPANTS Three hundred four community-residing adults aged 55 to 94 with a mean education level of 8 years; 65 were diagnosed with dementia. MEASUREMENTS PMIS: a culture-fair picture-based cognitive screen designed to be administered by nonspecialists. Diagnostic accuracy estimates (sensitivity, specificity, positive and negative predictive power) of PMIS cut-scores in detecting dementia (range 0-8). RESULTS PMIS scores were worse in participants with dementia (1.5) than in controls (7.7, P < .001). At the optimal cut-score of 5, PMIS had a sensitivity of 95.4% (95% confidence interval (CI) = 90.3-100.0%) and a specificity of 99.2% (95% CI = 98.0-100.0%) for detecting dementia. In the 167 participants with <10 years of education, PMIS scores of five or less had a sensitivity of 97.8% (95% CI = 93.6-100.0%) and specificity of 99.2% (95% CI = 97.6-100.0%). The PMIS had better specificity than the Mini-Mental State Examination in detecting dementia, especially in older adults with low education. CONCLUSION The PMIS is a brief and reliable screen for dementia in elderly populations with variable literacy rates.
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Affiliation(s)
- Joe Verghese
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York 10461, USA.
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Abstract
OBJECTIVE To explore the help-seeking strategies and the acceptance of services among a national sample of Italian, Greek and Chinese compared to third generation Australians. METHODS A cross-sectional telephone survey of 350 Italian, 414 Greek, 437 Chinese and 500 third generation Australians whose households were randomly selected from the national telephone directory was carried out. Participants were asked how they would seek help for a character in a vignette with dementia and what aged care services they would use. RESULTS The most frequently reported sources of help for all participants were general practitioners (55%), community organisations (27%) and family (26%). Significantly more racial minority participants reported that they would seek help from their families (32%) than did third generation Australians (13%). The percentage of participants who reported they would use aged care services were 96% for day activities, 95% for community nursing, 93% for bus outings, 91% for home help with housework, 88% for carer's support groups, 83% for nursing home care, 78% for one-week respite and 67% for Meals-on-Wheels. Racial minorities were equally or more likely to say that they would use some community-based services than third generation Australians and less likely to use residential respite. Italians were less likely to use permanent residential care. Acculturation parameters were inconsistently associated with help-seeking and service acceptability. CONCLUSIONS Racial minority groups have a greater preference for community services than third generation Australians. There are differences between racial minority groups on help-seeking and acceptability of services. Education and outreach to these groups needs to be tailored.
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Affiliation(s)
- Lee-Fay Low
- Dementia Collaborative Research Centre, School of Psychiatry, University of New South Wales, Sydney, Australia.
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Hunsaker A, Sarles CE, Rosen D, Lingler JH, Johnson MB, Morrow L, Saxton J. Exploring the reasons urban and rural-dwelling older adults participate in memory research. Am J Alzheimers Dis Other Demen 2011; 26:227-34. [PMID: 21343152 DOI: 10.1177/1533317511399569] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study examines how underrepresented older urban and rural-dwelling individuals conceptualize participation in cognitive impairment studies. Nine focus groups were held with urban and rural-dwelling older adults who had participated in a community-based memory screening study. Expected and experienced benefits of research participation were motivators for study participation in all focus groups. Results indicate that participation in memory research was believed to lead to an understanding of memory function. Focus group participants expressed an active interest in research on dementia, and viewed research participation as a way to address memory concerns and provide a benefit to society.
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Affiliation(s)
- Amanda Hunsaker
- School of Social Work, University of Pittsburgh, Pittsburgh, PA, USA.
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LoGiudice D, Strivens E, Smith K, Stevenson M, Atkinson D, Dwyer A, Lautenschlager N, Almeida OA, Flicker L. The KICA Screen: The psychometric properties of a shortened version of the KICA (Kimberley Indigenous Cognitive Assessment). Australas J Ageing 2010; 30:215-9. [DOI: 10.1111/j.1741-6612.2010.00486.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Gao S, Jin Y, Unverzagt FW, Liang C, Hall KS, Ma F, Murrell JR, Cheng Y, Matesan J, Li P, Bian J, Hendrie HC. Correlates of depressive symptoms in rural elderly Chinese. Int J Geriatr Psychiatry 2009; 24:1358-66. [PMID: 19347839 PMCID: PMC2833291 DOI: 10.1002/gps.2271] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Late life depression has been studied in many populations around the world. However, findings on risk factors for late life depression have remained inconsistent. METHODS A cross-sectional survey of 1737 rural Chinese age 65 and over from two provinces in China was conducted assessing cognitive functions using various cognitive instruments and collecting information on demographic characteristics and medical history. Depressive symptoms were assessed using the Geriatric Depression Scale (GDS). Analysis of covariance and logistic regression models were used to identify factors associated with the continuous GDS score, mild or severe depression. RESULTS In this cohort, 26.5% (95% CI: 24.4-28.6%) met the criteria for mild depression and 4.3% (95% CI: 3.4-5.4%) for severely depression. Living alone, history of heart attack, head injury, and fracture were associated with higher depressive symptoms. Alcohol consumption and higher cognitive function were associated with lower depressive symptoms. Living alone, not attended school, history of head injury, fracture, and low cognitive function were associated with increased probability of mild depression. Living alone, history of stroke or heart attack, and low cognitive function were associated with severe depression. CONCLUSIONS Depression, particularly mild depression, is common in rural elderly Chinese. Among a number of factors identified in this cohort as being significantly associated with depressive symptoms, living alone and lower cognitive function were the most consistent factors associated with depressive symptoms, mild and severe depression. History of stroke, heart attack, and fracture were also risk factors for depressive symptoms.
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Affiliation(s)
- Sujuan Gao
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
| | - Yinlong Jin
- Institute for Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Frederick W. Unverzagt
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Chaoke Liang
- Institute for Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Kathleen S. Hall
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Feng Ma
- Institute for Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jill R. Murrell
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Yibin Cheng
- Institute for Environmental Health and Related Product Safety, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Janetta Matesan
- Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Ping Li
- Sichuan Provincial Center for Disease Control and Prevention in China, Chengdu, China
| | - Jianchao Bian
- Shandong Institute for Prevention and Treatment of Endemic Disease in China, Jinan, China
| | - Hugh C. Hendrie
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USA, Indiana University Center for Aging Research, Indianapolis, Indiana, USA, Regenstrief Institute, Inc. Indianapolis, Indiana, USA
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Jitapunkul S, Chansirikanjana S, Thamarpirat J. Undiagnosed dementia and value of serial cognitive impairment screening in developing countries: A population-based study. Geriatr Gerontol Int 2009; 9:47-53. [DOI: 10.1111/j.1447-0594.2008.00501.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Scazufca M, Almeida OP, Vallada HP, Tasse WA, Menezes PR. Limitations of the Mini-Mental State Examination for screening dementia in a community with low socioeconomic status: results from the Sao Paulo Ageing & Health Study. Eur Arch Psychiatry Clin Neurosci 2009; 259:8-15. [PMID: 18560791 DOI: 10.1007/s00406-008-0827-6] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2008] [Accepted: 05/09/2008] [Indexed: 10/21/2022]
Abstract
BACKGROUND The Mini-Mental State Examination (MMSE) is the most widely used instrument for the screening of cognitive impairment worldwide, but its ability to produce valid estimates of dementia in populations of low socioeconomic status and minimal literacy skills has not been adequately established. The authors investigated the psychometric properties of the MMSE in a community-based sample of older Brazilians. METHOD Cross-sectional one-phase population-based study of all residents of pre-defined areas of the city of Sao Paulo, aged 65 years or over. The Brazilian version of the MMSE was compared with DSM-IV diagnosis of dementia assessed with a harmonized one-phase procedure developed by the 10/66 Dementia Research Group. RESULTS Analyses were performed with 1,933 participants of the SPAH study. Receiver operating characteristic analysis showed that the MMSE cut-point of 14/15 was associated with 78.7% sensitivity and 77.8% specificity for the diagnosis of dementia amongst participants with no formal education, and the cut-point 17/18 with 91.9% sensitivity and 89.5% specificity for those with at least 1 year of formal education (areas under the curves 0.87 and 0.94, respectively; P = 0.03). Even with these best fitting cut-points, the MMSE estimate of the prevalence of dementia was four times higher than determined by the DSM-IV criteria. Education, age, sex and income influenced MMSE scores, independently of dementia caseness. CONCLUSION The MMSE is an adequate tool for screening dementia in older adults with minimum literacy skills, but misclassification is unacceptably high for older adults who are illiterate, which has serious consequences for research and clinical practice in low and middle income countries, where the proportion of illiteracy among older adults is high.
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Press Y, Hazzan R, Clarfield AM, Dwolatzky T. A semi-structured computerized screening interview for the assessment of older patients in the primary care setting. ACTA ACUST UNITED AC 2009. [DOI: 10.1515/ijdhd.2009.8.3.259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Peleg R, Press Y, Asher M, Pugachev T, Glicensztain H, Lederman M, Biderman A. An intervention program to reduce the number of hospitalizations of elderly patients in a primary care clinic. BMC Health Serv Res 2008; 8:36. [PMID: 18254972 PMCID: PMC2258297 DOI: 10.1186/1472-6963-8-36] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2007] [Accepted: 02/06/2008] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The elderly population consumes a large share of medical resources in the western world. A significant portion of the expense is related to hospitalizations. OBJECTIVES To evaluate an intervention program designed to reduce the number of hospitalization of elderly patients by a more optimal allocation of resources in primary care. METHODS A multidimensional intervention program was conducted that included the re-engineering of existing work processes with a focus on the management of patient problems, improving communication with outside agencies, and the establishment of a system to monitor quality of healthcare parameters. Data on the number of hospitalizations and their cost were compared before and after implementation of the intervention program. RESULTS As a result of the intervention the mean expenditure per elderly patient was reduced by 22.5%. The adjusted number of hospitalizations/1,000 declined from 15.1 to 10.7 (29.3%). The number of adjusted hospitalization days dropped from 132 to 82 (37.9%) and the mean hospitalization stay declined from 8.2 to 6.7 days (17.9%). The adjusted hospitalization cost ($/1,000 patients) dropped from $32,574 to $18,624 (42.8%). The overall clinic expense, for all age groups, dropped by 9.9%. CONCLUSION Implementation of the intervention program in a single primary care clinic led to a reduction in hospitalizations for the elderly patient population and to a more optimal allocation of healthcare resources.
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Affiliation(s)
- Roni Peleg
- Clalit Health Services, Southern District, Israel
- Department of Family Medicine, Faculty of the Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yan Press
- Clalit Health Services, Southern District, Israel
- Department of Family Medicine, Faculty of the Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Maya Asher
- Clalit Health Services, Southern District, Israel
| | - Tatyana Pugachev
- Clalit Health Services, Southern District, Israel
- Department of Family Medicine, Faculty of the Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | | | | | - Aya Biderman
- Clalit Health Services, Southern District, Israel
- Department of Family Medicine, Faculty of the Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Baiyewu O, Smith-Gamble V, Lane KA, Gureje O, Gao S, Ogunniyi A, Unverzagt FW, Hall KS, Hendrie HC. Prevalence estimates of depression in elderly community-dwelling African Americans in Indianapolis and Yoruba in Ibadan, Nigeria. Int Psychogeriatr 2007; 19:679-89. [PMID: 17506912 PMCID: PMC2855127 DOI: 10.1017/s1041610207005480] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2007] [Accepted: 03/15/2007] [Indexed: 11/07/2022]
Abstract
BACKGROUND This is a community-based longitudinal epidemiological comparative study of elderly African Americans in Indianapolis and elderly Yoruba in Ibadan, Nigeria. METHOD A two-stage study was designed in which community-based individuals were first screened using the Community Screening Interview for Dementia. The second stage was a full clinical assessment, which included use of the Geriatric Depression Scale, of a smaller sub-sample of individuals selected on the basis of their performance in the screening interview. Prevalence of depression was estimated using sampling weights according to the sampling stratification scheme for clinical assessment. RESULTS Some 2627 individuals were evaluated at the first stage in Indianapolis and 2806 in Ibadan. All were aged 69 years and over. Of these, 451 (17.2%) underwent clinical assessment in Indianapolis, while 605 (21.6%) were assessed in Ibadan. The prevalence estimates of both mild and severe depression were similar for the two sites (p=0.1273 and p=0.7093): 12.3% (mild depression) and 2.2% (severe depression) in Indianapolis and 19.8% and 1.6% respectively in Ibadan. Some differences were identified in association with demographic characteristics; for example, Ibadan men had a significantly higher prevalence of mild depression than Indianapolis men (p<0.0001). Poor cognitive performance was associated with significantly higher rates of depression in Yoruba (p=0.0039). CONCLUSION Prevalence of depression was similar for elderly African Americans and Yoruba despite considerable socioeconomic and cultural differences between these populations.
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Affiliation(s)
- Olusegun Baiyewu
- Department of Psychiatry, College of Medicine, University of Ibadan, Nigeria
| | - Valerie Smith-Gamble
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, U.S.A
| | - Kathleen A. Lane
- Department of Medicine, Indiana University School of Medicine, Indianapolis, U.S.A
| | - Oye Gureje
- Department of Psychiatry, College of Medicine, University of Ibadan, Nigeria
| | - Sujuan Gao
- Department of Medicine, Indiana University School of Medicine, Indianapolis, U.S.A
| | - Adesola Ogunniyi
- Department of Medicine, College of Medicine, University of Ibadan, Nigeria
| | | | - Kathleen S. Hall
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, U.S.A
| | - Hugh C. Hendrie
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, U.S.A
- Indiana University Center for Aging Research, Regenstrief Institute, Indianapolis, U.S.A
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Carnero-Pardo C, Gurpegui M, Sanchez-Cantalejo E, Frank A, Mola S, Barquero MS, Montoro-Rios MT. Diagnostic accuracy of the Eurotest for dementia: a naturalistic, multicenter phase II study. BMC Neurol 2006; 6:15. [PMID: 16606455 PMCID: PMC1459198 DOI: 10.1186/1471-2377-6-15] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2006] [Accepted: 04/10/2006] [Indexed: 11/30/2022] Open
Abstract
Background Available screening tests for dementia are of limited usefulness because they are influenced by the patient's culture and educational level. The Eurotest, an instrument based on the knowledge and handling of money, was designed to overcome these limitations. The objective of this study was to evaluate the diagnostic accuracy of the Eurotest in identifying dementia in customary clinical practice. Methods A cross-sectional, multi-center, naturalistic phase II study was conducted. The Eurotest was administered to consecutive patients, older than 60 years, in general neurology clinics. The patients' condition was classified as dementia or no dementia according to DSM-IV diagnostic criteria. We calculated sensitivity (Sn), specificity (Sp) and area under the ROC curves (aROC) with 95% confidence intervals. The influence of social and educational factors on scores was evaluated with multiple linear regression analysis, and the influence of these factors on diagnostic accuracy was evaluated with logistic regression. Results Sixteen neurologists recruited a total of 516 participants: 101 with dementia, 380 without dementia, and 35 who were excluded. Of the 481 participants who took the Eurotest, 38.7% were totally or functionally illiterate and 45.5% had received no formal education. Mean time needed to administer the test was 8.2+/-2.0 minutes. The best cut-off point was 20/21, with Sn = 0.91 (0.84–0.96), Sp = 0.82 (0.77–0.85), and aROC = 0.93 (0.91–0.95). Neither the scores on the Eurotest nor its diagnostic accuracy were influenced by social or educational factors. Conclusion This naturalistic and pragmatic study shows that the Eurotest is a rapid, simple and useful screening instrument, which is free from educational influences, and has appropriate internal and external validity.
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Affiliation(s)
| | - Manuel Gurpegui
- Department of Psychiatry and Institute of Neurosciences, Universidad de Granada, Spain
| | | | - Ana Frank
- Hospital Universitario La Paz, Madrid, Spain
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