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Chithiramohan T, Santhosh S, Threlfall G, Hull L, Mukaetova-Ladinska EB, Subramaniam H, Beishon L. Culture-Fair Cognitive Screening Tools for Assessment of Cognitive Impairment: A Systematic Review. J Alzheimers Dis Rep 2024; 8:289-306. [PMID: 38405352 PMCID: PMC10894602 DOI: 10.3233/adr-230194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/17/2024] [Indexed: 02/27/2024] Open
Abstract
Background Cognitive screening tools are important in the detection of dementia, including Alzheimer's disease; however, they may contain cultural biases. Objective This review examines culture-fair cognitive screening tools and evaluates their screening accuracy, strengths, and limitations. Methods Medline, Embase, PsychINFO and CINAHL were searched. The protocol was registered on PROSPERO (CRD42021288776). Included studies used a culture-fair tool to assess cognition in older adults from varying ethnicities. Narrative synthesis was conducted. Results 28 studies were included assessing eleven different tools. The Rowland Universal Dementia Assessment Scale (RUDAS) was as accurate as the Mini-Mental State Examination (MMSE) (AUC 0.62-0.93), with a similar sensitivity (52-94%) and better specificity (70-98%), and the Multicultural Cognitive Examination (MCE) had improved screening accuracy (AUC 0.99) compared to RUDAS (AUC 0.92). The Visual Cognitive Assessment Test (VCAT) was equivalent to MMSE (AUC 0.84-0.91). The Kimberley Indigenous Cognitive Assessment tool (KICA) had AUC of 0.93-0.95; sensitivity of 90.6%, specificity 92.6%. Conclusions The RUDAS, KICA and VCAT were superior to MMSE for screening dementia in ethnic minorities. Other tools also showed good screening accuracy. Further research should be done to validate tools in different populations.
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Affiliation(s)
| | | | | | - Louise Hull
- Library and Information Service, University Hospitals of Leicester NHS Trust, Leicester, UK
| | - Elizabeta B. Mukaetova-Ladinska
- Leicestershire Partnership NHS Trust, Leicester UK
- Department of Psychology and Visual Sciences, University of Leicester, Leicester, UK
| | | | - Lucy Beishon
- University of Leicester, Department of Cardiovascular Sciences, Leicester, UK
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Sepúlveda-Ibarra C, Chaparro FH, Marcotti A, Soto G, Slachevsky A. Normalization of Rowland Universal Dementia Assessment Scale (RUDAS) in Chilean older people. Dement Neuropsychol 2023; 17:e20230033. [PMID: 38089173 PMCID: PMC10715235 DOI: 10.1590/1980-5764-dn-2023-0033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 09/12/2023] [Indexed: 02/01/2024] Open
Abstract
Rowland Universal Dementia Assessment Scale (RUDAS) is a cognitive screening that evaluates older people with low educational levels. In Chile, there are no normative data to assess this population. Objective To obtain normative data on RUDAS in older Chilean people with up to 12 years of schooling, and to determine whether age and schooling years influence a person's performance on RUDAS and on the items that constitute it. Methods A group of cognitively healthy people 60 years old or over, with up to 12 schooling years was evaluated (n=135). Multiple regression models were applied to obtain normative data on RUDAS, according to age and schooling years, and to measure the effects of schooling on different items. Results Regression analysis showed that none of the items had schooling as a significant predictor, except for the visuoconstruction item. The variables age and schooling explained 12.6% (R^2=0.126) of the RUDAS total score variance. The item visuoconstruction was the most associated with the educational level (OR=1,147). Conclusion This study showed that RUDAS is a recommended instrument for evaluating older people with low educational levels. However, more studies are needed to prove the validity of the RUDAS on Chilean older people.
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Affiliation(s)
- Consuelo Sepúlveda-Ibarra
- Universidad Bernardo O’Higgins, Facultad de Ciencias de la Salud, Escuela de Fonoaudiología, Santiago, Chile
- Universidad de Chile, Facultad de Filosofía y Humanidades, Santiago, Chile
| | - Fernando Henríquez Chaparro
- Geroscience Center for Brain Health and Metabolism, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Program Institute of Biomedical Sciences, Neuroscience and East Neuroscience Departments, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Hospital del Salvador Neurology Department, Memory and Neuropsychiatric Center, Santiago, Chile
- Pontificia Universidad Católica de Chile, Facultad de Medicina, Laboratorio de Neurociencia Cognitiva y Evolutiva, Santiago, Chile
| | - Anthony Marcotti
- Universidad San Sebastián, Facultad de Odontología y Ciencias de la Rehabilitación, Escuela de Fonoaudiología, Santiago, Chile
- Pontificia Universidad Católica de Chile, Facultad de Ciencias Sociales, Escuela de Psicología, Programa de Doctorado en Psicología, Santiago, Chile
| | - Guillermo Soto
- Universidad de Chile, Facultad de Filosofía y Humanidades, Santiago, Chile
| | - Andrea Slachevsky
- Geroscience Center for Brain Health and Metabolism, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Neuropsychology and Clinical Neuroscience Laboratory, Physiopathology Program Institute of Biomedical Sciences, Neuroscience and East Neuroscience Departments, Santiago, Chile
- Universidad de Chile, Faculty of Medicine, Hospital del Salvador Neurology Department, Memory and Neuropsychiatric Center, Santiago, Chile
- Clínica Alemana-Universidad del Desarrollo, Departamento de Medicina, Servicio de Neurología, Santiago, Chile
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Herrera-Perez E, Custodio N, Diaz M, Montesinos R, Chang A, Villafuerte M, Lanata S. Epidemiology of neurocognitive disorders in adults from urban-marginalized areas: a door-to-door population-based study in Puente Piedra, Lima, Peru. Front Public Health 2023; 11:1228008. [PMID: 37927880 PMCID: PMC10622761 DOI: 10.3389/fpubh.2023.1228008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
Background In Latin America (LA), the prevalence of dementia is expected to triple to 150 million people by 2050. The 2020 Lancet Commission report identified several modifiable dementia risk factors, yet few social and environmental factors, most relevant to vulnerable regions of LA, were highlighted in this report. We sought to assess the epidemiology of neurocognitive disorders (NCD) in Puente Piedra, one of the most socially and economically vulnerable districts of Lima, the capital of Peru. Methodology This was a cross-sectional door-to-door observational study that used two-stage household sampling. One young adult (30-59 years) and one older adult (>60 years) per household were enrolled. We collected demographic, clinical, and neurocognitive data. Addenbrooke's Cognitive Examination (young adults) and the RUDAS-PE (older adults) were used, classifying participants as cognitively normal, possible mild NCD, or possible major NCD. Results We enrolled 247 participants (median age 46 years; 67% female). One-fourth had not completed secondary school and more than 50% completed only secondary school. Most participants were housewives (46%) and 21% did not have health insurance. The overall prevalence of possible NCD was 30% (25.6 and 41.8% among younger adults and older adults, respectively). Among younger adults, those ages 55-59 years more frequently had NCD (70%) compared to younger age ranges. Among older adults, only 3 subjects (4.5%) had major NCD. Conclusion We found a high frequency of possible NCDs in a socially and economically vulnerable community in Lima, Peru, with younger adults showing levels of NCD higher than expected. Our findings support the need for health systems to incorporate cognitive screenings programs for NCD in younger ages. Future research on NCD would include younger populations, particularly in vulnerable communities.
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Affiliation(s)
- Eder Herrera-Perez
- Vicerrectorado de Investigación, Universidad San Ignacio de Loyola, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Centro de Excelencia en Biotecnología e Investigación Traslacional, Lima, Peru
| | - Nilton Custodio
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
| | - Monica Diaz
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Rosa Montesinos
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Alexandra Chang
- Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | | | - Serggio Lanata
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, United States
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Validation of the Rowland Universal Dementia Assessment Scale in Indonesia: Preliminary Evidence. J Cross Cult Gerontol 2023; 38:83-95. [PMID: 36795256 DOI: 10.1007/s10823-023-09472-8] [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: 02/07/2023] [Indexed: 02/17/2023]
Abstract
The South-East Asia region has one of the fastest-growing aging populations, for which standardized dementia screening measures will be essential for geriatric care. The Rowland Universal Dementia Assessment Scale (RUDAS) is adopted for use in the Indonesian setting but lacks evidence of its cross-cultural transportability. This study aimed to examine the reliability and validity of scores from the Rowland Universal Dementia Assessment Scale (RUDAS) in the Indonesian setting. Indonesian older adults from a geriatric nursing center (N = 135; 52 males, 83 females; age range 60-82) completed the Indonesian translation of the RUDAS (RUDAS-Ina), following content adaptation study with community living older adults (N = 35), nine neurologists and two geriatric nurses. For face and content validity, we utilized a consensus-building procedure. Results following confirmatory factor analysis yielded a single-factor model. The reliability of scores from the RUDAS-Ina was marginally satisfactory for research purposes (Cronbach α = 0.61). Multi-level linear regression for examining the association of the RUDAS-Ina scores with gender and age indicated older age to be associated with lower RUDAS-Ina scores. In contrast, the association with gender was not significant. Findings suggest a need to develop and validate locally generated items with cultural sensitivity to the Indonesian setting, which may also be studied in other Southeast Asian countries.
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Custodio N, Malaga M, Chambergo-Michilot D, Montesinos R, Moron E, Vences MA, Huilca JC, Lira D, Failoc-Rojas VE, Diaz MM. Combining visual rating scales to identify prodromal Alzheimer's disease and Alzheimer's disease dementia in a population from a low and middle-income country. Front Neurol 2022; 13:962192. [PMID: 36119675 PMCID: PMC9477244 DOI: 10.3389/fneur.2022.962192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 08/04/2022] [Indexed: 11/13/2022] Open
Abstract
Background Many low- and middle-income countries, including Latin America, lack access to biomarkers for the diagnosis of prodromal Alzheimer's Disease (AD; mild cognitive impairment due to AD) and AD dementia. MRI visual rating scales may serve as an ancillary diagnostic tool for identifying prodromal AD or AD in Latin America. We investigated the ability of brain MRI visual rating scales to distinguish between cognitively healthy controls, prodromal AD and AD. Methods A cross-sectional study was conducted from a multidisciplinary neurology clinic in Lima, Peru using neuropsychological assessments, brain MRI and cerebrospinal fluid amyloid and tau levels. Medial temporal lobe atrophy (MTA), posterior atrophy (PA), white matter hyperintensity (WMH), and MTA+PA composite MRI scores were compared. Sensitivity, specificity, and area under the curve (AUC) were determined. Results Fifty-three patients with prodromal AD, 69 with AD, and 63 cognitively healthy elderly individuals were enrolled. The median age was 75 (8) and 42.7% were men. Neither sex, mean age, nor years of education were significantly different between groups. The MTA was higher in patients with AD (p < 0.0001) compared with prodromal AD and controls, and MTA scores adjusted by age range (p < 0.0001) and PA scores (p < 0.0001) were each significantly associated with AD diagnosis (p < 0.0001) but not the WMH score (p=0.426). The MTA had better performance among ages <75 years (AUC 0.90 [0.85–0.95]), while adjusted MTA+PA scores performed better among ages>75 years (AUC 0.85 [0.79–0.92]). For AD diagnosis, MTA+PA had the best performance (AUC 1.00) for all age groups. Conclusions Combining MTA and PA scores demonstrates greater discriminative ability to differentiate controls from prodromal AD and AD, highlighting the diagnostic value of visual rating scales in daily clinical practice, particularly in Latin America where access to advanced neuroimaging and CSF biomarkers is limited in the clinical setting.
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Affiliation(s)
- Nilton Custodio
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Peru
- *Correspondence: Nilton Custodio
| | - Marco Malaga
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- San Martin de Porres University, Lima, Peru
| | - Diego Chambergo-Michilot
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Universidad Científica del Sur, Lima, Peru
| | - Rosa Montesinos
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Elizabeth Moron
- Departamento de Radiología, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima, Peru
- Servicio de Radiología, Centro de Diagnóstico por Imagen-DPI, Lima, Peru
| | - Miguel A. Vences
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Departamento de Neurología, Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima, Peru
| | - José Carlos Huilca
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Servicio de Neurología, Hospital Guillermo Kaelin de La Fuente, Lima, Peru
| | - David Lira
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Virgilio E. Failoc-Rojas
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Centro de Investigación en Medicina Traslacional, Universidad Privada Norbert Wiener, Lima, Peru
| | - Monica M. Diaz
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
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Cheng Y, Zhang Y, Zhang Y, Wu YH, Zhang S. Reliability and validity of the Rowland Universal Dementia Assessment Scale for patients with traumatic brain injury. APPLIED NEUROPSYCHOLOGY. ADULT 2022; 29:1160-1166. [PMID: 33321049 DOI: 10.1080/23279095.2020.1856850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective and accurate cognitive assessment scales are essential for guiding cognitive rehabilitation following traumatic brain injury (TBI). The aim of this study was to evaluate the reliability and validity of the Rowland Universal Dementia Assessment Scale (RUDAS) for TBI and to verify the clinical application value. Fifty patients with TBI and 32 matched controls were assessed using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and a newly developed Chinese version of RUDAS. These scales were then compared for internal consistency, inter-rater reliability, test‒retest reliability, content validity, construct validity, and diagnostic efficacy. Among the TBI group, the RUDAS demonstrated acceptable internal consistency (Cronbach's α = 0.733), high inter-rater reliability (intraclass correlation coefficients [ICCs] of 0.910‒0.999), and high test‒retest reliability (total score ICC = 0.938). The correlation coefficients between RUDAS total score and individual subscores were all > 0.5 except for body orientation (r = 0.363), indicating generally good content validity. Total RUDAS scores were moderately correlated with both MMSE total scores (r = 0.701, p < 0.001) and MoCA total scores (r = 0.778, p < 0.001), indicating good construct validity. Receiving operating characteristic curve analysis yielded comparable areas under the curve for diagnostic efficacy (RUDAS, 0.844; MMSE, 0.769; MoCA, 0.824; all p > 0.05). A RUDAS score cutoff of 23.5 distinguished TBI patients from controls with 60% sensitivity and 100% specificity. Therefore, the RUDAS demonstrates both good reliability and validity for evaluating cognitive impairments in TBI patients.
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Affiliation(s)
- Yun Cheng
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.,Department of Rehabilitation Medicine, School of Clinical Medicine, Soochow University, Soochow, China
| | - Yu Zhang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Yi Zhang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Ye-Huan Wu
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China
| | - Shuang Zhang
- Department of Rehabilitation Medicine, The Third Affiliated Hospital of Soochow University, Changzhou, China.,Department of Rehabilitation Medicine, School of Clinical Medicine, Soochow University, Soochow, China
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Torkpoor R, Frolich K, Nielsen RT, Londos E. Diagnostic Accuracy of the Swedish Version of the Rowland Universal Dementia Assessment Scale (RUDAS-S) for Multicultural Cognitive Screening in Swedish Memory Clinics. J Alzheimers Dis 2022; 89:865-876. [PMID: 35964182 PMCID: PMC9535584 DOI: 10.3233/jad-220233] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: The number of people with a migration background and dementia is increasing in Europe. All patients with suspected dementia have the right to an appropriate cognitive assessment and correct diagnosis for optimal treatment and support. Rowland Universal Dementia Assessment Scale (RUDAS) cognitive screening instrument is less affected by language, culture, and educational background, and adapted for use in multicultural populations. Objective: To compare the diagnostic accuracy of RUDAS-S to the Swedish version of Mini-Mental State Examination (MMSE-SR) for detecting dementia in a multicultural group of outpatients in Swedish memory clinics. Methods: We tested 123 outpatients (36 nonnative Swedish), in 4 memory clinics in Southern Sweden with RUDAS-S to supplement the usual cognitive assessment. Results: RUDAS-S had moderate to good diagnostic performance for detecting dementia in a multicultural population in Sweden, with an area under the receiver operating characteristic curve (AUC) of 0.81. At a cutoff score <25 its sensitivity was 0.92, specificity 0.60, and accuracy 76%. The AUC for the MMSE-SR was 0.79. At a cutoff score <23 its sensitivity was 0.65, specificity 0.81, and accuracy 73%. Conclusion: RUDAS-S is at least as accurate as MMSE-SR for detecting dementia in memory clinics in Sweden and can be used for all patients undergoing a cognitive assessment, irrespective of their cultural, language, and educational background. However, there is a need for other cross-cultural cognitive tests to complement RUDAS-S to extend cognitive examination.
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Affiliation(s)
- Rozita Torkpoor
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.,Memory Clinic, Skane University Hospital, Malmö, Sweden
| | - Kristin Frolich
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Rune T Nielsen
- Danish Dementia Research Center, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Elisabet Londos
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Lund, Sweden.,Memory Clinic, Skane University Hospital, Malmö, Sweden
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Caldichoury N, Soto-Añari M, Camargo L, Porto MF, Herrera-Pino J, Shelach S, Rivera-Fernández C, Ramos-Henderson M, Gargiulo PA, López N. Clinical utility of Phototest via teleneuropsychology in Chilean rural older adults. Dement Neuropsychol 2022; 16:316-323. [PMID: 36619838 PMCID: PMC9762386 DOI: 10.1590/1980-5764-dn-2021-0082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 01/11/2023] Open
Abstract
The COVID-19 pandemic has shown the need for neuropsychological care for older adults with memory complaints in different contexts, including rural areas or areas with difficult access. Objective This study aimed to analyze the clinical utility of the Phototest, through telemedicine, to identify mild cognitive impairment in rural older adults with memory complaints, during the COVID-19 pandemic. Methods We performed a cross-sectional, case-control, and clinical utility comparison of brief cognitive tests (BCTs). The sample included 111 rural elderly people with mild cognitive impairment (MCI) and 130 healthy controls from the Los Lagos region, Chile. The instruments adopted were modified Mini-Mental State Examination (MMSEm) and adapted version of the Phototest (PT) for Chile. Results To identify mild cognitive impairment, using a cutoff score of 27-28 points, the Phototest showed a sensitivity of 96.6% and a specificity of 81.8%; indicators superior to those of the MMSEm. Conclusions The Phototest is more accurate than the MMSEm in identifying cognitive alterations in rural older adults with cognitive memory complaints through telemedicine. Therefore, its use in primary care is recommended in order to perform early detection of preclinical cognitive alterations in mild cognitive impairment or neurodegenerative diseases.
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Affiliation(s)
- Nicole Caldichoury
- Universidad de Los Lagos, Departamento de Ciencias Sociales, Osorno,
Chile
| | - Marcio Soto-Añari
- Universidad Católica San Pablo, Laboratorio de Neurociencia,
Arequipa, Perú
| | - Loida Camargo
- Universidad del Sinú, Facultad de Medicina, Cartagena de Indias,
Colombia
| | - María Fernanda Porto
- Universidad de la Costa, Departamento de Ciencias Sociales,
Barranquilla, Colombia
| | | | - Salomón Shelach
- Universidad Católica San Pablo, Laboratorio de Neurociencia,
Arequipa, Perú
| | | | - Miguel Ramos-Henderson
- Universidad Santo Tomás, Facultad De Salud, Centro de Investigación
e Innovación en Gerontología Aplicada, Antofagasta, Chile
| | - Pascual Angel Gargiulo
- Universidad Nacional de Cuyo, Facultad de Ciencias Médicas,
Departamento de Patología, Laboratorio de Neurociencias y Psicología Experimental,
Mendoza, Argentina
| | - Norman López
- Universidad de la Costa, Departamento de Ciencias Sociales,
Barranquilla, Colombia
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Daniel B, Agenagnew L, Workicho A, Abera M. Validation of the Rowlands Universal Dementia Assessment Scale (RUDAS) to detect major neurocognitive disorder among elderly people in Ethiopia, 2020. PLoS One 2022; 17:e0262483. [PMID: 35051198 PMCID: PMC8775314 DOI: 10.1371/journal.pone.0262483] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 12/24/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The Rowland Universal Dementia Assessment Scale (RUDAS) is currently widely used for research and clinical purposes in many countries. However, its applicability and validity have not been evaluated in the Ethiopian context so far. Therefore, we designed this study to assess the reliability and validity of Rowland Universal Dementia Assessment Scale to detect major neurocognitive disorder among older people in Ethiopia. METHODS An institution-based cross-sectional study was conducted among selected older people residing in Macedonia institutional care center, Addis Ababa, Ethiopia. The gold standard diagnosis was determined using the Diagnostic and Statistical Manual of Mental Disorders criteria for major neurocognitive disorders. Stata v16 statistical software was used for data analysis. Receivers operating curve analysis, correlations, linear regression, and independent t-test were performed with statistically significant associations declared at a p-value of <0.05. Inter-rater, internal consistency reliabilities, content, criterion and construct validities were also determined. RESULTS A total of 116 individuals participated in the study with a 100% response rate. Most (52.7%) of the participants were male and the mean age in years was 69.9± 8. The Cronbach's alpha for RUDAS was 0.7 with an intra-class correlation coefficient value of 0.9. RUDAS has an area under the receivers operating curve of 0.87 with an optimal cutoff value of ≤ 22. At this cutoff point, RUDAS has sensitivity and specificity of 92.3 and 75.3 with positive and negative likelihood ratios as well as positive and negative predictive values of 3.7, 0.1, 65.5%, and 91.5%, respectively. There has also been a significant difference in the mean scores of RUDAS among the two diagnostic groups showing good construct validity. CONCLUSION The Rowland Universal Dementia Assessment Scale has been demonstrated to be a valid and reliable tool to detect major neurocognitive disorder. Policy makers and professionals can incorporate the tool in clinical and research practices in developing countries.
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Affiliation(s)
- Beniam Daniel
- Department of Psychiatry, Institute of Health, Jimma University, Jimma, Ethiopia
- * E-mail:
| | - Liyew Agenagnew
- Department of Psychiatry, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Abdulhalik Workicho
- Department of Epidemiology, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Mubarek Abera
- Department of Psychiatry, Institute of Health, Jimma University, Jimma, Ethiopia
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Custodio N, Montesinos R, Cruzado L, Alva-Díaz C, Failoc-Rojas VE, Celis V, Cuenca-Alfaro J, Lira D. Comparative study of the word capacity and episodic memory of patients with degenerative dementia. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2022; 51:8-16. [PMID: 35210208 DOI: 10.1016/j.rcpeng.2020.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 09/03/2020] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Although the absence of memory impairment was considered among the diagnostic criteria to differentiate Alzheimer's disease (AD) from Behavioural Variant of Frontotemporal Dementia (bvFTD), current and growing evidence indicates that a significant percentage of cases of bvFTD present with episodic memory deficits. In order to compare the performance profile of the naming capacity and episodic memory in patients with AD and bvFTD the present study was designed. METHODS Cross-sectional and analytical study with control group (32 people). The study included 42 people with probable AD and 22 with probable bvFTD, all over 60 years old. Uniform Data Set instruments validated in Spanish were used: Multilingual Naming Test (MINT), Craft-21 history and Benson's complex figure, among others. RESULTS A higher average age was observed among the patients with AD. The naming capacity was much lower in patients with bvFTD compared to patients with AD, measured according to the MINT and the nouns/verbs naming coefficient. All patients with bvFTD, 73.81% of those with AD and only 31.25% of the control group failed to recognise Benson's complex figure. All differences were statistically significant (p < 0.001). RESULTS This study confirms the amnesic profile of patients with AD and reveals the decrease in naming capacity in patients with bvFTD, an area of language that is typically affected early on with executive functions, according to recent findings. CONCLUSIONS Patients with AD perform worse in verbal and visual episodic memory tasks, while patients with bvFTD perform worse in naming tasks. These findings open the possibility of exploring the mechanisms of prefrontal participation in episodic memory, typically attributed to the hippocampus.
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Affiliation(s)
- Nilton Custodio
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Peru; Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Peru; Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru.
| | - Rosa Montesinos
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Peru; Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru; Servicio de Rehabilitación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Lizardo Cruzado
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Peru; Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru; Servicio de Psiquiatría, Instituto Peruano de Neurociencias, Lima, Peru; Sección Psiquiatría y Salud Mental, Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Carlos Alva-Díaz
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru; Universidad Científica del Sur, Facultad de Ciencias de la Salud, Lima, Peru; Servicio de Neurología, Departamento de Medicina y Oficina de Apoyo a la Docencia e Investigación (OADI), Hospital Daniel Alcides Carrión, Callao, Peru
| | - Virgilio E Failoc-Rojas
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru; Universidad San Ignacio de Loyola, Lima, Peru
| | - Violeta Celis
- Servicio de Neurología, Hospital Belén, Trujillo, Peru
| | - José Cuenca-Alfaro
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Peru; Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru; Facultad de Ciencias de la Salud, Departamento de Psicología, Universidad Privada del Norte, Lima, Peru
| | - David Lira
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Peru; Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Peru; Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
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Montesinos R, Parodi JF, Diaz MM, Herrera-Perez E, Valeriano-Lorenzo E, Soto A, Delgado C, Slachevsky A, Custodio N. Validation of Picture Free and Cued Selective Reminding Test for Illiteracy in Lima, Peru. Am J Alzheimers Dis Other Demen 2022; 37:15333175221094396. [PMID: 35465730 PMCID: PMC10581140 DOI: 10.1177/15333175221094396] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Dementia in Latin America is a crucial public health problem. Identifying brief cognitive screening (BCS) tools for the primary care setting is crucial, particularly for illiterate individuals. We evaluated tool performance characteristics and validated the free and total recall sections of the Free and Cued Selective Reminding Test-Picture version (FCSRT-Picture) to discriminate between 63 patients with early Alzheimer's disease dementia (ADD), 60 amnestic mild cognitive impairment (aMCI) and 64 cognitively healthy Peruvian individuals with illiteracy from an urban area. Clinical, functional, and cognitive assessments were performed. FCSRT-Picture performance was assessed using receiver operating characteristic curve analyses. The mean ± standard deviation scores were 7.7 ± 1.0 in ADD, 11.8 ± 1.6 in aMCI, and 29.5 ± 1.8 in controls. The FCSRT-Picture had better performance characteristics for distinguishing controls from aMCI compared with several other BCS tools, but similar characteristics between controls and early ADD. The FCSRT-Picture is a reliable BCS tool for illiteracy in Peru.
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Affiliation(s)
- Rosa Montesinos
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Perú
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Perú
| | - Jose F. Parodi
- Centro de Investigación del Envejecimiento, Facultad de Medicina, Universidad de San Martín de Porres, Lima, Perú
| | - Monica M. Diaz
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Eder Herrera-Perez
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Perú
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Perú
- Grupo de Investigación Molident, Universidad San Ignacio de Loyola, Lima, Perú
| | - Elizabeth Valeriano-Lorenzo
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Perú
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Perú
- Faculty of Psychology, Autonomous University of Madrid, Madrid, Spain
| | - Ambar Soto
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago, Chile
| | - Carolina Delgado
- Departamento de Neurología y Neurocirugía, Hospital Clínico Universidad de Chile, Santiago, Chile
- Departamento de neurociencia, Facultad de medicina Universidad de Chile, Santiago, Chile
| | - Andrea Slachevsky
- Neuropsychology and Clinical Neuroscience Laboratory (LANNEC), Physiopathology Department, ICBM, Neurosciences and East Neuroscience Departments, University of Chile School of Medicine, Santiago, Chile
- Geroscience Center for Brain Health and Metabolism (GERO), University of Chile School of Medicine, Santiago, Chile
- Memory and Neuropsychiatric Clinic (CMYN), Neurology Department, Del Salvador Hospital and University of Chile School of Medicine, Santiago, Chile
- Neurology Unit, Department of Medicine, Alemana Clinic, Universidad del Desarrollo, Santiago, Chile
| | - Nilton Custodio
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Perú
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Perú
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Perú
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Perú
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12
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Can RUDAS Be an Alternate Test for Detecting Mild Cognitive Impairment in Older Adults, Thailand? Geriatrics (Basel) 2021; 6:geriatrics6040117. [PMID: 34940342 PMCID: PMC8701789 DOI: 10.3390/geriatrics6040117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 12/08/2021] [Accepted: 12/15/2021] [Indexed: 11/17/2022] Open
Abstract
The Montreal Cognitive Assessment (MoCA) is the commonly used cognitive test for detecting mild cognitive impairment (MCI) in Thailand. Nevertheless, cultural biases and educational levels influence its performance. The Rowland Universal Dementia Assessment Scale (RUDAS) seems to lower the limitation of the MoCA. This study aimed to compare the performance of the RUDAS and the MoCA for the diagnosis of MCI and demonstrate the correlation between them. A cross-sectional study of 150 older participants from the outpatient setting of the Internal Medicine Department, Srinagarind Hospital, Thailand was recruited during January 2020 and March 2021. The diagnostic properties in detecting MCI of the RUDAS and the MoCA were compared. MCI was diagnosed in 42 cases (28%). The AUC for both RUDAS (0.82, 95% CI 0.75-0.89) and MoCA (0.80, 95% CI 0.72-0.88) were similar. A score of 25/30 provided the best cut-off point for the RUDAS (sensitivity 76.2%, specificity 75%) and a score of 19/30 for the MoCA had sensitivity and specificity of 76.2% and 71.3%. The Spearman's correlation coefficient between both tests was 0.6. In conclusion, the RUDAS-Thai could be an option for MCI screening. It was correlated moderately to the MoCA.
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Manjavong M, Limpawattana P, Sawanyawisuth K. Performance of the Rowland Universal Dementia Assessment Scale in Screening Mild Cognitive Impairment at an Outpatient Setting. Dement Geriatr Cogn Dis Extra 2021; 11:181-188. [PMID: 34721496 PMCID: PMC8460978 DOI: 10.1159/000517821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 06/13/2021] [Indexed: 01/03/2023] Open
Abstract
Introduction Mild cognitive impairment (MCI) is defined as the symptomatic pre-dementia phase on the continuum of cognitive decline. Early recognition and application of potential interventions could prevent or delay the progression to dementia. The Rowland Universal Dementia Assessment Scale (RUDAS) shows good performance in the screening of dementia but has limited data regarding its diagnostic properties in the screening of MCI. The objectives of this study were to assess the psychometric properties of the Thai version of the RUDAS (RUDAS-Thai) in the screening of MCI, identify associated factors for the RUDAS performance, and determine the optimal cutoff point in detecting MCI. Methods This was a cross-sectional study conducted from January 2020 to March 2021. Older patients at the outpatient clinic of an internal medicine department at a tertiary care hospital in Thailand were examined. Baseline data were collected, and the RUDAS-Thai was administered to each patient. Afterward, a geriatrician assessed each patient for MCI. Results A total of 150 patients were included, of whom 42 cases (28%) had MCI. The overall performance of the test using an area under the receiver operating characteristic curve (AUC) was 0.82 (95% confidence interval 0.75–0.89). At the optimal cutoff point of 25/30, the AUC was 0.76 with sensitivity and specificity of 76.2 and 75%, respectively. The educational level affected the test performance according to regression analysis. For patients with years of education ≤6 and >6, the optimal cutoff points were 25/30 and 26/30, respectively. Conclusion The RUDAS-Thai performed well in differentiating patients with MCI from normal cognition; however, it was affected by educational level. A score of 25/30 or lower for persons with ≤6 years of education or 26/30 or lower for persons with higher than 6 years of education is the optimal cutoff point for indication of developing MCI.
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Affiliation(s)
- Manchumad Manjavong
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Panita Limpawattana
- Division of Geriatric Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kittisak Sawanyawisuth
- Division of Ambulatory Medicine, Department of Internal Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
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Ibanez A, Parra MA, Butler C. The Latin America and the Caribbean Consortium on Dementia (LAC-CD): From Networking to Research to Implementation Science. J Alzheimers Dis 2021; 82:S379-S394. [PMID: 33492297 PMCID: PMC8293660 DOI: 10.3233/jad-201384] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
In comparison with other regions, dementia prevalence in Latin America is growing rapidly, along with the consequent clinical, social, and economic burden upon patients and their families. The combination of fragile health care systems, large social inequalities, and isolated clinical and research initiatives makes the coordination of efforts imperative. The Latin America and the Caribbean Consortium on Dementia (LAC-CD) is a regional organization overseeing and promoting clinical and research activities on dementia. Here, we first provide an overview of the consortium, highlighting the antecedents and current mission. Then, we present the consortium’s regional research, including the multi-partner consortium to expand dementia research in Latin America (ReDLat), which aims to identify the unique genetic, social, and economic factors that drive Alzheimer’s and frontotemporal dementia presentation in LAC relative to the US. We describe an extension of ReDLat which aims to develop affordable markers of disease subtype and severity using high density EEG. We introduce current initiatives promoting regional diagnosis, visibility, and capacity, including the forthcoming launch of the Latin American Brain Health Institute (BrainLat). We discuss LAC-CD-led advances in brain health diplomacy, including an assessment of responses to the impact of COVID-19 on people with dementia and examining the knowledge of public policies among experts in the region. Finally, we present the current knowledge-to-action framework, which paves the way for a future regional action plan. Coordinated actions are crucial to forging strong regional bonds, supporting the implementation of regional dementia plans, improving health systems, and expanding research collaborations across Latin America.
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Affiliation(s)
- Agustin Ibanez
- Global Brain Health Institute (GBHI), University of California San Francisco (UCSF), San Francisco, CA, USA.,Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina.,National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.,Universidad Autónoma del Caribe, Barranquilla, Barranquilla, Colombia.,Latin American Institute for Brain Health (BrainLat), Center for Social and Cognitive Neuroscience (CSCN), Universidad Adolfo Ibanez, Santiago de Chile, Chile
| | - Mario A Parra
- Universidad Autónoma del Caribe, Barranquilla, Barranquilla, Colombia.,School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
| | - Christopher Butler
- Department of Brain Sciences, Imperial College London, UK.,Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.,Instituto de Neurología Cognitiva, Buenos Aires, Argentina.,Departamento de Neurología, Pontificia Universidad de Chile, Santiago, Chile
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15
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Custodio N, Montesinos R, Diaz MM, Herrera-Perez E, Chavez K, Alva-Diaz C, Reynoso-Guzman W, Pintado-Caipa M, Cuenca J, Gamboa C, Lanata S. Performance of the Rowland Universal Dementia Assessment Scale for the Detection of Mild Cognitive Impairment and Dementia in a Diverse Cohort of Illiterate Persons From Rural Communities in Peru. Front Neurol 2021; 12:629325. [PMID: 34305773 PMCID: PMC8292605 DOI: 10.3389/fneur.2021.629325] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Accepted: 06/14/2021] [Indexed: 12/05/2022] Open
Abstract
Background: The accurate diagnosis of neurocognitive disorders in illiterate Peruvian populations is challenging, largely owing to scarcity of brief cognitive screening tools (BCST) validated in these diverse populations. The Peruvian version of the Rowland Universal Dementia Assessment Scale (RUDAS-PE) is a BCST that relies minimally on educational attainment and has shown good diagnostic accuracy in an urban illiterate population in Peru, yet its psychometric properties in illiterate populations in rural settings of the country have not been previously investigated. Objectives: To establish the diagnostic accuracy of the RUDAS-PE compared to expert clinical diagnosis using the Clinical Dementia Rating (CDR) Scale in healthy and cognitively impaired illiterate persons living in two culturally and geographically distinct rural communities of Peru. Methods: A cross-sectional, population-based study of residents ≥ 50 years of age living in the Peruvian rural communities of Santa Clotilde and Chuquibambilla. A total of 129 subjects (76 from Santa Clotilde and 53 from Chuquibambilla) were included in this study. Gold standard diagnostic neurocognitive evaluation was based on expert neurological history and examination and administration of the CDR. Receiver operating characteristics, areas under the curve (AUC), and logistic regression analyses were conducted to determine the performance of RUDAS-PE compared to expert gold standard diagnosis. Results: Compared to gold standard diagnosis, the RUDAS-PE was better at correctly discriminating between MCI and dementia than discriminating between MCI and controls in both sites (97.0% vs. 76.2% correct classification in Chuquibambilla; 90.0% vs. 64.7% in Santa Clotilde). In Chuquibambilla, the area under the curve (AUC) of the RUDAS to discriminate between dementia and MCI was 99.4% (optimal cutoff at <18), whereas between MCI and controls it was 82.8% (optimal cutoff at <22). In Santa Clotilde, the area under the curve (AUC) of the RUDAS to discriminate between dementia and MCI was 99.1% (optimal cutoff at <17), whereas between MCI and controls it was 75.5% (optimal cutoff at <21). Conclusions: The RUDAS-PE has acceptable psychometric properties and performed well in its ability to discriminate MCI and dementia in two cohorts of illiterate older adults from two distinct rural Peruvian communities.
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Affiliation(s)
- Nilton Custodio
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Rosa Montesinos
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Servicio de Rehabilitación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Monica M. Diaz
- Department of Neurology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Unidad de epidemiología, ITS y VIH, Facultad de Salud Pública y Administración, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Eder Herrera-Perez
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Grupo de investigación Molident, Universidad San Ignacio de Loyola, Lima, Peru
| | - Kristhy Chavez
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Carlos Alva-Diaz
- Facultad de Ciencias de la Salud, Universidad Científica del Sur, Lima, Peru
| | - Willyams Reynoso-Guzman
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Maritza Pintado-Caipa
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Atlantic Fellow, Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
| | - José Cuenca
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Servicio de Rehabilitación, Instituto Peruano de Neurociencias, Lima, Peru
- Servicio de Neuropsicología, Instituto Peruano de Neurociencias, Lima, Peru
- Carrera de Psicología, Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, Peru
| | - Carlos Gamboa
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
- Servicio de Neuropsicología, Instituto Peruano de Neurociencias, Lima, Peru
| | - Serggio Lanata
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
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Custodio N, Castro-Suárez S, Montesinos R, Failoc-Rojas VE, Cruz del Castillo R, Herrera-Perez E. Neuropsychiatric Symptoms in Patients With Alzheimer's Disease During SARS-COV-2 Pandemic in Peru. Am J Alzheimers Dis Other Demen 2021; 36:15333175211039089. [PMID: 34416114 PMCID: PMC10581147 DOI: 10.1177/15333175211039089] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
To evaluate neuropsychiatric symptoms in patients with Alzheimer's disease (AD) and their association with cognition and functionality during lockdown of the COVID-19's first wave. We included 91 patients and caregivers of people with AD from a memory clinic. The RUDAS, M@T, and CDR were administered to patients and NPI/ADCS-ADL to caregivers. Baseline and lockdown measurements scales were analyzed to compare the frequencies at baseline versus lockdown and conditional Odds Ratio (ORc) was calculated for the neuropsychiatric symptoms. During the pandemic, significant increase in the number of cases was observed in depression (23%), agitation (36.8%), aberrant motor activity (12%), sleep disorders (26.3%), and appetite change (12.1%). In worsening of pre-existing symptoms, the most frequent were delusions (75%), followed by sleep disorders (71.7%). Lockdown induces a rapid increase of neuropsychiatric symptoms affecting cognitive symptoms and functionality of Peruvian patients with AD.
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Affiliation(s)
- Nilton Custodio
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Perú
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Perú
- Departamento de Investigación y docencia, Instituto Peruano de Neurociencias, Lima, Perú
| | - Sheila Castro-Suárez
- Departamento de Investigación y docencia, Instituto Peruano de Neurociencias, Lima, Perú
- CBI en Demencias y Enfermedades Desmielinizantes del Sistema Nervioso, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Atlantic Senior Fellow of Global Brain Health Institute, University of California, San Francisco, CA. USA
| | - Rosa Montesinos
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Perú
- Departamento de Investigación y docencia, Instituto Peruano de Neurociencias, Lima, Perú
- Servicio de Rehabilitación, Instituto Peruano de Neurociencias, Lima, Perú
| | - Virgilio E. Failoc-Rojas
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Perú
- Departamento de Investigación y docencia, Instituto Peruano de Neurociencias, Lima, Perú
- Unidad de Investigación para la Generación y Síntesis de Evidencias en Salud, Universidad San Ignacio de Loyola, Vicerrectorado de Investigación, Lima, Perú
| | - Rossana Cruz del Castillo
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Perú
- Departamento de Investigación y docencia, Instituto Peruano de Neurociencias, Lima, Perú
- Servicio de Geriatría, Programa de Atención Domiciliaria-PADOMI, EsSalud, Lima, Perú
| | - Eder Herrera-Perez
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Perú
- Departamento de Investigación y docencia, Instituto Peruano de Neurociencias, Lima, Perú
- CBI en Demencias y Enfermedades Desmielinizantes del Sistema Nervioso, Instituto Nacional de Ciencias Neurológicas, Lima, Peru
- Grupo de investigación Molident, Universidad San Ignacio de Loyola, Lima, Perú
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Custodio N, Montesinos R, Cruzado L, Alva-Díaz C, Failoc-Rojas VE, Celis V, Cuenca-Alfaro J, Lira D. Comparative Study of the Word Capacity and Episodic Memory of Patients with Degenerative Dementia. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2020; 51:S0034-7450(20)30083-4. [PMID: 33735000 DOI: 10.1016/j.rcp.2020.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 09/03/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Although the absence of memory impairment was considered among the diagnostic criteria to differentiate Alzheimer's disease (AD) from Behavioural Variant of Frontotemporal Dementia (bvFTD), current and growing evidence indicates that a significant percentage of cases of bvFTD present with episodic memory deficits. In order to compare the performance profile of the naming capacity and episodic memory in patients with AD and bvFTD the present study was designed. METHODS Cross-sectional and analytical study with control group (32 people). The study included 42 people with probable AD and 22 with probable bvFTD, all over 60 years old. Uniform Data Set instruments validated in Spanish were used: Multilingual Naming Test (MINT), Craft-21 history and Benson's complex figure, among others. RESULTS A higher average age was observed among the patients with AD. The naming capacity was much lower in patients with bvFTD compared to patients with AD, measured according to the MINT and the nouns/verbs naming coefficient. All patients with bvFTD, 73.81% of those with AD and only 31.25% of the control group failed to recognise Benson's complex figure. All differences were statistically significant (p <0.001). RESULTS This study confirms the amnesic profile of patients with AD and reveals the decrease in naming capacity in patients with bvFTD, an area of language that is typically affected early on with executive functions, according to recent findings. CONCLUSIONS Patients with AD perform worse in verbal and visual episodic memory tasks, while patients with bvFTD perform worse in naming tasks. These findings open the possibility of exploring the mechanisms of prefrontal participation in episodic memory, typically attributed to the hippocampus.
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Affiliation(s)
- Nilton Custodio
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Perú; Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Perú; Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Perú.
| | - Rosa Montesinos
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Perú; Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Perú; Servicio de Rehabilitación, Instituto Peruano de Neurociencias, Lima, Perú
| | - Lizardo Cruzado
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Perú; Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Perú; Servicio de Psiquiatría, Instituto Peruano de Neurociencias, Lima, Perú; Sección Psiquiatría y Salud Mental, Facultad de Medicina, Universidad Peruana Cayetano Heredia, Lima, Perú
| | - Carlos Alva-Díaz
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Perú; Universidad Científica del Sur, Facultad de Ciencias de la Salud, Lima, Perú; Servicio de Neurología, Departamento de Medicina y Oficina de Apoyo a la Docencia e Investigación (OADI), Hospital Daniel Alcides Carrión, Callao, Perú
| | - Virgilio E Failoc-Rojas
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Perú; Universidad San Ignacio de Loyola, Lima, Perú
| | - Violeta Celis
- Servicio de Neurología, Hospital Belén, Trujillo, Perú
| | - José Cuenca-Alfaro
- Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Perú; Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Perú; Facultad de Ciencias de la Salud, Departamento de Psicología, Universidad Privada del Norte, Lima, Perú
| | - David Lira
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Perú; Unidad de Diagnóstico de Deterioro Cognitivo y Prevención de Demencia, Instituto Peruano de Neurociencias, Lima, Perú; Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Perú
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Cross-cultural dementia screening using the Rowland Universal Dementia Assessment Scale: a systematic review and meta-analysis. Int Psychogeriatr 2020; 32:1031-1044. [PMID: 32146910 DOI: 10.1017/s1041610220000344] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To quantitatively synthesize data on the accuracy of the Rowland Universal Dementia Assessment Scale (RUDAS) in different sociocultural settings and compare its performance to other brief screening instruments for the detection of dementia. DESIGN Systematic review and meta-analysis. Literature searches were performed in PubMed, EMBASE, and CINAHL from January 1, 2004 until September 1, 2019. SETTING Community, outpatient clinic, and hospital settings in high-, and low- and middle-income countries. PARTICIPANTS Twenty-six studies reporting diagnostic accuracy of the RUDAS were included with almost 4000 participants, including approximately 1700 patients with dementia. MEASUREMENTS Procedures for translation and cultural adaption of the RUDAS, and influence of demographic variables on diagnostic accuracy, were compared across studies. Bivariate random-effects models were used to pool sensitivity and specificity results, and diagnostic odds-ratios and the area under the hierarchical summary receiver operator characteristic curve were used to present the overall performance. RESULTS The pooled sensitivity and specificity for the detection of dementia were .82 (95% CI, .78-.86) and .83 (95% CI, .78-.87), respectively, with an area under the curve of .89. Subgroup analyses revealed that the RUDAS had comparable diagnostic performances across high-, and low- and middle-income settings (z = .63, P = .53) and in samples with a lower and higher proportion of participants with no formal education (z = -.15, P = .88). In 11 studies making direct comparison, the diagnostic performance of the RUDAS was comparable to that of the Mini-Mental State Examination (z = -.82, P = .41), with areas under the curve of .88 and .84, respectively. CONCLUSIONS The RUDAS has good diagnostic performance for detecting dementia in different sociocultural settings. Compared to other brief screening instruments, advantages of the RUDAS include its limited bias in people with limited or no formal education and a minimal need for cultural or language adaptation.
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Custodio N, Montesinos R, Lira D, Herrera-Perez E, Chavez K, Reynoso-Guzman W, Pintado-Caipa M, Cuenca J, Gamboa C, Metcalf T. Validation of the RUDAS for the Identification of Dementia in Illiterate and Low-Educated Older Adults in Lima, Peru. Front Neurol 2020; 11:374. [PMID: 32477248 PMCID: PMC7232574 DOI: 10.3389/fneur.2020.00374] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 04/14/2020] [Indexed: 11/13/2022] Open
Abstract
Objectives: To evaluate the performance of the Peruvian version of the Rowland Universal Dementia Assessment Scale (RUDAS-PE) in discriminating between controls and patients with mild cognitive impairment (MCI) and dementia in an illiterate population with low-levels of education. Methods: We compared the cognitive performance of 187 elderly subjects who were illiterate (controls n = 60; MCI n = 64; dementia n = 63). Neuropsychological measures included the RUDAS-PE, Mini-Mental State Examination (MMSE), INECO Frontal Screening (IFS), and Pfeffer Functional Activities Questionnaire (PFAQ). The results were compared to a neuropsychological evaluation (gold standard), including use of Clinical Dementia Rating (CDR) scores. Results: We found a Cronbach's alpha was 0.65; Spearman's correlation coefficient was 0.79 (p < 0.01). The area under the receiver operating characteristics curve for the RUDAS to discriminate dementia from MCI was 98.0% with an optimal cut-off <19 (sensitivity 95%, specificity 97%); whereas, to differentiate MCI and controls was 98.0% with an optimal cut-off <23 (sensitivity 89%, specificity 93%). Conclusions: Based on its excellent psychometric properties, we find the RUDAS-PE suitable to aid in the opportune detection of dementia in a geriatric illiterate population with low-levels of education.
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Affiliation(s)
- Nilton Custodio
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Peru.,Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru.,Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Rosa Montesinos
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru.,Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru.,Servicio de Rehabilitación, Instituto Peruano de Neurociencias, Lima, Peru
| | - David Lira
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Peru.,Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru.,Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Eder Herrera-Perez
- Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru.,Grupo de investigación Molident, Universidad San Ignacio de Loyola, Lima, Peru
| | - Kristhy Chavez
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru.,Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Willyams Reynoso-Guzman
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Peru.,Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru.,Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
| | - Maritza Pintado-Caipa
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Peru.,Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru.,Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru.,Atlantic Fellow, Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, United States
| | - José Cuenca
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru.,Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru.,Servicio de Neuropsicología, Instituto Peruano de Neurociencias, Lima, Peru.,Carrera de Psicología, Facultad de Ciencias de la Salud, Universidad Privada del Norte, Lima, Peru
| | - Carlos Gamboa
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru.,Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru.,Servicio de Neuropsicología, Instituto Peruano de Neurociencias, Lima, Peru
| | - Tatiana Metcalf
- Servicio de Neurología, Instituto Peruano de Neurociencias, Lima, Peru.,Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Instituto Peruano de Neurociencias, Lima, Peru.,Unidad de Investigación, Instituto Peruano de Neurociencias, Lima, Peru
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