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Neurophysiological changes associated with dementia in Down syndrome
Published in Vee P. Prasher, Down Syndrome and Alzheimer’s Disease, 2018
Frank E. Visser, Satnam Kunar, Vee P. Prasher
Philpot and colleagues91 provided further support for the hypothesis that P2–P100 latency on VEP testing could be used to diagnose presenile dementia when they recorded flash and pattern-reversal VEPs in 29 patients who fulfilled NINCDS–ADRDA criteria for probable AD. The results were compared with those obtained for groups of normal elderly subjects (n =13) and patients with mild mental impairment not amounting to dementia (n = 12). None of the patients were taking psychotropic drugs or showed evidence of ophthalmic pathology, and all of them had corrected binocular visual acuity of 6/9 or better. Furthermore, all of the patients received a clinical dementia rating. The VEPs recorded from four subjects with severe dementia were flat and indistinct, and due to poor cooperation with the procedure these individuals were excluded from any further analysis. The significant correlation between severity of dementia and flash P2 and the P2–P100 latency measure was confirmed. The P2 component of the flash VEP was significantly delayed in AD patients aged 74 years or less, and correlated with severity, whereas the P100 component of the pattern-reversal VEP remained relatively unchanged. However, the authors concluded that although P2–P100 latency VEPs had proved to be a valid discriminator between demented and non-demented subjects, the use of P2–P100 latency VEPs was limited to a younger age group (below 75 years) and to patients with at least moderately severe AD.
Assessment of Cognitive Impairment, Alzheimer’s Disease, and Other Forms of Dementia
Published in Gwen Yeo, Linda A. Gerdner, Dolores Gallagher-Thompson, Ethnicity and the Dementias, 2018
J. Wesson Ashford, Frederick A. Schmitt, Carr J. Smith, Vinod Kumar, Nusha Askari
An important component of a dementia evaluation is the assessment of severity. Clinicians have developed a large number of tools to quantitate dementia severity. Many measures of dementia severity have been developed and studied extensively (Ashford, 2008). Certain measures, such as the Global Deterioration Scale (Reisberg, Sclan, Franssen, Kluger, & Ferris, 1994) and the Clinical Dementia Rating Scale (Hughes, Berg, Danziger, Coben, & Martin, 1982), provide quick clinical guidelines to define dementia severity. Further, systematic composites of other scales can substantially improve the precision and reliability of the severity estimate (Ashford et al., 1992; Papp, Rentz, Orlovsky, Sperling, & Mormino, 2017; Rattanabannakit et al., 2016; Wang et al., 2016), including estimates of where a patient lies on the temporal course of progression (Ashford, 2008; Ashford & Schmitt, 2001; Ashford, Shan, Butler, Rajasekar, & Schmitt, 1995; McCleary, Dick, Buckwalter, Henderson, & Shankle, 1996). Tables 3.6a and 3.6b provides an overview of the progression of Minor Neurocognitive Disorder through the latest phases of Major Neurocognitive Disorder. However, the complexity of dementia requires attention to the relationship between individual clinical characteristics and the disease course, as well as the capacity to discriminate among diverse clinical entities and biological factors contributing to the progress of the disease.
Preliminary Evaluation of a Digital Diary for Elder People in Nursing Homes
Published in Bruno Bouchard, Smart Technologies in Healthcare, 2017
Laetitia Courbet, Agathe Morin, Jérémy Bauchet, Vincent Rialle
Step 2: evaluation of the participant’s appetence for new technologies. Step 3: testing the web application usability. Each participant was asked to complete a predefined list of tasks including the functionalities provided by the agenda. Level of independence when completing the listed tasks was evaluated thanks to a 6 items scale. Tools developed by occupational therapist, and used for the independent living skills assessment inspired this scale (Dutil et al. 1996). The Dutil’s scale is usually used to develop models for different cognitive tasks. Its measure is based on the level of assistance required to successfully complete the target task. It is evaluated according to six criteria on the clinical dementia rating (CDR): CDR 0 (independent), CDR 0.5 (success with confirmation), CDR 1 (success with incitement), CDR 2 (success with guidance), CDR 3 (success with guidance and slowness of execution), CDR 4 (failure). For each criterion, the level of support provided by the test administrator is scored from 0 to 3 (0 for a subject who performs without any help, 1 for a subject who requires a verbal cue, 2 for a subject who requires physical assistance, and 3 for a subject totally unable to perform that section of the test). All subjects who completed were able to respond to verbal or physical assistance. There was no time limitation to complete the different tasks, and the participant was allowed to ask for assistance to the experimenter.
Test–retest reliabilities and minimal detectable changes of 5 versions of the Alzheimer’s Disease Assessment Scale-Cognitive Subscale in people with dementia
Published in Disability and Rehabilitation, 2023
En-Chi Chiu, Yi-Ching Wang, Sheau-Ling Huang, I-Ping Hsueh, Hsin-yu Chiang, Ching-Lin Hsieh
Persons with dementia were recruited from one hospital, one elder care center, and two day-care centers. Specifically, one of the authors contacted the supervisors of the hospitals or centers. After the supervisors had agreed to join this study, the author then explained the content and inclusion/exclusion criteria for recruiting participants to the clinicians. Persons were included if they met the following criteria: (1) diagnosis of dementia based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; (2) age of at least 50 years; (3) Clinical Dementia Rating (CDR) scores ≥0.5; and (4) stability of conditions and medications throughout the preceding 4 weeks (ensured by the medical records and CDR scores). We did not set an upper age limit in this study. The exclusion criteria were as follows: (1) history of severe brain injury; (2) diagnosis of intellectual disability, e.g., intellectual and learning disability; and (3) change in severity of dementia, i.e., CDR scores differing between two assessments. The clinicians (therapists from the hospitals/centers) invited their patients with dementia who met the criteria to join the study. To ensure the consistency of how all of the assessments were delivered (in Mandarin), we excluded persons who spoke only Taiwanese.
Effects of working memory intervention on language production by individuals with dementia
Published in Neuropsychological Rehabilitation, 2021
AD was diagnosed according to the criteria of the National Institute of Neurological and Communicative Disorders and Stroke and Alzheimer’s Disease and Related Disorders Association (NINCDS-ADRDA) (McKhann et al., 1984). In addition, following the Clinical Dementia Rating (CDR) (Morris, 1993), the patients were classified into mild (CDR=1) and moderate (CDR=2) groups. The control group was determined to be normal in accordance with the Korean-mini mental state examination (K-MMSE, Kang, 2006) and selected as the control group that matched the distribution of the patients’ age, gender, and education level. All participants had at least 6 years of education. The study was conducted after receiving the approval of the institutional review board of the relevant organization (#HUGSAUD461850).
Is cortical automatic threshold estimation a feasible alternative for hearing threshold estimation with adults with dementia living in aged care?
Published in International Journal of Audiology, 2020
Anthea Bott, Louise Hickson, Carly Meyer, Fabrice Bardy, Bram Van Dun, Nancy A. Pachana
Clinical Dementia Rating Scale – Chronic Care Version. The Clinical Dementia Rating Scale – Chronic Care Version (CDR; Marin et al. 2001) is a tool that quantifies the severity of dementia specifically for individuals who are living in ACHs. Informant and participant interviews were conducted to assess cognitive function across six domains (memory, orientation, judgement and problem solving, community affairs, home and hobbies and personal care). Each domain was assigned a score of 0, 0.5, 1, 2, or 3 which corresponds to a severity of none, questionable, mild, moderate or severe, respectively. The overall severity rating was determined by averaging the six domain scores, with a higher weighting being given to the memory domain. For example, when the memory domain was rated as moderate, the global rating would only be assigned as mild in instances when three or more domains were rated as mild, otherwise the global rating would be moderate. The CDR contains 71 items across the six domains; yet, the CDR is flexible and allows for the interviewer to ask a variable number of questions to determine dementia severity. The CDR has excellent inter-rater reliability, correlation coefficient of 0.99, when the interview is conducted with two raters present and scores are calculated independently. The CDR also has excellent 1-month test-retest reliability with a correlation coefficient of 0.92 (Marin et al. 2001).