Dementia and Geriatric Cognitive Disorders最新文献

{"title":"The mediating effect of depressive symptoms between frailty and cognitive impairment in the Northeast Chinese older adults.","authors":"Xiaohan Geng, Changgui Kou, Songyu Wu, Wangyi Zhang, Biao Li, Ge Yu, Yuxuan Shen, Junling Gao, Wenjun Li, Wei Bai","doi":"10.1159/000543830","DOIUrl":"https://doi.org/10.1159/000543830","url":null,"abstract":"<p><strong>Objectives: </strong>Cognitive impairment among older adults is a significant public health concern worldwide. This study aims to investigate the prevalence of cognitive impairment, its correlates, and the mediating role of depressive symptoms between frailty and cognitive impairment among older adults in northeast region of China.</p><p><strong>Methods: </strong>This was a cross-sectional study which used the intercept interview method to recruit participants. Social demographic characteristic, health-related behaviours, physical health, and functional status of the participants were collected. Univariate and multivariate analyses were conducted to correlates of cognitive impairment. Additionally, mediating effect analysis was performed using the Bootstrap tool.</p><p><strong>Results: </strong>Among the 2,859 older adults included in the study, 32.4% of participants screened positive for cognitive impairment. Higher educational attainment had negative association with cognitive impairment in older adults (P<0.05). Living in rural areas, fair/poor self-rated health, pre-frailty, frailty, having depressive symptoms, impaired activities of daily living, poor sleep quality, and inactive physical activity had positive association with cognitive impairment in older adults(P<0.05). Furthermore, depressive symptoms exhibited a partial mediating role between frailty and cognitive impairment, with a mediating effect of 58.0%.</p><p><strong>Conclusions: </strong>Preventive measures should be implemented to address the associated factors with cognitive impairment. Promoting higher education levels, advocating for a positive and healthy lifestyle, and ensuring their physical and mental well-being among older adults are essential. Early diagnosis and proactive prevention of frailty and depressive symptoms in older adults may effectively decelerate cognitive decline.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-28"},"PeriodicalIF":2.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adaption and validation of the Greek version of Addenbrooke's Cognitive Examination III scale as a screening tool for perioperative cognitive impairment detection.","authors":"Georgia Tsaousi, Maria Zouka, Eleni Chatsiou, Anastasia Nikopoulou, Eleftheria Palaska, Vasiliki Birba, Georgios Papazisis, Zoi Tsimtsiou","doi":"10.1159/000543441","DOIUrl":"https://doi.org/10.1159/000543441","url":null,"abstract":"<p><strong>Introduction: </strong>Postoperative cognitive dysfunction constitutes an extremely prevalent implication in individuals subjected to cardiac or non-cardiac surgery. This study aims to assess the validity and reliability of a culturally adapted Greek version of the Addenbrooke's Cognitive Examination III (ACE-III) scale as a screening tool for perioperative neurocognitive status determination in elderly surgical patients.</p><p><strong>Methods: </strong>A cross-cultural adaptation and validation of instruments throughout the a cross-sectional study was conducted. The study sample consisted of 128 individuals over 55 years old scheduled for surgical intervention. All participants were screened twice; at the preadmission clinic and the day before surgery using the already established MoCA scale and the culturally adapted Greek version of the ACE-III scale. Subjects with a MoCA score of < 26 constituted the cognitively impaired group.</p><p><strong>Results: </strong>Regarding construct validity, ACE-III's performance in detecting cognitive impairment was excellent (AUC =0.942; 95%CI 0.899-0.971). Convergent validity between ACE-III and MoCA scales was excellent (r= 0.876; 95%CI 0.839-0.905). Known group validity was confirmed since advanced age and lower educational attainment adversely impacted ACE-III's total score (p<0.001). Additionally, specialists suggested face validity (mean 8.7 out of 10, SD 1.1). In terms of reliability, ACE-III demonstrated good internal consistency (Cronbach's alpha 0.786) and high inter-rater (ICC=0.936 [95%CI 0.921-0.941]) and test-retest reliability (ICC=0.972 (95%CI 0.958-0.981).</p><p><strong>Conclusion: </strong>The Greek version of ACE-III is a valid, and reliable screening tool that could be routinely employed perioperatively as a valid alternative to the MoCA test to distinguish the mild cognitively impaired from healthy elderly candidates for surgical interventions.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-17"},"PeriodicalIF":2.2,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of an Application-based Cognitive Screening Test for Older Thai Adults.","authors":"Benjapa Yangyuensathaporn, Supakorn Chansaengpetch, Angkana Jongsawadipatana, Weerasak Muangpaisan","doi":"10.1159/000543309","DOIUrl":"https://doi.org/10.1159/000543309","url":null,"abstract":"<p><p>Introduction The cognitive screening usually requires a face-to-face format, which might limit its use in many circumstances. We aimed to develop a new application-based cognitive screening test (ACST) to serve as an accessible and valid tool in the community. Methods The ACST was developed by using paired association and digit span tests. This test was administered to 70 cognitively normal participants, 62 participants with MCI and 64 participants with dementia. The 2nd edition of the Mini-Mental State Examination (MMSE-2), and the Montreal Cognitive Assessment (MoCA) were collected by certified psychologists. The ACST was performed by a clinician. The diagnosis was made according to DSM-V criteria by an experienced geriatric neurologist blinded to the application score. Content validity, test-retest reliability, interrater reliability, and correlations between application scores and MMSE-2 and MoCA scores were analyzed. Results The sensitivity and specificity for distinguishing cognitively normal participants from nonnormal participants was 92.9% and 70%, respectively (cutoff point ≤ 7). The sensitivity and specificity for distinguishing between the cognitively normal group and the MCI group was 87.1% and 70%, respectively (cut point ≤ 7). The sensitivity and specificity for distinguishing cognitively normal participants from participants with dementia was 93.8% and 82.9%, respectively (cut point ≤ 6). A cutoff point ≤ 6 was considered suitable for participants aged 75 years or older or with 6 or fewer years of education. Discussion The ACST is an easy-to-use and valid tool for cognitive screening in older Thai adults in clinical practice. Patients with an application score ≤ 7 are considered to be at risk of cognitive impairment and to require further evaluation.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-18"},"PeriodicalIF":2.2,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eye-Tracking-Based Cognitive Assessment Efficiently Detects Mild Cognitive Decline in the Predementia Stage.","authors":"Mizuki Katsuhisa, Akane Oyama, Yuki Ito, Nanami Sugihara, Shin Teshirogi, Sho Yamamoto, Yuya Ikegawa, Tsuneo Nakajima, Yoshitaka Nakatani, Eriko Yamamoto, Hiromi Bando, Sayaka Tanaka, Mamoru Hashimoto, Kazuhiko Iwata, Shuko Takeda","doi":"10.1159/000541235","DOIUrl":"10.1159/000541235","url":null,"abstract":"<p><strong>Introduction: </strong>The early detection of cognitive decline is key to maximizing the benefits of preventive and therapeutic interventions against dementia. Generally, dementia is first assessed by interview-based neuropsychological tests, but the lengthy interview and mental stress during the assessment process make screenings inefficient. We previously developed a rapid screening test for dementia using an eye-tracking technology (eye-tracking-based cognitive assessment [ETCA]) and reported its utility for clinically detecting cognitive impairment in dementia cases. However, the ETCA's performance in detecting people with mild cognitive decline, which is the major target population for dementia prevention strategies, remains insufficiently examined. Therefore, this study aimed to evaluate the ETCA's performance in individuals aged 40 years and older (n = 94, mean age: 61.0 [SD 13.1] years) without being formally diagnosed with dementia.</p><p><strong>Methods: </strong>All participants underwent both the ETCA and neuropsychological tests, including the Mini-Mental State Examination (MMSE), Rivermead Behavioral Memory Test (RBMT), and Addenbrooke's Cognitive Examination-III (ACE-III) on the same day. We examined the correlations in scores between the ETCA and each neuropsychological test. Furthermore, we selected participants who earned normal scores in each neuropsychological test and evaluated the ETCA's performance in this subgroup.</p><p><strong>Results: </strong>Participants' ETCA scores correlated significantly with their scores on neuropsychological tests, including the MMSE, RBMT, and ACE-III. Notably, the ETCA scores correlated with the RBMT or ACE-III scores in individuals who showed normal scores in each neuropsychological test.</p><p><strong>Conclusion: </strong>The ETCA has the potential to screen mild cognitive decline efficiently at the predementia stage in nonclinical settings.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"29-39"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142132098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship between Mentally Active Sedentary Behavior and Cognitive Function across Different Educational Levels.","authors":"Julinling Hu, Qian Deng, Chan Yong, Jie Peng, Chuiran Kong, Nanyan Li, Xianlan Li, Qin Ye, Qianqian Liu, Yufei Wang, Junmin Zhou","doi":"10.1159/000539863","DOIUrl":"10.1159/000539863","url":null,"abstract":"<p><strong>Introduction: </strong>How education affects the relationship between sedentary behavior and cognitive function remains unclear. The aim of this study was to investigate the relationship between mentally active sedentary behavior and cognitive function in rural older Chinese across different levels of education.</p><p><strong>Methods: </strong>Data from 517 participants aged 60 years and older in rural China at baseline, 4 weeks, 8 weeks, 6 months, 12 months, and 24 months were analyzed. Univariate analysis was carried out using descriptive statistical techniques and bivariate analysis was performed using linear mixed effects models.</p><p><strong>Results: </strong>Total mentally active sedentary behavior time and playing cards/mahjong time were significantly associated with global cognition (0.25 points [95% CI, 0.15-0.35], p < 0.001; 0.27 points [95% CI, 0.16-0.37], p < 0.001, respectively), the attention dimension (0.07 points [95% CI, 0.01-0.12], p = 0.025; 0.08 points [95% CI, 0.02-0.14], p = 0.011, respectively), and the memory dimension (0.20 points [95% CI, 0.13-0.26], p < 0.001; 0.18 points [95% CI, 0.12-0.25], p < 0.001, respectively). Such associations were more pronounced in illiterate participants.</p><p><strong>Conclusion: </strong>Our study suggested a positive association between mentally active sedentary behavior and cognitive function, with the association being more pronounced among illiterate older adults compared to the relatively well-educated. Future cognitive interventions should focus more on mentally active behavior. In addition, education-specific intervention strategy may be considered in cognitive interventions.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-9"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141533943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Shoulder Joint Range of Motion Related to Dementia.","authors":"Yasuyuki Honjo, Kuniaki Nagai, Takuma Yuri, Hideaki Nakai, Ippei Kawasaki, Shun Harada, Ippei Suganuma, Noriyuki Ogawa","doi":"10.1159/000541158","DOIUrl":"10.1159/000541158","url":null,"abstract":"<p><strong>Introduction: </strong>Dementia is caused by various diseases, including Alzheimer's disease dementia (ADD) and dementia with Lewy bodies (DLB). We often encounter patients with dementia who have limited shoulder joint range of motion (ROM), especially those with behavioral and psychological symptoms of dementia (BPSD). But the relationship between the diseases of dementia and restricted shoulder joint ROM is currently unclear.</p><p><strong>Methods: </strong>We examined cognitive function and shoulder joint ROM in 234 new outpatients at 7 memory clinics in Japan. We assessed cognitive function using the Mini-Mental State Examination (MMSE) and Revised Hasegawa Dementia Scale (HDS-R) and BPSD using the Neuropsychiatric Inventory Questionnaire (NPI-Q). Patients were categorized by dementia diagnosis (ADD, DLB, other dementia, and control). Right, left, and total shoulder joint ROM was assessed using validated the Japanese Orthopaedic Association (JOA) score.</p><p><strong>Results: </strong>We found significant associations of lower right, left, and total shoulder joint ROM scores with male sex, advanced age, higher NPI-Q score, lower HDS-R, and MMSE scores. Little difference was found between right and left shoulder joint ROM scores. Restricted shoulder joint ROM was related to serial 7, verbal frequency domain scores on the HDS-R and repeat score on the MMSE. It was also related to the hallucinations, irritability/lability and nighttime disturbances scores on the NPI-Q. Furthermore, the dementia groups, especially the DLB group, showed worse shoulder joint ROM than the control group.</p><p><strong>Conclusions: </strong>Dementia was significantly related to restricted shoulder joint ROM. Maintaining communication and social interaction may help maintain shoulder joint ROM.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"21-28"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142092521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contemporary Incidence of Cognitive Impairment or Dementia in Patients Undergoing Coronary Artery Bypass Grafting: A Systematic Review and Meta-Analysis.","authors":"Hui Zhen Lo, Caitlin Fern Wee, Chen Ee Low, Yao Hao Teo, Yao Neng Teo, Choi Ying Yun, Nicholas L Syn, Benjamin Y Q Tan, Ping Chai, Leonard L L Yeo, Tiong-Cheng Yeo, Yao Feng Chong, Kian-Keong Poh, William K F Kong, Raymond C C Wong, Mark Y Chan, Ching-Hui Sia","doi":"10.1159/000540450","DOIUrl":"10.1159/000540450","url":null,"abstract":"<p><strong>Introduction: </strong>Despite the high prevalence of cognitive impairment or dementia post-coronary artery bypass grafting (CABG), the incidence of cognitive impairment or dementia post-CABG in contemporary practice is currently unclear. Therefore, this paper aims to investigate the incidence and associated risk factors of cognitive impairment or dementia in patients' post-CABG.</p><p><strong>Methods: </strong>A systematic search across three databases (PubMed, SCOPUS, and Embase) was conducted for studies published in or after 2013 that reported cognitive impairment or dementia post-CABG. Subgroup analyses and meta-regression by risk factors were performed to determine their influence on the results.</p><p><strong>Results: </strong>This analysis included 23 studies with a total of 2,620 patients. The incidence of cognitive impairment or dementia less than 1 month, 2 to 6 months, and more than 12 months post-CABG was 35.96% (95% confidence interval [CI]: 28.22-44.51, I2 = 87%), 21.33% (95% CI: 13.44-32.15, I2 = 88%), and 39.13% (95% CI: 21.72-58.84, I2 = 84%), respectively. Meta-regression revealed that studies with more than 80% of the cohort diagnosed with hypertension were significantly associated with incidence of cognitive impairment or dementia less than 1 month post-CABG.</p><p><strong>Conclusion: </strong>This meta-analysis demonstrates a high incidence of cognitive impairment or dementia in patients' post-CABG in contemporary practice, particularly less than 1 month post-CABG and more than 12 months post-CABG. We found that hypertension was a significant risk factor in the short-term (less than 1 month) follow-up period for cognitive impairment or dementia post-CABG. Future research should be done to assess strategies to reduce cognitive impairment post-CABG.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"52-66"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hand Motor Dysfunction Is Associated with Both Subjective and Objective Cognitive Impairment across the Dementia Continuum.","authors":"Kaylee D Rudd, Katherine Lawler, Michele L Callisaya, Aidan D Bindoff, Sigourney Chiranakorn-Costa, Renjie Li, James S McDonald, Katharine Salmon, Alastair J Noyce, James C Vickers, Jane Alty","doi":"10.1159/000540412","DOIUrl":"10.1159/000540412","url":null,"abstract":"<p><strong>Introduction: </strong>Motor dysfunction is an important feature of early-stage dementia. Gait provides a non-invasive biomarker across the dementia continuum. Gait speed and rhythm aid risk stratification of incident dementia in subjective cognitive impairment (SCI) and are associated with cognitive domains in mild cognitive impairment (MCI) and dementia. However, hand movement analysis, which may be more accessible, has never been undertaken in SCI and rarely in MCI or dementia. We aimed to address this gap and improve understanding of hand motor-cognitive associations across the dementia continuum.</p><p><strong>Methods: </strong>A total of 208 participants were recruited: 50 with dementia, 58 MCI, 40 SCI, and 60 healthy controls. Consensus diagnoses were made after comprehensive gold-standard assessments. A computer key-tapping test measured frequency, dwell-time, rhythm, errors, and speed. Associations between key-tapping and cognitive domains and diagnoses were analysed using regression. Classification accuracy was measured using area under receiver operating characteristic curves.</p><p><strong>Results: </strong>Hand frequency and speed were associated with memory and executive domains (p ≤ 0.001). Non-dominant hand rhythm was associated with all cognitive domains. Frequency, rhythm, and speed were associated with SCI, MCI, and dementia. Frequency and speed classified ≥94% of dementia and ≥88% of MCI from controls. Rhythm of the non-dominant hand classified ≥86% of dementia and MCI and 69% of SCI.</p><p><strong>Conclusion: </strong>Our findings show hand motor dysfunction occurs across the dementia continuum and, similar to gait, is associated with executive and memory domains and with cognitive diagnoses. Key-tapping performance differentiated dementia and MCI from healthy controls. More research is required before recommending key-tapping as a non-invasive motor biomarker of cognitive impairment.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"10-20"},"PeriodicalIF":2.2,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141792147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reduced Functional Connectivity in the Default Mode Network in EEGs without Other Abnormalities in Early Creutzfeldt-Jacob Disease.","authors":"Agnes Pirker-Kees, Kirsten Platho-Elwischger, Clemens Lang, Anna Oder, Christoph Baumgartner","doi":"10.1159/000542976","DOIUrl":"10.1159/000542976","url":null,"abstract":"<p><strong>Introduction: </strong>Creutzfeldt-Jakob disease (CJD) is a rare, neurodegenerative disorder that is incurable, always fatal, and transmissible. EEG is an integral part of the diagnostic workup with typical periodic sharp wave complexes indicative of CJD, but early in the disease EEG is often unaltered. Accordingly, we aimed at evaluating disruption of brain network functional connectivity (FC) in regions belonging to the default mode network (DMN) as a potential early marker in CJD when EEG is considered visually normal.</p><p><strong>Methods: </strong>EEGs considered visually normal obtained from 7 CJD patients were compared to EEGs of 7 patients with subjective cognitive impairment (SCI) using Brainstorm application for MATLAB. FC was calculated using the phase locking value separately for the delta-, theta-, alpha-, and beta-frequency band. The global efficacy of the DMN was calculated as the inverse characteristic path length with brain regions belonging to the DMN as nodes.</p><p><strong>Results: </strong>CJD versus SCI had significantly lower global efficacy of the DMN in the gamma band. FC was decreased between bilateral orbitofrontal regions and the right parahippocampal gyrus and between bilateral orbitofrontal gyrus and the right anterior cingulate gyrus in CJD.</p><p><strong>Conclusion: </strong>Our findings provide evidence of disruption of the DMN in the gamma band and alterations of FC between specific brain regions in early CJD patients with visually normal EEGs. EEG brain network properties bear potential as a diagnostic tool for CJD early in the disease course in addition to established criteria. These findings call for further studies evaluating the diagnostic value of FC in early CJD.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Screening for Cognitive Impairment in the Emergency Department: Agreement between Older Adult Patient- and Informant-Completed Ascertain Dementia 8 Tool.","authors":"James Galske, Anna Sather, Tonya Chera, Ula Hwang, Christopher R Carpenter, Matthew Babcock, Cameron J Gettel","doi":"10.1159/000542895","DOIUrl":"10.1159/000542895","url":null,"abstract":"<p><strong>Introduction: </strong>Emergency department (ED) screening for cognitive impairment (CI) is crucial for early intervention, yet guidance on dementia screening protocols remains limited. Our objective was to assess the concordance between the Ascertain Dementia 8 (AD8) tool, a brief screening tool for CI, administered to ED patients and their informants.</p><p><strong>Methods: </strong>We conducted a prospective observational study of dyads, including patients ≥65 years without a diagnosis of dementia seeking care in the ED and their informants (e.g., family, friend with close contact). Trained research assistants used the 4AT to exclude patients with concern for delirium. The AD8 was then administered to blinded patients (pAD8) and informants (iAD8), with scores ranging from 0 to 8 and scores of ≥2 indicating CI. We used the intraclass correlation coefficient (ICC) to calculate the level of agreement between AD8 scores.</p><p><strong>Results: </strong>Our analytic sample included 538 dyads, of which 63.3% of patients were female with a mean age of 73.5 years. A total of 131 (24.3%) patients without a diagnosis of dementia self-identified as having CI using the pAD8, in comparison to 110 (20.4%) informants using the iAD8. The ICC of 0.519 (95% CI 0.454-0.578) indicated moderate agreement between pAD8 and iAD8 scores.</p><p><strong>Conclusions: </strong>When seeking emergency care, one in four older adults without a diagnosis of dementia and approximately 20% of informants indicated that patients were cognitively impaired. Our finding of moderate agreement between the pAD8 and iAD8 has important implications for clinicians providing care to patients with suspected CI and investigators conducting dementia-related studies.</p>","PeriodicalId":11126,"journal":{"name":"Dementia and Geriatric Cognitive Disorders","volume":" ","pages":"1-7"},"PeriodicalIF":2.2,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142767144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}