DOCSLIB.ORG

Screening for Memory Disorders, Dementia and Alzheimer's Disease

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
Screening for Memory Disorders, Dementia and Alzheimer's Disease REVIEW Screening for memory disorders, dementia and Alzheimer’s disease J Wesson Ashford Dementia and its most common cause, Alzheimer’s disease, affect memory and occur Stanford/VA Aging Clinical Research Center, VA Palo Alto predominantly in the elderly. Dementia has become increasingly prevalent in the world as Health Care System, 151-Y, health has improved and life expectancy has increased. However, the fields of clinical care 3801 Miranda Ave, Palo have not responded adequately to develop diagnostic tools and treatments for this rapidly Alto, CA 94304, USA Tel.: +1 650 852 3287; increasing group of conditions. While scientists search for cures for the numerous causes of Fax: +1 650 852 3297; dementia, improvement of diagnostic measures are needed now and should begin with E-mail: [email protected] screening elderly populations for memory difficulties and other cognitive problems. This review examines the history of cognitive screening tests, the numerous excellent tests that are currently available and ready for use, and directions and methods that will lead to progressively better evaluations. There has been a growing question of whether to over the last 100 years and is expected to become screen for dementia [1]. The proposed answer is a much greater proportion of the USA and that screening for memory dysfunction, dementia World population in the future, the time has and Alzheimer’s disease (AD) is important, but come to address the global medical needs to care there are many practical and ethical considerations for individuals with dementia and AD on a that need to be addressed before general screening timely basis. Accordingly, there is a present need practices can be widely implemented [2–5]. to develop appropriate screening programs for As of 2008, there are numerous recommenda- these conditions, so proper care can be initiated. tions for screening for a variety of conditions, The purpose of this discussion is to review the including breast cancer, cervical cancer, colorec- history of testing for the presence of dementia tal cancer, skin cancer, diabetes, hypertension, and the problem of screening for dementia and high cholesterol, obesity, osteoporosis and even AD. There are published guidelines (Box 1) and for depression, provided treatment can be criteria (Box 2) for developing screening pro- offered [6]. However, the evidence for dementia grams, which provide specific information about screening has been complicated by a variety of what to consider in the development of factors, including the complexities of diagnosis screening systems. Finally, an analysis will be pre- and difficulties in assessing treatment benefits [7]. sented for making recommendations for useful For example, screening needs to be directed screening procedures. toward dementia (generic inclusion of a group of The discussion of the secondary steps which related conditions that impair memory and must be taken in response to a positive screen other forms of cognition), AD (a specific disease to establish any diagnosis is beyond the scope Authorprocess), or mild cognitive impairment (MCIProofof this presentation. However, it is critical to [8–13], a loosely defined group of conditions con- recognize that a screening test does not pro- sidered to include states prodromal to dementia, duce any diagnosis, anymore than a nonspe- particularly AD [12,13]). Clinicians should cific blood test result would be considered a become prepared to evaluate and manage the diagnosis. A diagnosis of dementia requires vast numbers of undiagnosed cases currently esti- specific criteria (for example, the Diagnostic mated as well as the huge increase in numbers of and Statistical Manual of Mental Disorders, 4th Keywords: Alzheimer’s demented patients expected between now and Edition [DSM-IV] [15] criteria for Dementia of disease, cognitive, dementia, item response theory, 2050. This preparedness must confront an addi- Alzheimer Type), and the diagnosis of AD has memory, mental, mini-mental tional obstacle, the considerable amount of been accepted to require clinical and neuro- state, modern test theory, ambivalence related to the prejudices about psychological assessment [16,17] to make a possi- neuropsychology, screening aging individuals and their optimal care. How- ble or probable diagnosis, with tissue ever, in general, patients have a positive reaction examination required for a certain diagnosis. part of to dementia diagnostic information [14]. As the There are also considerable differential diag- elderly population has progressively increased nostic issues for memory problems and demen- 10.2217/1745509X.4.4.xxx 2008 Future Medicine Ltd ISSN 1745-509X Aging Health (2008) 4(4), xxx–xxx 1 REVIEW – Ashford Box 1. User’s guides for guidelines and recommendations general, such tests have included the assessment of about screening. a range of functions, but few tests have been developed using specific theory, either about the Are the recommendations valid? mechanisms by which dementing diseases affect • Is there RCT evidence that earlier intervention works? the brain, the continua of dementia severity • Were the data identified, selected and combined in an unbiased fashion? associated with these various diseases, or the methodology of test construction. What are the recommendations and will they help you in caring for Since 1960, many test developers have used your patients? classical test theory concepts, recommending • What are the benefits? unweighted combinations of binary or graded • What are the harms? responses (frequently including Likert scaling) to • How do these compare in different people and with different simple tests or questions. screening strategies? Virtually all cognitive, behavioral and func- • What is the impact of people’s values and preferences? tional tests used in medical research make an • What is the impact of uncertainty? a priori assumption that the items take on val- • What is the cost–effectiveness? ues that are additive. In order for items to be Note: these guidelines are difficult to apply to a large, heterogeneous population such added together to generate a total score, meas- as that at risk for dementia. urement properties of ordinality and concaten- Adapted from [119] for the Evidence-Based Medicine Working Group; authors based in ability must be demonstrated. If ordinality is the British Commonwealth. satisfied, then nonparametric statistical meth- ods can be used to analyze the test results, but tia. There are related conditions for which parametric statistics cannot. If the items can be separate screens might be considered, such as concatenated and ordinality is satisfied, then vascular dementia, alcohol dependence and the items can be added together. Unless appro- depression, which are important for treatment priate measurement properties are satisfied, the determination. Depression, a treatable condi- statistical methods that have been applied to tion, may accompany or confuse the dementia the majority of cognitive, behavioral and func- diagnosis, in some cases even leading to a tional tests in medical research may be invalid. wrong diagnosis. Given the difficulties and This is a general problem in medical research importance of a correct diagnosis [18], careful that has largely been ignored, and is reflected in attention to full clinical assessment following a this review. positive screen is recommended. Several tests have been studied using the A developing issue which has not yet been receiver operator characteristic (ROC) curve addressed in the literature to the point of mak- model (many investigations employing inap- ing a clinical recommendation is screening for propriate subject sampling), though this MCI. The concept of determining the earliest approach requires a binary diagnostic decision signs of cognitive impairment that will precede not easily suited for a syndrome such as demen- dementia has long been a topic of consideration tia that is complex and usually has an insidious [19]. The term MCI was introduced in 1991 [9], onset. Modern test theory (item response the- was defined as a clinically meaningful syn- ory and item characteristic curve analysis [21–26], dromeAuthor in 1999 [8] and has acquired standard- Proofspecifically estimating level of ability/disability ized methods for distinguishing its clinical on a defined continuum based on performance, features [20], so that it is now recognized as a provides a considerably more powerful formal diagnosis (ICD-9 code 331.83), which approach for test development. The implemen- Medicare (USA) recognized as a valid reason for tation of this approach will be discussed. A neuropsychological testing in 2007. Tests are practical example, the brief Alzheimer screen now being developed for screening for MCI, [27], a 3–5 min test (see Appendix), provides and these are discussed below. more information about the presence of dementia than the Folstein Mini-Mental State History & progressive development Exam (MMSE) [28]. Progressively better tests of cognitive assessment for evidence can be developed with this theory. Ideally, of dementia screening tests will become computerized and Since the 1930’s, clinicians have developed a wide provide scores that indicate probability of variety of tests for assessing cognitive function dementia and ‘maximum-likelihood estimates’ and facilitating clinical screening for dementia. In of dementia severity. 2 Aging Health (2008) 4(4) futurefuture sciencescience groupgroup Screening for memory disorders, dementia and Alzheimer’s
Load more

Recommended publications
  • Seattle Washington, USA Sheraton Seattle Hotel
    International Neuropsychological Society 42nd Annual Meeting February 12-15, 2014 Translating Evidence into Practice Seattle Washington, USA Sheraton Seattle Hotel KEYNOTE PRESENTATIONS WEDNESDAY, FEBRUARY 12 Update on Acute Effects and Early A Social Neuroscience Perspective Clinical Trials of Behavioral Recovery After Mild TBI: Lessons on Adolescent Risk-Taking Interventions in Neurologic Patients: Toward the Development of a from Sports Concussion Laurence Steinberg, Ph.D. Developing Evidence Rehabilitation Treatment Taxonomy: Michael McCrea, Ph.D. Chaired by Sureyya Dikmen, Ph.D. A Conceptual Framework John Whyte, M.D., Ph.D. Ecologically Valid Methods of FRIDAY, FEBRUARY 14 Traumatic Brain Injury – Assessment in Neuropsychology. The Challenge to Improve Outcome Why is Autism More Common Chaired by Deirdre Dawson, Ph.D. Jennie Ponsford, Ph.D. THURSDAY, FEBRUARY 13 in Males? Simon Baron-Cohen, Ph.D. Mild Cognitive Best Practices for Enhancing Cognitive Recovery: Restoration, SATURDAY, FEBRUARY 15 Impairment Comes of Age Age-Related Memory Decline: Compensation, and Can We Tell Glenn Smith, Ph.D. New insights from Imaging, Sifting Through the Smoke: the Difference? Genetics, and Biomarkers Uncovering the Impact of Marijuana Featured Debate Hemodynamic Factors Underlying Andrew Saykin, Psy.D. Use on Neurocognition the Pathogenesis and Clinical Chaired by Raul Gonzalez, Ph.D. Expression of Alzheimer’s Disease Angela Jefferson, Ph.D. International Neuropsychological Society 700 Ackerman Road, Suite 625 • Columbus, Ohio 43202 Phone: 614-263-4200 • Fax: 614-263-4366 • Email: [email protected] • www.the-ins.org Performance You Can See & Hear Coming Early Spring Evaluate attention disorders and neurological functioning with the Conners Continuous Performance Tests, now with both visual and auditory attention assessments.
    [Show full text]
  • Are Cognitive Changes the First Symptoms of Huntington's Disease
    J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.64.2.172 on 1 February 1998. Downloaded from 172 J Neurol Neurosurg Psychiatry 1998;64:172–177 Are cognitive changes the first symptoms of Huntington’s disease? A study of gene carriers V Hahn-Barma, B Deweer, A Dürr, C Dodé, J Feingold, B Pillon, Y Agid, A Brice, B Dubois Abstract Huntington’s disease is an autosomal domi- Background—Huntington’s disease is a nant disorder with complete lifetime pen- neurodegenerative disorder due to an etrance, characterised by insidious onset of excessive number of CAG repeats in the symptoms associating choreic movements, af- IT15 gene on chromosome 4. The first fective disorders, and cognitive impairment.1 symptoms are typically choreic move- The diagnosis is typically based on the appear- ments or psychiatric disorders, whereas ance of the first motor symptoms, and global cognitive decline generally becomes confirmed by the presence of an excessive obvious later. This study was aimed at number (over 36) of CAG repeats in the IT15 2 detecting early subtle cognitive deficits in gene on chromosome 4. Together with genetic asymptomatic gene carriers. analysis, neuropsychological testing has been performed either on asymptomatic subjects at Methods—As part of the testing procedure for predictive diagnosis of Huntington’s high risk for Huntington’s disease (indirect method)3–5 or asymptomatic gene carriers disease, 91 asymptomatic at risk candi- 6–8 dates had a neuropsychological examin- (direct method). Some of these studies with neuropsychological evaluation have reported ation, evaluating global eYciency, that gene carriers were less eYcient than non- attention, memory (Wechsler memory carriers in the domains of executive functions scale and California verbal learning test), and, to a lesser degree, memory.
    [Show full text]
  • Validation of Brief Cognitive Tests in Mild Cognitive Impairment, Alzheimer's Disease and Dementia with Lewy Bodies
    Validation of brief cognitive tests in mild cognitive impairment, Alzheimer's disease and dementia with Lewy bodies. Palmqvist, Sebastian 2011 Link to publication Citation for published version (APA): Palmqvist, S. (2011). Validation of brief cognitive tests in mild cognitive impairment, Alzheimer's disease and dementia with Lewy bodies. Clinical Memory Research Unit, Lund University. Total number of authors: 1 General rights Unless other specific re-use rights are stated the following general rights apply: Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Read more about Creative commons licenses: https://creativecommons.org/licenses/ Take down policy If you believe that this document breaches copyright please contact us providing details, and we will remove access to the work immediately and investigate your claim. LUND UNIVERSITY PO Box 117 221 00 Lund +46 46-222 00 00 VALIDATION OF BRIEF COGNITIVE TESTS in mild cognitive impairment, Alzheimer’s disease and dementia with Lewy bodies Sebastian Palmqvist MD Clinical Memory Research Unit Department of Clinical Sciences, Malmö Faculty of Medicine Lund University Sweden Front cover: Drawings from two patients (right).
    [Show full text]
  • National Academy of Neuropsychology Abstracts from the 25Th Annual Meeting, Tampa, Florida October 19–22, 2005 Convention Abst
    Archives of Clinical Neuropsychology 20 (2005) 805–950 Abstracts National Academy of Neuropsychology Abstracts from the 25th Annual Meeting, Tampa, Florida October 19–22, 2005 Convention Abstracts Accepted under the Guest Editorship of T. Andrew Zabel (PhD) Kennedy Krieger Institute John Hopkins University School of Medicine Members of the 2005 NAN Poster Program Committee: John Bayless E. Mark Mahone Leigh Beglinger Roy Martin Lynn Blackburn Thomas Martin Jeffrey Browndyke Stephen Moelter Thomas Burns Judith O’Jile Shane Bush Cynthia Salorio Kevin Duff Mark Sandberg David Erlanger Mike Schoenberg Phillip Fastenau Mark Sherer Tania Giovannetti Matthew Thompson Frank Hillary Rodney Vanderploeg Paul Jones Frank Webbe Carrie Kennedy Timothy Wynkoop Gregory Lee Assistant to the Editor Christopher Vaughan 0887-6177/$ – see front matter doi:10.1016/j.acn.2005.06.001 806 Abstracts / Archives of Clinical Neuropsychology 20 (2005) 805–950 ADULT GRAND ROUNDS Moderator: Rick Naugle AGR1 Reversible frontotemporal dementia: verbal fluency content says it all Walker LA, de Meulemeester C A 55-year-old gentleman (M.M.) presented with the cognitive and behavioural profile typically observed in frontotemporal dementia in the context of a diagnosis of spontaneous intracranial hypotension (SIH). Objective: Our goal is to expand upon the only other case report in the literature with this presentation of SIH (Hong et al., 2002), particularly with regard to useful assessment tools, and to illustrate that early diagnosis and treatment can hasten and maximize recovery of cognitive functions. Method: M.M. was healthy until 8 weeks prior to admission to the Neurology in-patient service. Symptoms then included severe orthostatic headache, as well as cognitive and personality changes.
    [Show full text]
  • Comparison of Cognitive and UHDRS Measures in Monitoring Disease
    Toh et al. Translational Neurodegeneration 2014, 3:15 http://www.translationalneurodegeneration.com/content/3/1/15 Translational Neurodegeneration RESEARCH Open Access Comparison of cognitive and UHDRS measures in monitoring disease progression in Huntington’s disease: a 12-month longitudinal study Eng A Toh1,2*, Michael R MacAskill1,2, John C Dalrymple-Alford1,2,3, Daniel J Myall2, Leslie Livingston1,2, Sandy AD Macleod4 and Tim J Anderson1,2,5 Abstract Progressive cognitive decline is a feature of Huntington’s disease (HD), an inherited neurodegenerative movement disorder. Comprehensive neuropsychological testing is the ‘gold standard’ to establish cognitive status but is often impractical in time-constrained clinics. The study evaluated the utility of brief cognitive tests (MMSE and MoCA), UHDRS measures and a comprehensive neuropsychological tests battery in monitoring short-term disease progression in HD. Twenty-two manifest HD patients and 22 matched controls were assessed at baseline and 12-month. A linear mixed-effect model showed that although the HD group had minimal change in overall global cognition after 12 months, they did show a significant decline relative to the control group. The controls exhibited a practice effect in most of the cognitive domain scores over time. Cognitive decline at 12-month in HD was found in the executive function domain but the effect of this on global cognitive score was masked by the improvement in their language domain score. The varying practice effects by cognitive domain with repeated testing indicates the importance of comparing HD patients to control group in research trials and that cognitive progression over 12 months in HD should not be judged by changes in global cognitive score.
    [Show full text]
  • Neuropsychological Testing: a Useful but Underutilized Resource
    Neuropsychological testing: A useful but underutilized resource How to work with a neuropsychologist to fine-tune your diagnosis and treatment e have all treated a patient for whom you know you had the diagnosis correct, the medication regi- Wmen was working, and the patient adhered to treat- ment, but something was still “off.” There was something cognitively that wasn’t right, and you had identified subtle (and some overt) errors in the standard psychiatric cognitive assessment that didn’t seem amenable to psychotropic medi- cations. Perhaps what was needed was neuropsychological testing, one of the most useful but underutilized resources available to help fine-tune diagnosis and treatment. Finding a neuropsychologist who is sensitive to the unique needs of patients with psychiatric disorders, and knowing what and how to communicate the clinical picture and need for the KMIMTZ66 Mary D. Moller, PhD(h), Douglas W. Lane, PhD, referral, can be challenging due to the limited availability, DNP, ARNP, PMHCNS-BC, ABPP, CPsychol time, and cost of a full battery of standardized tests. CPRP, FAAN Geropsychologist This article describes the purpose of neuropsychological Associate Professor Clinical Associate Professor testing, why it is an important part of psychiatry, and how to Coordinator, PMHNP DNP Program Department of Psychiatry and School of Nursing Behavioral Sciences make the best use of it. Pacific Lutheran University University of Washington Director of Psychiatric Services School of Medicine Northwest Integrated Health VA Puget Sound Healthcare Tacoma, Washington System, American Lake Division What is neuropsychological testing? Lakewood, Washington Brett A. Parmenter, Neuropsychological testing is a comprehensive evaluation PhD, ABPP designed to assess cognitive functioning, such as attention, lan- Clinical Neuropsychologist guage, learning, memory, and visuospatial and executive func- Clinical Assistant Professor tioning.
    [Show full text]
  • The Development, Pilot and Validation of a Multicultural Cognitive Assessment Scale
    The development, pilot and validation of a multicultural cognitive assessment scale. A thesis for the Degree of Doctor of Philosophy in Public Health and Community Medicine. Joella E Storey University of New South Wales 2005 1 Table of Contents The development, pilot and validation of a multicultural cognitive assessment scale. ...................................................................................................1 Table of Contents..................................................................................................2 List of Figures .......................................................................................................6 List of Tables.........................................................................................................7 CERTIFICATE OF ORIGINALITY.................................................................9 Abstract ...............................................................................................................10 Awards and Publications ...................................................................................12 Acknowledgements.............................................................................................15 Introduction ........................................................................................................17 Chapter 1 The problem: There are no culture-fair cognitive screening tests. .....................................................................................................................20 The epidemiology
    [Show full text]
  • Screening for Cognitive Impairment
    Montana Geriatric Education Center Instructions on Completing the Module Screening for Cognitive Impairment *The results of the assessments and evaluations are confidential, and the data is used to meet requirements of our federally funded grant. Please make sure to turn in Pre-Test, Post-Test, and Module Evaluation. 1. Before reading the module, and without looking at it, complete the Pre-Test. Record your answers on the examination form marked Pre-Test. (Found at the start of the module.) Keep the completed answer form to turn in at the completion of the module. 2. Complete the module as outlined in the syllabus. 3. After reading the module, please complete the Post-Test. Use the questions in Appendix C and record your answers on the examination form marked Post-Test. (Found at the end of Appendix C.) Keep the completed answer form to turn in with the pre-test at the completion of the module. Complete the Module Evaluation. (Found after the post-test.) Keep the completed module evaluation form to turn in with the pre-test and post-test at the completion of the module. 4. To obtain credit for the module you must: a. Complete and turn in MTGEC Participant Profile b. Turn in the Pre-Test, Post-Test, and Module Evaluation c. Obtain a score of 70% or better on the Post-Test Rachael Zins MTGEC/IPHARM Skaggs Building Room 317 University of Montana 32 Campus Drive Missoula MT, 59812-1522 Email: [email protected] Phone# (406) 243-2339 & Fax# (406) 243-4353 MTGEC Screening for Cognitive Impairment Page 1 of 46 MNA CE expiration date: May 28, 2014 Pre-test: Screening for Cognitive Impairment Record responses on examination form.
    [Show full text]
  • Development of a Concussion Assessment Instrument
    DEVELOPMENT OF A CONCUSSION ASSESSMENT INSTRUMENT FOR THE SOUTH KOREAN SOLDIERS by Junbae Mun A Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy in Human Performance Middle Tennessee State University December 2017 Dissertation Committee: Dr. Minsoo Kang, Chair Dr. Norman L. Weatherby Dr. Ying Jin I dedicate this dissertation to my wife, Wonwoo Choi, for her endless love, sacrifice, and support. ii ACKNOWLEDGEMENTS Thank you to God for your endless love and guidance, thank you to my lovely wife (Wonwoo Choi) and my children (Samuel Mun and Hyungyeom Mun) for being my family, thank you to Dr. Minsoo Kang and Dr. Brian Ragan for their never ending support, patience, and consideration during last four years, thank you to Dr. Norman L. Weatherby, and Dr. Ying Jin for being on my committee and their support, and thank you to members of Kinesmetrics laboratory (Youngdeok Kim, James Farnsworth, Heontae Kim, and Seungho Ryu) for their great help. iii ABSTRACT The purpose of this study was to develop and validate a practical concussion evaluation tool for the South Korean soldiers (SKS). This study was conducted in two phases. For phase 1, the English version of the current standardized assessment of concussion (SAC) was adapted for SKS by modifying and adding some items for resolving psychometric issues and considering cultural and linguistic equivalences, which led to develop the Korean version of the adapted SAC (K-SAC). The psychometric properties of the K-SAC were evaluated using an advanced measurement theory of Rasch model in a sample of healthy young adults without concussive injury.
    [Show full text]
  • Addenbrooke's Cognitive Examination III: Psychometric Characteristics
    Journal of the International Neuropsychological Society (2018), 24, 854–863 Copyright © INS. Published by Cambridge University Press, 2018. doi:10.1017/S1355617718000541 Addenbrooke’s Cognitive Examination III: Psychometric Characteristics and Relations to Functional Ability in Dementia Matthew So,1,2 David Foxe,2,3 Fiona Kumfor,2,3 Cynthia Murray,2,3 Sharpley Hsieh,2,3 Greg Savage,1,2 2,5 2,4 5 2,3 2,3 Rebekah M. Ahmed, James R. Burrell, John R. Hodges, Muireann Irish, AND Olivier Piguet 1Department of Psychology, Macquarie University, Sydney, Australia 2Australian Research Council Centre of Excellence in Cognition and Its Disorders, Macquarie University, Sydney, New South Wales 3School of Psychology and Brain & Mind Centre, The University of Sydney, Sydney, Australia 4Concord Clinical School, The University of Sydney, Sydney, Australia 5Central Medical School and Brain & Mind Centre, The University of Sydney, Sydney, Australia (RECEIVED September 13, 2017; FINAL REVISION May 16, 2018; ACCEPTED June 6, 2018; FIRST PUBLISHED ONLINE September 7, 2018) Abstract Objectives: The Addenbrooke’s Cognitive Examination (ACE) is a common cognitive screening test for dementia. Here, we examined the relationship between the most recent version (ACE-III) and its predecessor (ACE-R), determined ACE- III cutoff scores for the detection of dementia, and explored its relationship with functional ability. Methods: Study 1 included 199 dementia patients and 52 healthy controls who completed the ACE-III and ACE-R. ACE-III total and domain scores were regressed on their corresponding ACE-R values to obtain conversion formulae. Study 2 included 331 mixed dementia patients and 87 controls to establish the optimal ACE-III cutoff scores for the detection of dementia using receiver operator curve analysis.
    [Show full text]
  • Appendix C: Report of the Mental-Cognitive Subcommittee
    Mental Cognitive Subcommittee Content Model and Classification Recommendations APPENDIX C Report of the Metal-Cognitive Subcommittee Mental Cognitive Subcommittee Content Model and Classification Recommendations This page is left intentionally blank. Mental Cognitive Subcommittee Content Model and Classification Recommendations REPORT OF THE MENTAL COGNITIVE SUBCOMMITTEE OF THE OCCUPATIONAL INFORMATION DEVELOPMENT ADVISORY PANEL Subcommittee Chair David J. Schretlen, Ph.D. Subcommittee Members Robert T. Fraser, Ph.D. Sylvia E. Karman, Project Director September 1, 2009 Mental Cognitive Subcommittee Content Model and Classification Recommendations This page left intentionally blank. Mental Cognitive Subcommittee Content Model and Classification Recommendations TABLE OF CONTENTS Executive Summary ........................................................................................................ 1 Introduction ..................................................................................................................... 3 Methodology, Procedures, and Findings......................................................................... 5 Mental Cognitive Subcommittee Recommendations..................................................... 19 Core Mental Residual Functional Capacities ............................................................. 21 Suggested Studies ........................................................................................................ 27 References...................................................................................................................
    [Show full text]
  • Item Response Theory Analysis of Cognitive Tests In
    McGrory et al. BMC Psychiatry 2014, 14:47 http://www.biomedcentral.com/1471-244X/14/47 RESEARCH ARTICLE Open Access Item response theory analysis of cognitive tests in people with dementia: a systematic review Sarah McGrory1*, Jason M Doherty2, Elizabeth J Austin2, John M Starr1,3,4 and Susan D Shenkin3,4 Abstract Background: Performance on psychometric tests is key to diagnosis and monitoring treatment of dementia. Results are often reported as a total score, but there is additional information in individual items of tests which vary in their difficulty and discriminatory value. Item difficulty refers to an ability level at which the probability of responding correctly is 50%. Discrimination is an index of how well an item can differentiate between patients of varying levels of severity. Item response theory (IRT) analysis can use this information to examine and refine measures of cognitive functioning. This systematic review aimed to identify all published literature which had applied IRT to instruments assessing global cognitive function in people with dementia. Methods: A systematic review was carried out across Medline, Embase, PsychInfo and CINHAL articles. Search terms relating to IRT and dementia were combined to find all IRT analyses of global functioning scales of dementia. Results: Of 384 articles identified four studies met inclusion criteria including a total of 2,920 people with dementia from six centers in two countries. These studies used three cognitive tests (MMSE, ADAS-Cog, BIMCT) and three IRT methods (Item Characteristic Curve analysis, Samejima’s graded response model, the 2-Parameter Model). Memory items were most difficult. Naming the date in the MMSE and memory items, specifically word recall, of the ADAS-cog were most discriminatory.
    [Show full text]