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Severe Impairment Battery (severe + impairment_battery)
Selected AbstractsClinical features and assessment of severe dementia.EUROPEAN JOURNAL OF NEUROLOGY, Issue 2 2002A review Sound understanding of the dementia syndrome requires adequate acquaintance with its entire spectrum, from the lightest to the most advanced stages. Most studies of dementia deal with light to moderate stages of the condition, while relatively little attention has been paid to its most severe stages. This review presents a clinical description of patients with severe dementia and of the tests currently available to evaluate their cognitive, behavioural, and functional status. Available instruments such as the Hierarchic Dementia Scale or the Severe Impairment Battery now allow quantification of the cognitive and behavioural status of patients with severe dementia. Experience with severe dementia shows that, far from being in a `vegetative state', as is commonly thought, late-stage patients are in fact quite different from one another and in most cases continue to have an interaction with their environment. This ability to better define the characteristics of patients with severe dementia provides the basis for correlations between clinical data and data derived from neuroimaging, neurochemistry, or neuropathology. It also sets the stage for possible therapeutic trials involving these patients. [source] Effects of memantine on cognition in patients with moderate to severe Alzheimer's disease: post-hoc analyses of ADAS-cog and SIB total and single-item scores from six randomized, double-blind, placebo-controlled studiesINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 5 2009Patrizia Mecocci Abstract Objectives The post-hoc analyses reported here evaluate the specific effects of memantine treatment on ADAS-cog single-items or SIB subscales for patients with moderate to severe AD. Methods Data from six multicentre, randomised, placebo-controlled, parallel-group, double-blind, 6-month studies were used as the basis for these post-hoc analyses. All patients with a Mini-Mental State Examination (MMSE) score of less than 20 were included. Analyses of patients with moderate AD (MMSE: 10,19), evaluated with the Alzheimer's disease Assessment Scale (ADAS-cog) and analyses of patients with moderate to severe AD (MMSE: 3,14), evaluated using the Severe Impairment Battery (SIB), were performed separately. Results The mean change from baseline showed a significant benefit of memantine treatment on both the ADAS-cog (p,<,0.01) and the SIB (p,<,0.001) total score at study end. The ADAS-cog single-item analyses showed significant benefits of memantine treatment, compared to placebo, for mean change from baseline for commands (p,<,0.001), ideational praxis (p,<,0.05), orientation (p,<,0.01), comprehension (p,<,0.05), and remembering test instructions (p,<,0.05) for observed cases (OC). The SIB subscale analyses showed significant benefits of memantine, compared to placebo, for mean change from baseline for language (p,<,0.05), memory (p,<,0.05), orientation (p,<,0.01), praxis (p,<,0.001), and visuospatial ability (p,<,0.01) for OC. Conclusion Memantine shows significant benefits on overall cognitive abilities as well as on specific key cognitive domains for patients with moderate to severe AD. Copyright © 2009 John Wiley & Sons, Ltd. [source] Reliability and validity of the Norwegian version of the Severe Impairment Battery (SIB)INTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 9 2008Sverre Bergh Abstract Objective The Severe Impairment Battery (SIB) is developed to test cognitive function in patients with dementia of moderate to severe degree. We have conducted a study to assess the inter-rater reliability and the validity of the Norwegian version of SIB. Methods The reliability study comprised 30 patients, and the validity study 59 patients in nursing homes. We assessed Cronbach's alpha coefficient of the scale and the inter-rater reliability for the total SIB score and its nine sub scores between two testers by means of the Spearman's correlation coefficients. In the validity study we compared the SIB scores with the scores on the Clinical Dementia Rating Scale. Results The mean SIB score was 72.10 (SD 25.37). The Cronbach's alpha was 0.97, and the inter-rater reliability of total SIB score was Spearman's rho 0.85, and ranged from 0.46 to 0.76 for the nine sub-scores. The mean SIB score for patients with a CDR score,<,2 was 84.2(13.4), whereas total scores for patients with CDR 2 and 3 were 74 (18.9) and 48.4 (33.3), respectively. A cut-off point of 80.5 points gave the highest accuracy in discriminating between patients with CDR 2 and CDR 3, while a cut-off point of 87.5 best discriminated between CDR,<,2 and CDR 3. Conclusion The study indicates that the Norwegian version of SIB is a reliable and valid test with which to evaluate the cognition in patients with dementia of moderate to severe degree. Copyright © 2008 John Wiley & Sons, Ltd. [source] Validation of the Severe Impairment Battery for patients with Alzheimer's disease in KoreaINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 7 2006Guk-Hee Suh Abstract Objective To examine the reliability and the validity of the Korean version of the SIB (SIB-K); and to determine its usefulness in patients with severe dementia. Methods Sixty-five patients (56 women, nine men) who lived in a nursing home and met the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th edn, for the dementia of the Alzheimer's type were selected. Following clinical examination and evaluation using the Korean version of the Severe Impairment Battery (SIB-K), the Korean versions of the Mini-Mental State Examination (MMSE-K) and the cognitive subscale of the Alzheimer's Disease Assessment Scale (ADAS-K-cog) were applied as comparators. Results The mean scores on the SIB-K were 63.9 (SD,=,29.1), with a possible maximum of 100 points. Patients with MMSE scores from 0 to 4 points showed wide range of the SIB score from 4 to 62. The internal consistency of the SIB-K obtained by the Cronbach's alpha was 0.98. The inter-rater and test,retest reliabilities of the SIB-K obtained by the Spearman's rho were 0.99 and 0.97, respectively. Correlation between the SIB-K and the MMSE-K was 0.87, while correlation between the SIB-K and the ADAS-K-cog was ,0.76. Conclusions This study indicates that the Korean version of the SIB is a reliable, valid and useful test for measuring cognition of severely demented patients at a point where other conventional tests lose their sensitivity and show a floor effect. Copyright © 2006 John Wiley & Sons, Ltd. [source] Randomized, Placebo-Controlled Trial of the Cognitive Effect, Safety, and Tolerability of Oral Extended-Release Oxybutynin in Cognitively Impaired Nursing Home Residents with Urge Urinary IncontinenceJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 5 2008Thomas E. Lackner PharmD OBJECTIVES: Determine the cognitive effect, safety, and tolerability of oral extended-release oxybutynin in cognitively impaired older nursing home residents with urge urinary incontinence. DESIGN: Randomized, double-blinded, placebo-controlled trial. SETTING: Twelve skilled nursing homes. PARTICIPANTS: Fifty women aged 65 and older with urge incontinence and cognitive impairment. INTERVENTION: Four-week treatment with once-daily oral extended-release oxybutynin 5 mg or placebo. MEASUREMENTS: Withdrawal rates and delirium or change in cognition from baseline at 1, 3, 7, 14, 21, and 28 days after starting treatment using the Confusion Assessment Method (CAM), Mini-Mental State Examination (MMSE), and Severe Impairment Battery (SIB). The Brief Agitation Rating Scale, adverse events, falls incidence, and serum anticholinergic activity change with treatment were also assessed. RESULTS: Participants' mean age ±standard deviation was 88.6±6.2, and MMSE baseline score was 14.5±4.3. Ninety-six percent of subjects receiving oxybutynin (n=26) and 92% receiving placebo (n=24) completed treatment (P=.50). The differences in mean change in CAM score from baseline to all time points were equivalent between the oxybutynin and placebo groups. Delirium did not occur in either group. One participant receiving oxybutynin was withdrawn because of urinary retention, which resolved without treatment. Mild adverse events occurred in 38.5% of participants receiving oxybutynin and 37.5% receiving placebo (P=.94). CONCLUSION: Short-term treatment using oral extended-release oxybutynin 5 mg once daily was safe and well tolerated, with no delirium, in older female nursing home participants with mild to severe dementia. Future research should investigate different dosages and long-term treatment. [source] Energy-Containing Nutritional Supplements Can Affect Usual Energy Intake Postsupplementation in Institutionalized Seniors with Probable Alzheimer's DiseaseJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 9 2006Matthew D. Parrott BSc OBJECTIVES: To determine whether increases in caloric intake associated with consumption of a mid-morning nutritional supplement for 3 weeks were maintained in the week after stopping the supplement and to investigate the effects of body mass index (BMI) and cognitive and behavioral measures on this response. DESIGN: Secondary analysis of a previously published randomized, crossover, nonblinded clinical trial. SETTING: A fully accredited geriatric care facility affiliated with the University of Toronto. PARTICIPANTS: Thirty institutionalized seniors with probable Alzheimer's disease (AD) who ate independently. MEASUREMENTS: Investigator-weighed food intake, body weight, cognitive (Severe Impairment Battery; Global Deterioration Scale) and behavioral (Neuropsychiatric Inventory,Nursing Home version; London Psychogeriatric Rating Scale) assessments. RESULTS: Individuals who responded successfully to supplementation as indicated by increases in daily energy intake were likely to maintain 58.8% of that increase postsupplementation, although stopping the supplement was associated with decreased habitual energy intake in low-BMI individuals who reduced their daily intakes during supplementation in response to the extra calories. Cognitive/behavioral tests were not reliable predictors of postsupplement intake. CONCLUSION: Institutionalized seniors with probable AD are likely to alter their usual energy intakes to maintain changes resulting from 3 weeks of supplementation. This effect may allow for rotating supplementation schedules in nursing homes that could reduce staff burden, but only for those individuals who are most likely to respond favorably. These data indicate that nutritional supplements and diet plans should be carefully prescribed in low-BMI individuals to limit variability in total energy provided and thus prevent lower-than-normal intake. [source] Providing Nutrition Supplements to Institutionalized Seniors with Probable Alzheimer's Disease Is Least Beneficial to Those with Low Body Weight StatusJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 8 2004Karen W. H. Young MSc Objectives: To examine whether providing a midmorning nutrition supplement increases habitual energy intake in seniors with probable Alzheimer's disease (AD) and to investigate the effects of body weight status and cognitive and behavioral function on the response to the intervention. Design: Randomized, crossover, nonblinded clinical trial. Setting: A fully accredited geriatric teaching facility affiliated with the University of Toronto's Medical School with a home for the aged. Participants: Thirty-four institutionalized seniors with probable AD who ate independently. Intervention: Nutrition supplements were provided between breakfast and lunch for 21 consecutive days and compared with 21 consecutive days of habitual intake. Measurements: Investigator-weighed food intake, body weight, cognitive function (Severe Impairment Battery and Global Deterioration Scale), behavioral disturbances (Neuropsychiatric Inventory,Nursing Home Version), and behavioral function (London Psychogeriatric Rating Scale). Results: Relative to habitual intake, group mean analyses showed increased 24-hour energy, protein, and carbohydrate intake during the supplement phase, but five of 31 subjects who finished all study phases completely compensated for the energy provided by the supplement by reducing lunch intake, and 24-hour energy intake was enhanced in only 21 of 31 subjects. Compensation at lunch was more likely in subjects with lower body mass indices, increased aberrant motor behavior, poorer attention, and increased mental disorganization/confusion. Conclusion: Nutrition supplements were least likely to enhance habitual energy intake in subjects who would normally be targeted for nutrition intervention,those with low body weight status. Those likely to benefit include those with higher body mass indices, less aberrant motor problems, less mental disorganization, and increased attention. [source] | ||||||||||