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Mini-Mental State Exam (mini-mental + state_exam)
Selected AbstractsComparison of the diagnostic accuracy of the Cognitive Performance Scale (Minimum Data Set) and the Mini-Mental State Exam for the detection of cognitive impairment in nursing home residentsINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 4 2007Louis Paquay Abstract Objective To compare the diagnostic accuracy of an outcome measurement scale of the Minimum Data Set of the Resident Assessment Instrument for nursing homes (MDS/RAI-NH), the Cognitive Performance Scale (CPS) and the Mini-Mental State Exam (MMSE) for the detection of cognitive impairment. The Cambridge Examination for Mental Disorders of the Elderly , Revised (CAMDEX-R) was used as the reference standard. Study design and setting This study was part of a larger prospective study (QUALIDEM) involving a diagnostic procedure and two-year follow-up on the quality of primary care for demented patients. CAMDEX-R and MDS/RAI-NH were administered to 198 residents, aged 65 or more, living in 42 low and high care institutions for aged people. Main outcome measures Indicators of diagnostic accuracy: sensitivity, specificity, predictive values, likelihood ratios, odds ratio and area under receiver operating characteristics curve (AUC). Results The CAMDEX-based prevalence of cognitive impairment was 75%. The diagnostic values of a CPS score of two or more for the detection of cognitive impairment were: sensitivity,=,0.81; specificity,=,0.80; PPV,=,0.92; NPV,=,0.57. The diagnostic values of a MMSE score of less than or equal 23 were: sensitivity,=,0.97; specificity,=,0.59; PPV,=,0.88; NPV,=,0.85. For CPS, the area under the receiver operating characteristic (ROC) curve was 0.87 (95% CI, 0.81,0.91), and not significantly different (p,=,0.63) from the MMSE score, 0.88 (0.83,0.93). Conclusions CPS and MMSE demonstrated similar performance to detect cognitive impairment in nursing home residents. Copyright © 2006 John Wiley & Sons, Ltd. [source] Deficient Knowledge Nursing Diagnosis: Identifying the Learning Needs of Patients With Cardiac DiseaseINTERNATIONAL JOURNAL OF NURSING TERMINOLOGIES AND CLASSIFICATION, Issue 3 2010Luzia Elaine Galdeano PhD Assistência ao paciente; avaliação de processos; conhecimento; doença das coronárias; enfermagem OBJECTIVES., To identify the learning needs of patients with cardiac disease and the aspects of the disease and anesthetic and surgical procedures about which Brazilian patients have the greatest gaps in knowledge. METHODS., Eighty preoperative patients answered a General Evaluation Questionnaire, a Questionnaire to Evaluate Patient Knowledge, and the Mini-Mental State Exam. FINDINGS., Fifty-nine patients had learning needs. More than 50% of the patients were mistaken or unable to answer questions about the disease, and the goals of and type of surgery to be performed and anesthesia to be used. CONCLUSIONS., Most patients had poor performance on the questionnaire that assessed their knowledge about coronary artery disease and its treatment. PRACTICE IMPLICATIONS., This study can contribute to health professionals' assessment of patients' knowledge. OBJETIVOS., Identificar as necessidades de aprendizagem de pacientes com doença cardíaca e os aspectos da doença arterial coronariana e da revascularização do miocárdio do nos quais os pacientes brasileiros apresentam conhecimento deficiente. MÉTODO., Oitenta pacientes responderam o Questionário para avaliação geral, o Questionário para avaliar o conhecimento e o Mini-Exame do Estado Mental. RESULTADOS., Cinqüenta e nove pacientes apresentaram necessidade de aprendizagem. Mais de 50% dos pacientes erraram ou não souberam responder as questões referentes ao nome da doença, aos sinais e sintomas de complicação da doença, aos objetivos e tipo de cirurgia e anestesia. CONCLUSÃO., Muitos pacientes não apresentaram bom desempenho no questionário para medir conhecimento em relação à Doença Arterial Coronária e seu tratamento. IMPLICAÇÕES PRÁTICAS., Este estudo poderá contribuir para a avaliação do conhecimento dos pacientes por profissionais da saúde. [source] A comparison between the accuracy of voxel-based morphometry and hippocampal volumetry in Alzheimer's diseaseJOURNAL OF MAGNETIC RESONANCE IMAGING, Issue 3 2004Cristina Testa PhD Abstract Purpose To compare the accuracy of voxel-based morphometry (VBM) and region of interest (ROI)-based hippocampal volumetry to detect medial temporal lobe atrophy in Alzheimer's disease (AD). Materials and Methods A total of 27 AD patients (age 74 ± 9 years; 22 women; Mini-Mental State Exam [MMSE] 21 ± 4) and 25 controls (age 70 ± 8; 16 women; MMSE 29 ± 1) were studied. Accuracy of VBM to detect gray matter loss in those seven AD patients and 11 controls with similar ROI-based hippocampal measures and of ROI-based volumetry to detect gray matter loss in those four AD patients and five controls with similar VBM-based hippocampal measures was assessed. VBM was performed with statistical parametric mapping (SPM99). Results The area under the curve was 0.96 (95% C.I., 0.92,1.00) for VBM, 0.89 (95% C.I., 0.80,0.98) for ROI-based hippocampal measures, and 0.99 (95% C.I., 0.96,1.00) for both. In subjects with similar ROI-based hippocampal measures, VBM detected atrophy in AD patients at P < 0.0001, while in subjects with similar VBM-based hippocampal measure, volumetry was not significant (P = 0.11). Both measures independently contributed to discrimination (P = 0.004 and P = 0.032) in a logistic regression model. Conclusion These results indicate that VBM is more accurate, but the combination of both methods provides the highest accuracy for detection of hippocampal atrophy in AD. J. Magn. Reson. Imaging 2004;19:274,282. © 2004 Wiley-Liss, Inc. [source] Clinical correlates of depressive symptoms in familial Parkinson's disease,,MOVEMENT DISORDERS, Issue 15 2008Nathan Pankratz PhD Abstract Depression is one of the most common nonmotor complications of Parkinson's disease (PD) and has a major impact on quality of life. Although several clinical factors have been associated with depression in PD, the relationship between depression and stage of illness as well as between depression and degree of disability remains controversial. We have collected clinical data on 1,378 PD cases from 632 families, using the Unified Parkinson's Disease Rating Scale (UPDRS) Parts II (activities of daily living) & III (motor), the Mini-Mental State Exam, the Geriatric Depression Scale (GDS), and the Blessed Functional Activity Scale (Blessed). Analyses were performed using the 840 individuals with verified PD and without evidence of cognitive decline. Logistic regression was used to identify study variables that individually and collectively best predicted the presence of depressive symptoms (GDS , 10). After correcting for multiple tests, depressive symptoms were significantly associated with Hoehn and Yahr stage and other clinical measures but not with any genetic variant (parkin, LRRK2, APOE). The Blessed score, education, presence of a first degree relative with signs of depression, and UPDRS Part II were found to best predict depressive symptomatology (R2 = 0.33; P = 4 × 10,48). Contrary to several reports, the results from this large study indicate that stage of illness, motor impairment, and functional disability are strongly correlated with depressive symptoms. © 2008 Movement Disorder Society [source] Bayesian estimation of cognitive decline in patients with alzheimer's diseaseTHE CANADIAN JOURNAL OF STATISTICS, Issue 1 2002Patrick Béalisle Abstract Recently, there has been great interest in estimating the decline in cognitive ability in patients with Alzheimer's disease. Measuring decline is not straightforward, since one must consider the choice of scale to measure cognitive ability, possible floor and ceiling effects, between-patient variability, and the unobserved age of onset. The authors demonstrate how to account for the above features by modeling decline in scores on the Mini-Mental State Exam in two different data sets. To this end, they use hierarchical Bayesian models with change points, for which posterior distributions are calculated using the Gibbs sampler. They make comparisons between several such models using both prior and posterior Bayes factors, and compare the results from the models suggested by these two model selection criteria. Estimation bayésienne du déclin cognitif de patients atteints de la maladie d'Alzheimer On s'est beaucoup intéressé ces derniers temps à l'estimation du déclin des fonctions cognitives des personnes atteintes de la maladie d'Alzheimer. Il n'est pas facile de quantifier ce déclin, qui dépend de l'échelle utilisée pour mesurer les fonctions cognitives, mais aussi de la variabilité entre les individus, de 1'incertitude entourant le moment exact du début de leur maladie et d'éventuels effets plancher et plafond. Les auteurs montrent comment il est possible de tenir compte de ces différents éléments en modélisant le déclin observé dans les résultats obtenus par deux groupes de patients au mini-examen de l'état mental. Ils utilisent pour ce faire des modèles bayésiens hiérarchiques avec points de jonction, pour lesquels ils calculent les lois a posteriori au moyen de l'échantillonneur de Gibbs. Ils comparent plusieurs modèles de ce type au moyen de facteurs de Bayes a priori et a posteriori; ils comparent ensuite les résultats des modèles suggérés par ces deux critères de sélection. [source] Effects of stimulus intensity on the efficacy and safety of twice-weekly, bilateral electroconvulsive therapy (ECT) combined with antipsychotics in acute mania: a randomised controlled trialBIPOLAR DISORDERS, Issue 2 2009Titus SP Mohan Objectives:, To examine differences in speed of improvement and remission in people with mania undergoing bilateral, brief-pulse, twice-weekly electroconvulsive therapy (ECT) at stimulus intensities administered just above and 2.5 times their individually titrated seizure threshold. Methods:, Consecutive, eligible subjects with mania, prescribed ECT, were randomised to receive treatments at stimulus doses either just above or 2.5 times their individually titrated seizure thresholds. Main outcomes were the speed of improvement and remission as measured by the Young Mania Rating Scale (YMRS) and the Clinical Global Impressions,Improvement scale (CGI-I) and cognitive side effects assessed by the Mini-Mental State Exam, the Wechsler Memory Scale, and a scale for autobiographical memory. Results:, A total of 24/26 subjects (92.3%) given threshold ECT and 22/24 subjects (91.7%) given suprathreshold ECT were significantly improved [CGI = 2; odds ratio (OR) = 1.1, 95% confidence interval (CI): 0.1,8.4; p = 1.0] at the end of ECT. A total of 88% of the sample had remitted [YMRS < 10; threshold 23/26 (88.5%) versus suprathreshold 21/24 (87.5%)], with no significant differences between interventions (OR = 1.1, 95% CI: 0.2, 6.0; p = 1.0). The interventions did not differ significantly in the time or number of ECT treatments required for improvement or remission. Both interventions were equally safe. Conclusions:, Bilateral, twice-weekly ECT delivered at stimulus intensities just above individually titrated seizure threshold was as effective and safe as ECT administered at stimulus intensities 2.5 times seizure threshold in rapidly resolving the symptoms of acute mania. [source] Subjective memory decline in healthy community-dwelling elders.ACTA NEUROLOGICA SCANDINAVICA, Issue 3 2010What does this complain mean? Balash Y, Mordechovich M, Shabtai H, Merims D, Giladi N. Subjective memory decline in healthy community-dwelling elders. What does this complain mean? Acta Neurol Scand: 2010: 121: 194,197. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objectives,,, Subjective feelings of memory decline are fairly common among the elderly. The causes of this are heterogeneous, and may be related to both affective and cognitive disorders. We attempted to explore the associations between subjective and cognitive measures. Materials and Methods,,, Healthy subjects were studied. They completed questionnaires regarding memory difficulties and lifestyle habits, the Geriatric Depression scale (GDS), and the Spielberger State-Trait Anxiety Inventory. Cognitive functions were tested using the Mini-Mental State Exam and supplemented with NeuroTrax, a computerized neurophysiological battery. Univariate logistic regression model was applied to estimate odd ratios (OR) and 95% confidence intervals of associations. Results,,, Of 341 consecutive non-depressed subjects, 257 participants (75.4%) reported subjective memory decline (SMD). Subjects with and without SMD did not differ in age, gender, education, marital status, employment and life-style. Subjects with SMD had elevated GDS scores (OR = 1.14, 95% CI: 1.003,1.29), white anxiety level showed a tendency to be increased (OR = 1.03, 95% CI: 0.99,1.06). Comparison of cognitive performance has not revealed differences in cognitive domains between subjects with and without SMD. Conclusions,,, SMD in healthy elderly people is associated with sub-clinical depression even among those without objectively measured cognitive decline. [source] | ||||||||||||||||||||||