Validity and Reliability of Rapid Cognitive Screening Test for Turkish Older Adults.

OBJECTIVES: Practical cognitive screening tests, brief and easy-to-administer are needed for primary care. The Rapid Cognitive Screen (RCS) is one of the cognitive screening tests used. The present study aimed to establish the validity and reliability of the Turkish version of RCS (RCS-T) in patients with impaired cognitive status. DESIGN: Prospective validation study. SETTING AND PARTICIPANTS: Total 323 outpatients aged 60 or older, who were performed comprehensive geriatric assessment, were included in the study. MEASUREMENTS: Patients were screened by RCS-T, Turkish version of Saint Louis University Mental Status Examination (SLUMS-T), Mini-Mental State Examination (MMSE) and clock drawing test for cognitive impairment (CI). RESULTS: The mean age of the patients was 72.2±7.4. Out of the patients, 217 were considered as cognitively intact, 54 as mild cognitive impairment (MCI), and 52 as Alzheimer's disease (AD). Cronbach's alpha value of the RCS-T was 0.674 for AD and 0.713 for CI. The total RCS-T scores were positively correlated with MMSE and SLUMS-T scores (r = 0.647 and r = 0.864, respectively) (p < .001, for each). The area under the receiver-operating characteristics curve (95% confidence interval) was 0.96 for AD, 0.92 for CI and 0.856 for MCI. The sensitivity and specificity for RCS-T for cut-off point of 6 and 4 were 85.85 (%) and 87.56 (%) for CI and 84.62 (%) and 91.14 (%) for AD, respectively. CONCLUSIONS: In a bedside consultation and primary care practice, RCS-T, a simple, quick and sensitive tool for screening CI, seems to be a useful screening test for older patients with CI.

Effects of Acetylcholinesterase Inhibitors on Nutritional Status in Elderly Patients with Dementia: A 6-month Follow-up Study.

OBJECTIVES: Nutritional status is one of the factors that affects disease progression, morbidity and mortality in elderly patients with dementia. The present study aimed to evaluate the effect of acetylcholinesterase inhibitor (AchEI) therapy on nutritional status and food intake in the elderly. DESIGN, SETTING AND PARTICIPANTS: Newly diagnosed patients with dementia, who underwent comprehensive geriatric assessment (CGA) and were followed at regular intervals, were retrospectively evaluated. A total of 116 patients, who began to receive AchEI therapy and completed 6-month follow-up period under this treatment, were enrolled in the study. MEASUREMENTS: Socio-demographic characteristics and data on comorbidity, polypharmacy, cognitive function, depression, activities of daily living and nutritional status (weight, Body Mass Index (BMI), Mini Nutritional Assessment (MNA)-Short Form) were recorded. RESULTS: The mean age of the patients was 78.0±8.9 years. There was no significant difference between baseline and 6-month BMI, weight and MNA scores of dementia patients who received AchEI therapy (p>0.05). With regard to the relation between changes in BMI, weight and MNA on the 6th month versus baseline, and donepezil, rivastigmine and galantamine therapies, no difference was determined (p>0.05). However, no worsening in food intake was observed (kappa: 0.377). When the effects of each AchEI on food intake were compared, food intake in rivastigmine treated patients was not decreased as much as it was in galantamine or donepezil treated patients (p<0.05). CONCLUSION: AchEI therapy has no unfavorable effect on nutritional status or weight in elderly patients with different types of dementia, but it seems that food intake is better in those treated by rivastigmine patch.