Disability in a memory clinic: Frequency and associations with low cognitive performance

BACKGROUND AND OBJECTIVE: To document the frequency of disability in a Psychiatry Memory Clinic (MC); to test the conjecture that there is an association between low cognitive performance and disability, even when controlling by dementia and clinically significant depression. METHODS: A sample of 158 individuals referred to a Psychiatry MC were assessed with a full clinical protocol. Instruments used: Mini-Mental Status Examination (MMSE); Semantic verbal fluency; the Clock Drawing test; Katz Index; Lawton and Brody Scale. DSM-IV criteria were used for diagnosing depression and dementia. The statistical analysis included logistic regression models. RESULTS: The frequency of disability was 71.6%. MMSE score was significantly associated with moderate-severe disability on instrumental activities of daily living (ADL's) (OR 0.83; 95%CI 0.72-0.96) and with social ADL's (OR 0.87; 95%CI 0.79-0.95)). Orientation, attention and language MMSE subscores were the cognitive domains most significantly associated with disability. CONCLUSIONS: Disability in patients referred to a Psychiatry MC with a heterogeneous clinical population is associated with low cognitive performance. The probability of having moderate-severe disability is related to the degree of impairment on MMSE global scores

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Different subpopulations of mild cognitive impairment are identified by using Petersen's or DSM-5 criteria

OBJECTIVES: In view of differences in the prevalence and conversion rate to dementia of Petersen's (P-MCI) and DSM-5's (DSM-5-MCI) categories of mild cognitive impairment, this paper is intended to examine the diagnostic agreement between the categories and to analyze clinical factors related to the potential discrepancies. METHOD: A representative population cohort of 4580 dementia-free individuals 55+ years of age was examined in Zaragoza, Spain (ZARADEMP). Validated Spanish versions of instruments, including the Geriatric Mental State-AGECAT, were used for assessment. Research psychiatrists diagnosed DSM-5-MCI and P-MCI following operationalized criteria. Between-category differences were analyzed, and the statistical methods included the calculation of Cohen's Kappa coefficients of agreement, and the McNemar's test to compare the performance of the intermediate cognitive definitions. RESULTS: Diagnostic concordance in the classification of MCI cases was very limited. In the total sample, 2.7% of individuals did not meet the P-MCI criteria but met the DSM-5-MCI criteria; and 6.4% met the P-MCI criteria, but not the DSM-5-MCI criteria. Overlap of both categories was observed in only 0.6%. The overall Kappa (agreement between both MCI categories) was 0.08 (95% CI: 0.04-0.12; p < 0.001). While no between-category significant differences was observed in cognitive scores, relevant differences in the populations identified had to do with demographic, non-cognitive psychopathological factors, activities of daily living and general health factors. CONCLUSIONS: This study shows 'poor' diagnostic agreement between the P-MCI and the DSM-5-MCI categories. The non-cognitive factors should receive special attention when trying to improve the validity of the MCI construct

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Transferencia de datos de investigación epidemiológica a la práctica clínica en psiquiatría geriátrica / No disponible

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Transferencia de datos de investigación epidemiológica a la práctica clínica en psiquiatría geriátrica / No disponible

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Neumonía extrahospitalaria con bacteriemia por Ochrobactrum anthropi en un niño inmunocompetente / Community-acquired pneumonia and Ochrobactrum antrhopi bacteraemia in an immunocompetent child

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