Clinical Outcome Measure Crosswalks in Alzheimer's Disease: A Systematic Review.

BACKGROUND: A key challenge in studies that model outcomes, disease progression, and cost-effectiveness of existing and emerging dementia treatments is the lack of conversion criteria to translate, or 'crosswalk', scores on multiple measurement scales. Clinical status in dementia is commonly characterized in the cognitive, functional, and behavioral domains. OBJECTIVE: We conducted a systematic review of peer-reviewed dementia measure crosswalks in the three domains. METHODS: We systematically reviewed published literature for crosswalks between scales used to measure cognitive, functional, or behavioral outcomes in Alzheimer's and related dementias. The search was conducted in PubMed, and additional crosswalks were identified through snowballing and expert input from dementia modelers. RESULTS: Of the reviewed articles, 2,334 were identified through a PubMed search, 842 articles were sourced from backward and forward citation snowballing, and 8 additional articles were recommended through expert input. 31 papers were eligible for inclusion, listing 74 unique crosswalks. Of those, 62 (83.8%) were between endpoints of the cognitive domain and 12 (16.2%) were either between endpoints of the functional domain or were hybrid in nature. Among crosswalks exclusively in the cognitive domain, a majority involved the Mini-Mental State Examination (MMSE) (37 crosswalks) or the Montreal Cognitive Assessment (MoCA) and its variants (25 crosswalks). MMSE was directly compared to MoCA or MoCA variants in 16 crosswalks. CONCLUSION: Existing crosswalks between measures of dementia focus largely on a limited selection of outcome measures, particularly MMSE and MoCA. Few crosswalks exist in the functional domain, and no crosswalks were identified for solely behavioral measures.

Spanish consortium for ageing normative data (scand): screening tests (mmse, gds-15 and mfe) / Consorcio Español para la Obtención de Datos Normativos del Envejecimiento: Pruebas de Cribado (MMSE, GDS-15 y MFE)

BACKGROUND: Detecting cognitive impairment is a priority for health systems. The aim of this study is to create normative data on screening tests (MMSE, GDS and MFE) for middle-aged and older Spanish adults, considering the effects of sociodemographic factors. METHOD: A total of 2,030 cognitively intact subjects who lived in the community, aged from 50 to 88 years old, participated voluntarily in SCAND consortium studies. The statistical procedure included the conversion of percentile ranges into scalar scores. Secondly, the effects of age, educational level and gender were verified. Linear regressions were used to calculate the scalar adjusted scores. Cut-off values for each test were also calculated. RESULTS: Scalar scores and percentiles corresponding to MMSE, GDS-15 and MFE are shown. An additional table is provided which shows the points that must be added or subtracted from MMSE score depending on the subject's educational level. CONCLUSIONS: The current norms should provide clinically useful data for evaluating Spanish people aged 50 to 88 years old and should contribute to improving the detection of initial symptoms of cognitive impairment in people living in the community, taking into account the influence of gender, age and educational level

ANTECEDENTES: detectar el deterioro cognitivo es una prioridad del sistema sanitario. El objetivo de este estudio es la presentación de datos normativos de pruebas de cribado (MMSE, GDS y MFE) para adultos españoles de mediana edad y adultos mayores, considerando los efectos de factores sociodemográficos. MÉTODO: en los estudios realizados por el consorcio SCAND participaron voluntariamente 2.030 personas cognitivamente sanas, de 50 a 88 años, residentes en su comunidad. El procedimiento estadístico supuso la conversión de rangos percentiles en puntuaciones escalares. Posteriormente, se comprobaron los efectos de la edad, el nivel educativo y el género. Se utilizaron regresiones lineales para calcular las puntuaciones escalares ajustadas. También se calcularon los puntos de corte para cada prueba. RESULTADOS: se muestran las puntuaciones escalares y los percentiles correspondientes a MMSE, GDS-15 y MFE. Además, se presenta una tabla que muestra los puntos que deben sumarse o restarse a la puntuación del MMSE dependiendo del nivel educativo del individuo. CONCLUSIONES: los datos normativos presentados tienen una utilidad clínica para evaluar a población española de 50 a 88 años, y contribuyen a mejorar la detección de los síntomas iniciales del deterioro cognitivo teniendo en cuenta la influencia del género, la edad y el nivel educativo

A new scoring system for increasing the sensitivity of the MMSE.

BACKGROUND: The mini mental state examination (MMSE) has been criticized for its lack of sensitivity, especially in mild cases of dementia. There have been several attempts to increase the sensitivity by adding or deleting items, which never became accepted in clinical practice. OBJECTIVE: In the current study a new scoring system for improving the sensitivity of the MMSE is proposed, which preserves the original items and the total score of 30 points. Instead of changing the number of items or the total score of 30 points, the weighting of the different items in the total score of 30 points was changed. MATERIAL AND METHODS: Neuropsychological test data of 765 patients were retrospectively included in the study to determine the difficulty of each MMSE item. Multiple scoring systems for the MMSE were developed by inclusion of the item difficulty and clinical relevance. The sensitivity of the new scoring system was compared to the original scoring system by using the DemTect as an established measure. RESULTS: The results showed that an increase of 24.3% in sensitivity was statistically significant. Within the mild cognitive impairment subgroup, the sensitivity of the new scoring system was twice as high in comparison to the original MMSE and within the dementia group the sensitivity was increased by 8.2%. CONCLUSION: A new scoring system with a higher sensitivity than the original MMSE was developed, which can easily be administered in clinical practice because it preserves all items and the total score of 30 points.

Comparison of the effectiveness of the Montreal Cognitive Assessment 7.2 and the Mini-Mental State Examination in the detection of mild neurocognitive disorder in people over 60 years of age. Preliminary study. / Porównanie skutecznosci Montreal Cognitive Assessment 7.2 z Mini-Mental State Examination w wykrywaniu lagodnych zaburzen neuropoznawczych u osób po 60. roku zycia. Doniesienie wstepne.

OBJECTIVES: Analysis of reliability of the Polish version of the MoCA 7.2 vs. the MMSE in mild NCD detecting, while taking into consideration the sensitivity and specificity of cut-off points for each type of education. METHODS: Cross-sectional study was conducted at the Department of Geriatrics, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University in Torun. The study was conducted between September 2014 and December 2015. The study involved 131 participants, including 54 people assigned to the group without NCD and 77 to the group with mild NCD. Recruitment for both groups was performed on the basis of specific inclusion and exclusion criteria. RESULTS: Mean scores of the MoCA 7.2 and the MMSE showed a statistically significant difference between the groups with and without mild NCD. The optimal cut-off point on the MoCA scale for mild NCD was 24/25. The optimal cut-off point on the MMSE scale for mild NCD was 28/29. In the ROC curve analysis, area under the curve (AUC) for the MoCA was significantly greater than the AUC for the MMSE. CONCLUSIONS: The MoCA 7.2 detect mild NCD with greater sensitivity than the MMSE. In the case of this tool, we propose the use of 24/25 cut-off point which has a higher sensitivity than the recommended 25/26 cut-off point. The MoCA 7.2 therefore can be used by primary healthcare and in the geriatric practice as a screening tool in detecting early cognitive impairment.

Validity and reliability of the kiddie schedule for affective disorders and schizophrenia present and lifetime version DSM-5 (K-SADS-PL-5) Spanish version.

BACKGROUND: There are various language adaptations of the Schedule for Affective Disorders and Schizophrenia for School Age Children Present and Lifetime Version (K-SADS-PL). In order to comply with the changes in DSM classification, the Spanish edition of the interview was in need of update and evaluation. METHODS: K-SADS-PL was adapted to correspond to DSM-5 categories. All clinicians received training, and a 90% agreement was reached. Patients and their parents or guardians were interviewed and videotaped, and the videos were exchanged between raters. Factor analysis was performed and inter-rater reliability was calculated only in the case of diagnoses in which there were more than five patients. RESULTS: A total of 74 subjects were included. The Factor Analysis yielded six factors (Depressive, Stress Hyperarousal, Disruptive Behavioral, Irritable Explosive, Obsessive Repetitive and Encopresis), representing 72% of the variance. Kappa values for inter-rater agreement were larger than 0.7 for over half of the disorders. CONCLUSIONS: The factor structure of diagnoses, made with the instrument was found to correspond to the DSM-5 disorder organization. The instrument showed good construct validity and inter-rater reliability, which makes it a useful tool for clinical research studies in children and adolescents.

Using Base Rate of Low Scores to Identify Progression from Amnestic Mild Cognitive Impairment to Alzheimer's Disease.

OBJECTIVES: To investigate the implications of obtaining one or more low scores on a battery of cognitive tests on diagnosing mild cognitive impairment (MCI). DESIGN: Observational longitudinal study. SETTING: Alzheimer's Disease Neuroimaging Initiative. PARTICIPANTS: Normal controls (NC, n = 280) and participants with MCI (n = 415) according to Petersen criteria were reclassified using the Jak/Bondi criteria and number of impaired tests (NIT) criteria. MEASUREMENTS: Diagnostic statistics and hazard ratios of progression to Alzheimer's disease (AD) were compared according to diagnostic criteria. RESULTS: The NIT criteria were a better predictor of progression to AD than the Petersen or Jak/Bondi criteria, with optimal sensitivity, specificity, and positive and negative predictive value. CONCLUSION: Considering normal variability in cognitive test performance when diagnosing MCI may help identify individuals at greatest risk of progression to AD with greater certainty.

The clock-drawing test: normative data in adult and elderly Israeli Arabs.

AIM: Despite the widespread use of the clock-drawing test (CDT), normative data and information regarding the influence of sociodemographic factors on test performance by adult and elderly Israeli Arabs are lacking. The current study aimed to establish normative data for this population group by exploring the impact of sociodemographic factors such as age, education, and gender on CDT performance. In addition, this study examined the association between CDT performance and Mini-Mental State Examination (MMSE) scores. METHODS: The sample consisted of 295 community-dwelling healthy adult and elderly Israeli Arabs, aged 20-86 years, with a MMSE score ≥24. The MMSE and the CDT were administered to participants. RESULTS: Statistical analyses revealed that age had a negative effect on CDT performance, which was most pronounced in the 60-86 age group, but education and occupation (academic vs non-academic) had a positive effect. Gender and place of residence (urban vs rural) had no effect. CDT performance predicted the MMSE score. CONCLUSIONS: The present study provides preliminary normative data on adult and elderly Israeli Arabs. The CDT appears to be applicable to Israeli Arabs, while the normative data might help interpret cognitive function results in this population.

The association between educational parameters and a cognitive screening measure in older blacks.

ABSTRACTBackground:To expand on prior literature by examining how various education parameters (performance-based reading literacy, years of education, and self-rated quality of education) relate to a cognitive screening measure's total and subscale scores of specific cognitive abilities. METHODS: Black adults (age range: 55-86) were administered self-rated items years of education and quality of education, and a measure of performance-based reading literacy. The Mini-Mental State Examination (MMSE) was used to screen for overall cognitive functioning as well as performance on specific cognitive abilities. RESULTS: Sixty-nine percent of the sample had reading grade levels that were less than their reported years of education. Lower years of education and worse reading literacy are associated with poorer MMSE performance, particularly on the attention and calculation subscales. CONCLUSIONS: Years of education, a commonly used measure for education, may not be reflective of Black adults' educational experiences/qualities. Thus, it is important to account for the unique educational experiences of adults that could influence their MMSE performance. Incorporating quality and quantity of education will provide a more comprehensive understanding of the individual's performance on cognitive measures, specifically as it relates to sociocultural differences.

Validation and diagnostic accuracy of predictive curves for age-associated longitudinal cognitive decline in older adults.

BACKGROUND: The Mini-Mental State Examination continues to be used frequently to screen for cognitive impairment in older adults, but it remains unclear how to interpret changes in its score over time to distinguish age-associated cognitive decline from an early degenerative process. We aimed to generate cognitive charts for use in clinical practice for longitudinal evaluation of age-associated cognitive decline. METHODS: We used data from the Canadian Study of Health and Aging from 7569 participants aged 65 years or older who completed a Mini-Mental State Examination at baseline, and at 5 and 10 years later to develop a linear regression model for the Mini-Mental State Examination score as a function of age and education. Based on this model, we generated cognitive charts designed to optimize accuracy for distinguishing participants with dementia from healthy controls. We validated our model using a separate data set of 6501 participants from the National Alzheimer's Coordinating Center's Uniform Data Set. RESULTS: For baseline measurement, the cognitive charts had a sensitivity of 80% (95% confidence interval [CI] 75% to 84%) and a specificity of 89% (95% CI 88% to 90%) for distinguishing healthy controls from participants with dementia. Similar sensitivities and specificities were observed for a decline over time greater than 1 percentile zone from the first measurement. Results in the validation sample were comparable, albeit with lower sensitivities. Negative predictive value was 99%. INTERPRETATION: Our innovative model, which factors in age and education, showed validity and diagnostic accuracy for determining whether older patients show abnormal performance on serial Mini-Mental State Examination measurements. Similar to growth curves used in pediatrics, cognitive charts allow longitudinal cognitive evaluation and enable prompt initiation of investigation and treatment when appropriate.

Catatonia - an unusual presenting clinical manifestation of systemic lupus erythematosus / Catatonía - manifestación clínica de presentación infrecuente del lupus eritematoso sistémico

A 24-year-old female presented with catatonia and symptoms suggestive of Depressive Disorder. She also gave history of undocumented low grade irregular fever. The patient was worked up to rule out any organic cause or psychiatric illness. However, further investigations revealed immunological profile diagnostic of Systemic Lupus Erythematosus (SLE) with CNS involvement (CNS lupus). The diagnosis of SLE in this patient presenting with catatonia was of practical importance because catatonia as one of the manifestations of SLE or as a standalone presenting symptom is extremely rare. Hence, clinicians should be aware of this rarity so that diagnosis of Neuropsychiatric SLE (NPSLE) or catatonia as a presenting feature of SLE is never missed (AU)

Mujer de 24 años que se presentó con catatonía y síntomas indicativos de trastorno depresivo. También presentó historia de febrícula discontinua no registrada. Se llevó a cabo evaluación diagnóstica para descartar cualquier causa orgánica o enfermedad psiquiátrica. Sin embargo, exploraciones complementarias posteriores revelaron un perfil inmunológico diagnóstico de lupus eritematoso sistémico (LES) con implicación del SNC (lupus del SNC). El diagnóstico de LES en esta paciente que se presenta con catatonía era de significado práctico ya que la catatonía, como una de las manifestaciones del LES o como un síntoma que se presenta de forma independiente, es extremadamente rara. Por ello, los médicos deben ser conscientes de esta rareza y no deben olvidar nunca el diagnóstico de LES neuropsiquiátrico (LESNP) o catatonía como rasgo presente en el LES (AU)

Distribución diagnóstica de los trastornos de la conducta alimentaria: comparativa entre el DSM-IV-TR y el DSM-5 / Diagnostic Distribution of eating disorders: Comparison between DSM-IV-TR and DSM-5

Introducción. La quinta edición del Manual Diagnóstico y Estadístico de los Trastornos Mentales (DSM-5) incluye una significativa revisión de los Trastornos de la Conducta Alimentaria (TCA). El objetivo de este estudio es comparar la distribución diagnóstica en adolescentes con TCA según los criterios de la 4ª edición revisada del DSM (DSM-IV-TR) y del DSM-5. Un segundo objetivo es estudiar las diferencias psicopatológicas entre los pacientes con TCA (DSM-IV-TR) y los que cambian de diagnóstico al aplicar los criterios del DSM-5. Metodología. Se evaluaron a 101 pacientes con TCA (Media: 14.68 años; DE: 1.46) a través de entrevista clínica y escalas de psicopatología alimentaria, perfeccionismo, ansiedad y depresión. Resultados. Se observa una disminución significativa de los casos diagnosticados de TCA-No Especificado (TCANE) aplicando los criterios DSM-5 (34.7% frente a 23.8%; p<0.001) y un aumento significativo de los casos de Anorexia Nerviosa (AN) (58.4% frente a 66.3%; p<0.001) y Bulimia Nerviosa (BN) (6.9% frente a 8.9%; p<0.001). No se encontraron diferencias significativas a nivel psicopatológico entre los pacientes diagnosticados de AN y BN según criterios DSM-IV-TR y los nuevos casos diagnosticados de AN y BN con el DSM-5. Conclusiones. La aplicación de los criterios DSM-5 en adolescentes con TCA hace disminuir de forma significativa la frecuencia del diagnóstico de TCA-NE. Las similares características psicopatológicas entre los pacientes con TCA según el DSM-IV-TR y los nuevos casos que pasan de TCA-NE a AN y BN (DSM-5) apoyaría la validez de los nuevos criterios de los TCA del DSM-5 en población adolescente

Introduction. The fifth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a significant revision of Eating Disorders (ED). The objective of this study is to compare the distribution of diagnosis of ED in adolescents according to DSM-VI-TR and DSM-5 criteria. A second objective is to study the psychopathological differences between patients with ED (based on DSM-IV-TR) and those whose diagnosis changed by applying DSM-5 criteria. Methodology. One hundred and one adolescents diagnosed with ED (mean: 14.68 years; SD: 1.46) were evaluated with clinical interviews and scales for eating psychopathology, perfectionism, anxiety, and depression. Results. Applying the DSM-5 criteria led to a significant decrease in the diagnosed cases of Eating Disorders Not Otherwise Specified (EDNOS) (from 34.7% to 23.8%; p<0.001) and to a significant increase in those of anorexia nervosa (AN) (from 58.4% to 66.3%; p<0.001) and of bulimia nervosa (BN) (from 6.9% to 8.9%; p<0.001). No significant psychopathological differences were found between patients diagnosed with AN and BN based on DSM-IV-TR criteria and those newly diagnosed with AN and BN based on DSM-5 criteria. Discussion. Using DSM-5 criteria for adolescents with ED leads to a significant decrease in the frequency of an EDNOS diagnosis. As similar psychopathological characteristics were observed between ED patients diagnosed based on DSM-IV-TR and those who were switched from EDNOS to AN or BN based on DSM-5, we conclude that the new criteria for ED in DSM-5 are valid for an adolescent population

Cognitive assessment in stroke: feasibility and test properties using differing approaches to scoring of incomplete items.

OBJECTIVES: Cognitive screening is recommended in stroke, but test completion may be complicated by stroke related impairments. We described feasibility of completion of three commonly used cognitive screening tools and the effect on scoring properties when cognitive testing was entirely/partially incomplete. METHODS: We performed a cross-sectional study, recruiting sequential stroke patient admissions from two University Hospital stroke rehabilitation services. We assessed Folstein's mini-mental state examination (MMSE), Montreal cognitive assessment (MoCA) and Addenbrooke's cognitive examination (ACE-III). The multidisciplinary team gave an independent diagnostic formulation. We recorded numbers fully/partially completing tests, assistance and time required for testing. We calculated test discrimination metrics in relation to clinical assessment using four differing statistical approaches to account for incomplete testing. RESULTS: We recruited 51 patients. Direct assistance to complete cognitive tests was required for 33 (63%). At traditional cut-offs, the majority screened "positive" for cognitive impairment (ACE-III: 98%; MoCA: 98%; MMSE: 81%). Comparing against a clinical diagnosis, ACE-III and MoCA had excellent sensitivity but poor specificity. Partial completion of cognitive tests was common (ACE-III: 14/51, MMSE: 22/51; MoCA: 20/51 fully complete); greatest non completion was for test items that required copying or drawing. Adapting analyses to account for these missing data gave differing results; MMSE sensitivity ranged from 0.66 to 0.85, and specificity ranged from 0.44 to 0.71 depending on the approach employed. CONCLUSIONS: For cognitive screening in stroke, even relatively brief tools are associated with substantial incompletion. The way these missing data are accounted for in analyses impacts on apparent test properties. When choosing a cognitive screening tool, feasibility should be considered and approaches to handling missing data made explicit. Copyright © 2016 John Wiley & Sons, Ltd.

Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis. / Czy test Montreal Cognitive Assessment (MoCA) moze byc skuteczniejszy od powszechnie stosowanego Mini-Mental State Examination (MMSE) w wykrywaniu lagodnych zaburzen funkcji poznawczych u osób po 60. roku zycia? Metaanaliza.

OBJECTIVES: Screening tests play a crucial role in dementia diagnostics, thus they should be very sensitive for mild cognitive impairment (MCI) assessment. Nowadays, the MiniMental State Examination (MMSE) is the most commonly used scale in cognitive function evaluation, albeit it is claimed to be imprecise for MCI detection. The Montreal Cognitive Assessment (MoCA), was created as an alternative method for MMSE. Aim. MoCA vs. MMSE credibility assessment in detecting MCI, while taking into consideration the sensitivity and specificity by cut-off points. METHODS: A systematic literature search was carried out by the authors using EBSCO host Web, Wiley Online Library, Springer Link, Science Direct and Medline databases. The following medical subject headings were used in the search: mild cognitive impairment, mini-mental state examination, Montreal cognitive assessment, diagnostics value. Papers which met inclusion and exclusion criteria were chosen to be included in this review. At the end, for the evaluation of MoCA 20, and MMSE 13 studies were qualified. Research credibility was established by computing weighted arithmetic mean, where weight is defined as population for which the result of sensitivity and specificity for the cut-off point was achieved. The cut-offs are shown as ROC curve and accuracy of diagnosis for MoCA and MMSE was calculated as the area under the curve (AUC). RESULTS: ROC curve analysis for MoCA demonstrated that MCI best detection can be achieved with a cut-off point of 24/25 (n = 9350, the sensitivity of 80.48% and specificity of 81.19%). AUC was 0.846 (95% CI 0.823-0.868). For MMSE, it turned out that more important cut-off was of 27/28 (n = 882, 66.34% sensitivity and specificity of 72.94%). AUC was 0.736 (95% CI 0.718-0.767). CONCLUSIONS: MoCA test better meets the criteria for screening tests for the detection of MCI among patients over 60 years of age than MMSE.

Validación al castellano de la escala de estigma social: community Attitudes towards Mental Illness en población adolescente / Spanish validation of the social stigma scale: Community Attitudes towards Mental Illness

Introducción. El estigma hacia las personas con una enfermedad mental es muy elevado. En España no existen instrumentos actuales para evaluar este constructo. El objetivo del presente estudio es validar la versión española del cuestionario Community Attitudes towards Mental Illness en una población de adolescentes, estudiando la consistencia interna del instrumento, así como la estabilidad temporal. Este último análisis se realizará también por género. Material y métodos. Se llevó a cabo una traducción y retrotraducción del Community Attitudes towards Mental Illness. Se evaluaron con este instrumento un total de 150 alumnos de Enseñanza Secundaria Obligatoria, de entre 14 y 18 años, en 2 momentos. Se analizó la consistencia interna del instrumento mediante el α de Cronbach, y la fiabilidad test-retest con el coeficiente de correlación intraclase. Se realizaron análisis estratificados por género. Resultados. El α de Cronbach fue de 0,861 para la primera evaluación y de 0,909 para la segunda evaluación. Los valores del coeficiente de correlación intraclase oscilan entre 0,775-0,339 en el análisis de ítem por ítem, y entre 0,88-0,81 en las subescalas. En la segmentación por género encontramos que las puntuaciones en el coeficiente de correlación intraclase en el grupo de chicas está entre 0,797-0,863 y en los chicos entre 0,889-0,774. Conclusiones. En conclusión podemos afirmar que el Community Attitudes towards Mental Illness es un instrumento fiable para la evaluación del estigma social. A pesar de resultar fiable de la misma manera para chicos y para chicas, se han encontrado algunas diferencias en el análisis por género (AU)

Introduction. The stigma against people with mental illness is very high. In Spain there are currently no tools to assess this construct. The aim of this study was to validate the Spanish version of the Community Attitudes towards Mental Illness questionnaire in an adolescent population, and determining its internal consistency and temporal stability. Another analysis by gender will be also performed. Material and methods. A translation and back-translation of the Community Attitudes towards Mental Illness was performed. A total of 150 students of between 14 and 18 years-old were evaluated with this tool in two stages. Internal consistency was tested using Cronbach α; and intraclass correlation coefficient was used for test-retest reliability. Gender-stratified analyses were also performed. Results. The Cronbach α was 0.861 for the first evaluation and 0.909 for the second evaluation. The values of the intraclass correlation coefficient ranged from 0.775 to 0.339 in the item by item analysis, and between 0.88 and 0.81 in the subscales. In the segmentation by gender, it was found that girls scored between 0.797 and 0.863 in the intraclass correlation coefficient, and boys scored between 0.889 and 0.774. Conclusions. In conclusion, the Community Attitudes towards Mental Illness is a reliable tool for the assessment of social stigma. Although reliable results have been found for boys and girls, our results found some gender differences in the analysis (AU)

The usfulness of the SLUMS test for diagnosis of mild cognitive impairment and dementia. / Przydatnosc testu SLUMS w diagnostyce lagodnych zaburzen poznawczych i otepien.

OBJECTIVES: To compare Polish version of the The Saint Louis University Mental Status Examination test (SLUMS) to generally used psychometric screening tools for detecting mild cognitive impairment and dementia. METHODS: The total number of 58 nursing home residents were divided into 3 groups: 1) people showing no symptoms of dementia, 2) people with mild cognitive impairment and 3) people with suspected dementia. The Saint Louis University Mental Status Examination (SLUMS), Mini Mental State Examination (MMSE), Short Test of Mental State (STMS) and Test Your Memory (TYM) were administered for comparison. RESULTS: Mean age was 81.7 ± 8.62. Regarding the education, 37.9% of the sample was educated at the primary school level, 31% completed high school and 22.4 % had higher education. The SLUMS internal consistency was 0.7031. The mean of total SLUMS score was 23.3 in no demented residents, 19.3 among those identified as having cognitive impairments and 13.1 residents with suspected dementia. The statistical analysis illustrated that SLUMS differentiate the dementia residents from those considered as having cognitive impairment (p = 0.01), as well as from non demented participants (p = 0.0001). Moreover, it seems to be useful for detecting mild cognitive impairment in non demented participants (p=0.017), while MMSE does not offer such a possibility (p = 0.51). CONCLUSIONS: The SLUMS is not just another screening tool that can complement the range of existing cognitive tests in Polish clinical practice, but according to statistical analysis it demonstrates superior capabilities in the screening diagnosis compared to the most famous scale used in Poland - MMSE.

The Zürich Maxi Mental Status Inventory (ZüMAX): Test-Retest Reliability and Discriminant Validity in Stroke Survivors.

OBJECTIVE: To examine discriminant validity and test-retest reliability of the Zürich maxi mental status inventory (ZüMAX) in patients with stroke. BACKGROUND: The ZüMAX is a novel domain-specific cognitive assessment tool to screen for disturbances in neuropsychological function. The test can be used in stroke rehabilitation to estimate severity of cognitive impairment. Because evidence for validity and reliability is lacking, the tool's clinical use is limited. METHODS: We administered the ZüMAX in a test-retest design to 33 community-dwelling stroke survivors, and once to 35 healthy controls matched for age and sex. RESULTS: We found significant group differences in subscores for the cognitive domains of executive functions and language as well as total score (P=0.001 to 0.004); we did not find group differences for the domains of praxia (defined as the ability to perform purposeful actions), visual perception and construction, or learning and memory. Test-retest reliability of the total score was good (intraclass correlation coefficient=0.81), with the individual domain subscores ranging from poor to fair (0.59 to 0.79). The ZüMAX could detect changes in patients with low smallest detectable differences in executive functions, language, and praxia (0.05 to 1.49) and total score (0.09). CONCLUSION: The ZüMAX has moderate to good test-retest reliability. Furthermore, the tool might discriminate between healthy persons and chronic stroke survivors on three of five subscales. The ZüMAX shows promise in measuring neuropsychological disturbances in stroke survivors; however, further trials are required with larger samples.

Validation of the Spanish version of the Baylor Profound Mental Status Examination.

BACKGROUND: There are no short valid instruments to evaluate cognitive status in severe Alzheimer's disease (AD) patients in the Spanish language. OBJECTIVE: To validate the Spanish version of the Baylor Profound Mental Status Examination (BPMSE-Sp). METHODS: The Baylor Profound Mental Status Examination (BPMSE) was translated to Spanish and back translated. Validation was conducted in 100 patients with severe probable AD with a Mini-Mental State Examination (MMSE) <12. We assessed internal consistency (Cronbach's alpha), concurrent validity (Pearson's correlations) with the MMSE, Severe Impairment Battery (SIB), Neuropsychiatric Inventory Short Form (NPI-Q) and the Functional Assessment Staging and reliability. RESULTS: The mean age of patients was 84.9; 74% were female; 64% were institutionalized. The mean MMSE was 5.6; the mean BPMSE-Sp was 13.6; the mean BPMSE-Sp behavior was 1.2; the mean SIB was 42.2; and the mean NPI-Q was 4.7. BPMSE-Sp presented good internal consistency (Cronbach α= 0.84). There were significant correlations between the BPMSE-Sp and MMSE (r = 0.86, p <  0.001), and between the BPMSE-Sp and SIB (r = 0.92, p <  0.001). Inter-rater and test-retest reliability were in both cases excellent, ranging between 0.96 and 0.99 (p <  0.001). BPMSE-Sp had fewer floor and ceiling effects than the MMSE. CONCLUSIONS: The BPMSE-Sp is a valid tool for use in daily practice and research in the evaluation of cognitive function of patients with severe AD.