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Clinical evaluation of brief cognitive assessment measures for patients with severe dementia

Published online by Cambridge University Press:  29 March 2017

Jasmine S. Dixon Open the ORCID record for Jasmine S. Dixon [Opens in a new window] ,
Deborah G. Saddington ,
Celia J. Shiles ,
Kavya P. Sreevalsan ,
Cynthia A. Munro  and
Paul B. Rosenberg
Jasmine S. Dixon
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Deborah G. Saddington
Affiliation:
University of Texas Southwestern Medical School, Dallas, Texas, USA
Celia J. Shiles
Affiliation:
University Southampton Hospital, Hampshire, UK
Kavya P. Sreevalsan
Affiliation:
Department of Internal Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD, USA
Cynthia A. Munro
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
Paul B. Rosenberg*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
*
Correspondence should be addressed to: Paul B. Rosenberg, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Phone: +(410) 550-9883; Fax: (410) 550-1407. Email: prosenb9@jhmi.edu.
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Abstract

Background:

Alzheimer's disease has become an important public health burden for older adults. Clinicians face a challenging task to efficiently evaluate cognition in dementia in clinical settings. We sought to assess the validity and inter-correlations of brief cognitive assessments in a cohort of severely demented patients.

Methods:

In total, 49 individual patients (N = 49) ranging in age from 62 to 97 years old were included in this performance improvement project. Over the course of two–three sessions, five cognitive instruments were administered to each patient: Severe Impairment Battery (SIB), Severe Impairment Battery-8 (SIB-8), Mini Mental State Examination (MMSE), Severe Mini Mental State Examination (sMMSE) and Brief Interview of Mental Status (BIMS). We sought to assess patient factors that might have been barriers to optimal performance on cognitive/functional tests. Researchers assessed her impression of the participants’ difficulty comprehending instructions, distractibility, apparent fatigue, and frustration, which were the four barriers rated.

Results:

Data were analyzed for 49 patients from the inpatient dementia unit with a total of 51 samples. All of the inter-correlations between the five cognitive instruments had Spearman coefficients of (rs) > 0.7 and were statistically significant with p < 0.001. The SIB-8 and sMMSE were positively correlated with the SIB. The perceived barrier scores ranged from 0- no issue to 1-mild issue on all five cognitive instruments.

Conclusion:

Brief cognitive tests designed for severe dementia such as the SIB-8 and sMMSE have been evaluated in this project to be shorter in administration duration and highly correlated with gold standard instruments: the SIB and MMSE.

Keywords

dementiaalzheimer'scognitive assessmentmental status examination
Type
Research Article
Information
International Psychogeriatrics , Volume 29 , Issue 7 , July 2017 , pp. 1169 - 1174
Copyright
Copyright © International Psychogeriatric Association 2017 

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