In this editorial we comment on the article by Cahn-Hidalgo D published in a recent issue of the World Journal of Psychiatry 2020;10(1);1-11.We focus on the importance of utilizing psychometrically valid cognitive scr...In this editorial we comment on the article by Cahn-Hidalgo D published in a recent issue of the World Journal of Psychiatry 2020;10(1);1-11.We focus on the importance of utilizing psychometrically valid cognitive screening tools when assessing for cognitive decline in older adults in a psychiatric outpatient setting.We compared the use of Cognivue®to use of the montreal cognitive assessment(MoCA)as a cognitive screening tool.A total of 58 patients aged 55 and over participated in this comparison study.Patients completed cognitive screening on Cognivue®,a new Food and Drug Administration-cleared computer screening device,and the MoCA.The results of patient performance using these two instruments were analyzed.Sixteen(28%)patients screened negative for cognitive impairment on both assessments.Forty-two(72%)patients screened positive on one or both of the assessments.There was 43%agreement between Cognivue®and the MoCA in identifying patients with cognitive impairment,and individual subtests were weakly correlated.The MoCA was determined to be the preferred instrument due to its high sensitivity and specificity(100%and 87%,respectively)when screening for cognitive impairment.We propose that the use of Cognivue®cognitive screening tool be closely reviewed until more research proves that the test meets the standards for reliability and validity.It is important for clinicians to remember that screeners should not be used to diagnosis patients with neurocognitive disorders;instead,they should be used to determine whether further evaluation is warranted.Additionally,misdiagnosing of neurocognitive disorders can pose unnecessary psychological and emotional harm to patients and their families and also lead to incorrect treatment and undue healthcare costs.展开更多
BACKGROUND Cognitive decline is common among older patients with cardiovascular disease(CVD) and can decrease their self-management abilities. However, the instruments for identifying mild cognitive impairment(MCI) ar...BACKGROUND Cognitive decline is common among older patients with cardiovascular disease(CVD) and can decrease their self-management abilities. However, the instruments for identifying mild cognitive impairment(MCI) are not always feasible in clinical practice. Therefore, this study evaluated whether MCI could be detected using the Japanese version of the Rapid Dementia Screening Test(RDST-J), which is a simple screening tool for identifying cognitive decline.METHODS This retrospective single-center study included patients who were ≥ 65 years old and hospitalized because of CVD.Patients with a pre-hospitalization diagnosis of dementia were excluded. Each patient's cognitive function had been measured at discharge using the RDST-J and the Japanese version of the Montreal Cognitive Assessment(Mo CA-J), which is a standard tool for MCI screening. The correlation between the two scores was evaluated using Spearman's rank correlation coefficient. Receiver operating characteristic(ROC) analysis was also to evaluate whether the RDST-J could identify MCI, which was defined as a Mo CA-J score of ≤ 25 points.RESULTS The study included 78 patients(mean age: 77.2 ± 8.9 years). The RDST-J and Mo CA-J scores were strongly correlated(r = 0.835, P < 0.001). The ROC analysis revealed that an RDST-J score of ≤ 9 points provided 75.4% sensitivity and 95.2% specificity for identifying MCI, with an area under the curve of 0.899(95% CI: 0.835-0.964). The same cut-off value was identified when excluding patients with a high probability of dementia(RDST-J score of ≤ 4 points).CONCLUSIONS The RDST-J may be a simple and effective tool for identifying MCI in older patients with CVD.展开更多
BACKGROUND Cognitive issues such as Alzheimer’s disease and other dementias confer a substantial negative impact.Problems relating to sensitivity,subjectivity,and inherent bias can limit the usefulness of many tradit...BACKGROUND Cognitive issues such as Alzheimer’s disease and other dementias confer a substantial negative impact.Problems relating to sensitivity,subjectivity,and inherent bias can limit the usefulness of many traditional methods of assessing cognitive impairment.AIM To determine cut-off scores for classification of cognitive impairment,and assess Cognivue®safety and efficacy in a large validation study.METHODS Adults(age 55-95 years)at risk for age-related cognitive decline or dementia were invited via posters and email to participate in two cohort studies conducted at various outpatient clinics and assisted-and independent-living facilities.In the cut-off score determination study(n=92),optimization analyses by positive percent agreement(PPA)and negative percent agreement(NPA),and by accuracy and error bias were conducted.In the clinical validation study(n=401),regression,rank linear regression,and factor analyses were conducted.Participants in the clinical validation study also completed other neuropsychological tests.RESULTS For the cut-off score determination study,92 participants completed St.Louis University Mental Status(SLUMS,reference standard)and Cognivue^®tests.Analyses showed that SLUMS cut-off scores of<21(impairment)and>26(no impairment)corresponded to Cognivue^®scores of 54.5(NPA=0.92;PPA=0.64)and 78.5(NPA=0.5;PPA=0.79),respectively.Therefore,conservatively,Cognivue^®scores of 55-64 corresponded to impairment,and 74-79 to no impairment.For the clinical validation study,401 participants completed≥1 testing session,and 358 completed 2 sessions 1-2 wk apart.Cognivue^®classification scores were validated,demonstrating good agreement with SLUMS scores(weightedκ0.57;95%CI:0.50-0.63).Reliability analyses showed similar scores across repeated testing for Cognivue^®(R2=0.81;r=0.90)and SLUMS(R2=0.67;r=0.82).Psychometric validity of Cognivue^®was demonstrated vs.traditional neuropsychological tests.Scores were most closely correlated with measures of verbal processing,manual dexterity/speed,visual contrast sensitivity,visuospatial/executive function,and speed/sequencing.CONCLUSION Cognivue^®scores≤50 avoid misclassification of impairment,and scores≥75 avoid misclassification of unimpairment.The validation study demonstrates good agreement between Cognivue^®and SLUMS;superior reliability;and good psychometric validity.展开更多
Background: Measuring cognition in clinical practice is clearly essential to the appropriate characterisation of patients’ clinical status and to the development of a personalised care plan. The Screen for Cognitive ...Background: Measuring cognition in clinical practice is clearly essential to the appropriate characterisation of patients’ clinical status and to the development of a personalised care plan. The Screen for Cognitive Impairment in Psychiatry (SCIP) has been developed in order to provide a brief and accessible tool allowing the evaluation of cognitive function in psychiatric conditions. Objective: We present a validation of a French version of the SCIP. Method: Translation from English into French is carried out using the accepted back-translation method. Seventy-two healthy volunteers are characterised by demographic questionnaires and a neuropsychological battery. The French version of the SCIP is then administered on two separate occasions separated by at least a one-week interval. Results: High internal consistencies as well as strong correlations with comparable neuropsychological tests are obtained. A normalised Cronbach’s α = 0.66 is obtained. Conclusions: The French version of the SCIP (SCIP-F) yields results comparable to the English version. The SCIP represents an essential tool for the preliminary evaluation of cognition. Its characteristics, brevity and the lack of need for a technological platform, allow for its integration into clinical practice. Further testing of SCIP-F in various psychiatric conditions will yield valuable information on its potential in clinical settings.展开更多
文摘In this editorial we comment on the article by Cahn-Hidalgo D published in a recent issue of the World Journal of Psychiatry 2020;10(1);1-11.We focus on the importance of utilizing psychometrically valid cognitive screening tools when assessing for cognitive decline in older adults in a psychiatric outpatient setting.We compared the use of Cognivue®to use of the montreal cognitive assessment(MoCA)as a cognitive screening tool.A total of 58 patients aged 55 and over participated in this comparison study.Patients completed cognitive screening on Cognivue®,a new Food and Drug Administration-cleared computer screening device,and the MoCA.The results of patient performance using these two instruments were analyzed.Sixteen(28%)patients screened negative for cognitive impairment on both assessments.Forty-two(72%)patients screened positive on one or both of the assessments.There was 43%agreement between Cognivue®and the MoCA in identifying patients with cognitive impairment,and individual subtests were weakly correlated.The MoCA was determined to be the preferred instrument due to its high sensitivity and specificity(100%and 87%,respectively)when screening for cognitive impairment.We propose that the use of Cognivue®cognitive screening tool be closely reviewed until more research proves that the test meets the standards for reliability and validity.It is important for clinicians to remember that screeners should not be used to diagnosis patients with neurocognitive disorders;instead,they should be used to determine whether further evaluation is warranted.Additionally,misdiagnosing of neurocognitive disorders can pose unnecessary psychological and emotional harm to patients and their families and also lead to incorrect treatment and undue healthcare costs.
文摘BACKGROUND Cognitive decline is common among older patients with cardiovascular disease(CVD) and can decrease their self-management abilities. However, the instruments for identifying mild cognitive impairment(MCI) are not always feasible in clinical practice. Therefore, this study evaluated whether MCI could be detected using the Japanese version of the Rapid Dementia Screening Test(RDST-J), which is a simple screening tool for identifying cognitive decline.METHODS This retrospective single-center study included patients who were ≥ 65 years old and hospitalized because of CVD.Patients with a pre-hospitalization diagnosis of dementia were excluded. Each patient's cognitive function had been measured at discharge using the RDST-J and the Japanese version of the Montreal Cognitive Assessment(Mo CA-J), which is a standard tool for MCI screening. The correlation between the two scores was evaluated using Spearman's rank correlation coefficient. Receiver operating characteristic(ROC) analysis was also to evaluate whether the RDST-J could identify MCI, which was defined as a Mo CA-J score of ≤ 25 points.RESULTS The study included 78 patients(mean age: 77.2 ± 8.9 years). The RDST-J and Mo CA-J scores were strongly correlated(r = 0.835, P < 0.001). The ROC analysis revealed that an RDST-J score of ≤ 9 points provided 75.4% sensitivity and 95.2% specificity for identifying MCI, with an area under the curve of 0.899(95% CI: 0.835-0.964). The same cut-off value was identified when excluding patients with a high probability of dementia(RDST-J score of ≤ 4 points).CONCLUSIONS The RDST-J may be a simple and effective tool for identifying MCI in older patients with CVD.
文摘BACKGROUND Cognitive issues such as Alzheimer’s disease and other dementias confer a substantial negative impact.Problems relating to sensitivity,subjectivity,and inherent bias can limit the usefulness of many traditional methods of assessing cognitive impairment.AIM To determine cut-off scores for classification of cognitive impairment,and assess Cognivue®safety and efficacy in a large validation study.METHODS Adults(age 55-95 years)at risk for age-related cognitive decline or dementia were invited via posters and email to participate in two cohort studies conducted at various outpatient clinics and assisted-and independent-living facilities.In the cut-off score determination study(n=92),optimization analyses by positive percent agreement(PPA)and negative percent agreement(NPA),and by accuracy and error bias were conducted.In the clinical validation study(n=401),regression,rank linear regression,and factor analyses were conducted.Participants in the clinical validation study also completed other neuropsychological tests.RESULTS For the cut-off score determination study,92 participants completed St.Louis University Mental Status(SLUMS,reference standard)and Cognivue^®tests.Analyses showed that SLUMS cut-off scores of<21(impairment)and>26(no impairment)corresponded to Cognivue^®scores of 54.5(NPA=0.92;PPA=0.64)and 78.5(NPA=0.5;PPA=0.79),respectively.Therefore,conservatively,Cognivue^®scores of 55-64 corresponded to impairment,and 74-79 to no impairment.For the clinical validation study,401 participants completed≥1 testing session,and 358 completed 2 sessions 1-2 wk apart.Cognivue^®classification scores were validated,demonstrating good agreement with SLUMS scores(weightedκ0.57;95%CI:0.50-0.63).Reliability analyses showed similar scores across repeated testing for Cognivue^®(R2=0.81;r=0.90)and SLUMS(R2=0.67;r=0.82).Psychometric validity of Cognivue^®was demonstrated vs.traditional neuropsychological tests.Scores were most closely correlated with measures of verbal processing,manual dexterity/speed,visual contrast sensitivity,visuospatial/executive function,and speed/sequencing.CONCLUSION Cognivue^®scores≤50 avoid misclassification of impairment,and scores≥75 avoid misclassification of unimpairment.The validation study demonstrates good agreement between Cognivue^®and SLUMS;superior reliability;and good psychometric validity.
文摘Background: Measuring cognition in clinical practice is clearly essential to the appropriate characterisation of patients’ clinical status and to the development of a personalised care plan. The Screen for Cognitive Impairment in Psychiatry (SCIP) has been developed in order to provide a brief and accessible tool allowing the evaluation of cognitive function in psychiatric conditions. Objective: We present a validation of a French version of the SCIP. Method: Translation from English into French is carried out using the accepted back-translation method. Seventy-two healthy volunteers are characterised by demographic questionnaires and a neuropsychological battery. The French version of the SCIP is then administered on two separate occasions separated by at least a one-week interval. Results: High internal consistencies as well as strong correlations with comparable neuropsychological tests are obtained. A normalised Cronbach’s α = 0.66 is obtained. Conclusions: The French version of the SCIP (SCIP-F) yields results comparable to the English version. The SCIP represents an essential tool for the preliminary evaluation of cognition. Its characteristics, brevity and the lack of need for a technological platform, allow for its integration into clinical practice. Further testing of SCIP-F in various psychiatric conditions will yield valuable information on its potential in clinical settings.
