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
We designed a Japanese version of the Smartphone Dependence Scale (J-SDS) for university students, and assessed its validity and reliability. For development of this scale, we initially selected 43 preliminary items b...We designed a Japanese version of the Smartphone Dependence Scale (J-SDS) for university students, and assessed its validity and reliability. For development of this scale, we initially selected 43 preliminary items based on previous studies of Internet and mobile phone dependence. Each response was scored using a Likert scale (0, 1, 2, 3), with higher scores indicating greater dependence. After administering the preliminary scale to 149 university students, the final 29 items were selected according to exploratory factor analysis. The final scale consisted of 5 factors: 1) craving and withdrawal, 2) overuse and tolerance, 3) virtual life orientation, 4) disturbance of concentration in class, and 5) physical symptoms. Reliability coefficient (Cronbach’s alpha) values for the 5 factors and total J-SDS were 0.87, 0.87, 0.76, 0.77, 0.69, and 0.92, respectively. We then summed the Likert scores for each item to provide a quantitative overall smartphone dependence score, with higher scores indicating greater dependence. The J-SDS score became significantly higher with longer hours of smartphone use (p < 0.001). Our results suggest that the J-SDS is a reliable and valid scale for screening university students who may be at risk of developing smartphone dependence.展开更多
Objective: Clozapine is regarded as the most effective drug for treatment of schizophrenia but has complex adverse effects associated with hyperglycemia and diabetes mellitus. Method: We report that clozapine was very...Objective: Clozapine is regarded as the most effective drug for treatment of schizophrenia but has complex adverse effects associated with hyperglycemia and diabetes mellitus. Method: We report that clozapine was very effective to treat positive, negative, and cognitive symptoms and well tolerated to a treatment-resistant schizophrenia patient with severe type 2 diabetes mellitus (DM) under cautious blood-sugar monitoring. Results: Clozapine itself and discontinuation of other psychotropic and anticholinergic agents after switching may improve cognitive function and adherence to the treatment regimens for schizophrenia and DM. Conclusion: Clozapine can be administered to treatment-resistant schizophrenia patients even with severe DM with caution.展开更多
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We designed a Japanese version of the Smartphone Dependence Scale (J-SDS) for university students, and assessed its validity and reliability. For development of this scale, we initially selected 43 preliminary items based on previous studies of Internet and mobile phone dependence. Each response was scored using a Likert scale (0, 1, 2, 3), with higher scores indicating greater dependence. After administering the preliminary scale to 149 university students, the final 29 items were selected according to exploratory factor analysis. The final scale consisted of 5 factors: 1) craving and withdrawal, 2) overuse and tolerance, 3) virtual life orientation, 4) disturbance of concentration in class, and 5) physical symptoms. Reliability coefficient (Cronbach’s alpha) values for the 5 factors and total J-SDS were 0.87, 0.87, 0.76, 0.77, 0.69, and 0.92, respectively. We then summed the Likert scores for each item to provide a quantitative overall smartphone dependence score, with higher scores indicating greater dependence. The J-SDS score became significantly higher with longer hours of smartphone use (p < 0.001). Our results suggest that the J-SDS is a reliable and valid scale for screening university students who may be at risk of developing smartphone dependence.
文摘Objective: Clozapine is regarded as the most effective drug for treatment of schizophrenia but has complex adverse effects associated with hyperglycemia and diabetes mellitus. Method: We report that clozapine was very effective to treat positive, negative, and cognitive symptoms and well tolerated to a treatment-resistant schizophrenia patient with severe type 2 diabetes mellitus (DM) under cautious blood-sugar monitoring. Results: Clozapine itself and discontinuation of other psychotropic and anticholinergic agents after switching may improve cognitive function and adherence to the treatment regimens for schizophrenia and DM. Conclusion: Clozapine can be administered to treatment-resistant schizophrenia patients even with severe DM with caution.
