J Geriatr Psych Neur
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J Geriatr Psych Neur · Dec 2012
Cognitive impairment in Parkinson disease: impact on quality of life, disability, and caregiver burden.
To compare quality of life, level of disability, and caregiver burden in 3 groups of people with Parkinson disease (PD): those with mild cognitive impairment (PD-MCI), those with dementia (PDD), and those with no cognitive impairment (PD-NC). ⋯ The presence of dementia significantly increases caregiver burden and decreases quality of life. However, even mild levels of cognitive impairment increase disability and overall functional impairment progresses in tandem with cognitive decline.
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J Geriatr Psych Neur · Dec 2012
The Informant Questionnaire on Cognitive Decline in the Elderly individuals in screening mild cognitive impairment with or without functional impairment.
The Informant Questionnaire on Cognitive Decline in the Elderly individuals (IQCODE) is a reliable, validated informant-based instrument. Most of the studies well support the validity of the IQCODE in dementia screening, but the sensitivity of the rating scale at the early stage during the course of dementia is limited. In this study, we investigate the utility of the IQCODE for patients with mild cognitive impairment (MCI) and the discriminative power of the IQCODE in patients having MCI with and without functional impairment. ⋯ The optimal cutoff scores of the IQCODE were 3.19 for the MCI (sensitivity/specificity: 0.979/0.714) and MCI-fn (0.900/0.817), 3.25 for the MCI-fi (0.978/0.701), and 3.31 for mild AD (0.893/0.779), while the MMSE was identical, that is 26, for both MCI and its functional normal and functional impaired subgroups (0.892/0.755, 0.867/0.745, and 0.913/0.745, respectively) and 24 for mild AD (0.807/0.836). The discriminating accuracy of the IQCODE was slightly superior to that of the MMSE but did not reach statistical significance. Our study suggests that the IQCODE might be useful in screening for MCI, with hierarchical scores indicating functional normal or impaired.
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J Geriatr Psych Neur · Sep 2012
Symptom profile of postoperative delirium in patients with and without dementia.
This study compares the symptom profile of patients with postoperative delirium after femoral neck fracture surgery in those with and without dementia. In this study, 129 patients of age ≥70 years (mean age ±SD, 86±6 yr, 72% women) with postoperative delirium, were included. Delirium and dementia were diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) criteria. ⋯ In contrast, patients with delirium but without dementia were more often diagnosed with pure hypoactive and any psychotic delirium. The symptom profile of postoperative delirium varies according to whether it occurs in patients with or without dementia. This may indicate that postoperative delirium among patients with hip fracture differs based on the presence or absence of dementia.
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J Geriatr Psych Neur · Sep 2012
Validation of the Hebrew version of the MoCA test as a screening instrument for the early detection of mild cognitive impairment in elderly individuals.
The English version of the Montreal Cognitive Assessment (MoCA) test has been shown to be reliable in screening for mild cognitive impairment (MCI). However, the sensitivity and specificity of the Hebrew version of this instrument are yet to be determined. ⋯ The Hebrew version of the MoCA test is effective for identifying MCI in older patients. As a screening instrument for MCI, its higher sensitivity makes it preferable o the MMSE, which is used extensively in the clinical setting.
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In a cross-sectional study, 31 dementia caregivers were compared to a group of 25 noncaregiving controls to evaluate whether the stress of being the primary caregiver of a person with dementia produces cognitive dysfunction. Cognitive differences were examined to evaluate the relationships between cognitive function and stress-related physiological and psychological measures to contribute information regarding its potential mechanism. The cognitive assessments were 2 measures of attention-executive function and 1 word list memory task. ⋯ There was no interaction of caregiver status and age on cognitive performance. The caregivers and noncaregivers differed in morning salivary cortisol and most of the self-rated stress-related measures with the caregiver values reflecting greater stress. Of note, impaired sleep was the only potential mediator of the caregiver effect on cognitive performance in our small sample.