Skip to main content Accessibility help
×
Home
Hostname: page-component-55b6f6c457-85hf2 Total loading time: 0.383 Render date: 2021-09-25T06:09:28.240Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": true, "newCiteModal": false, "newCitedByModal": true, "newEcommerce": true, "newUsageEvents": true }

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

Published online by Cambridge University Press:  29 March 2017

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.

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.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Auer, S. R., Sclan, S. G., Yaffee, R. A. and Reisberg, B. (1994). The neglected half of Alzheimer disease: cognitive and functional concomitants of severe dementia. Journal of the American Geriatrics Society, 42, 12661272.CrossRefGoogle ScholarPubMed
Boller, F., Verny, M., Hugonot-Diener, L. and Saxton, J. (2002). Clinical features and assessment of severe dementia. A review1. European Journal of Neurology, 9, 125136.CrossRefGoogle Scholar
Chodosh, J. et al. (2008). Nursing home assessment of cognitive impairment: development and testing of a brief instrument of mental status. Journal of the American Geriatrics Society, 56, 20692075.CrossRefGoogle ScholarPubMed
Corp (2013). Stata statistical software: release 13.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle ScholarPubMed
Harrell, L. E., Marson, D., Chatterjee, A. and Parrish, J. A. (2000). The severe mini-mental state examination: a new neuropsychologic instrument for the bedside assessment of severely impaired patients with Alzheimer disease. Alzheimer Disease & Associated Disorders, 14, 168175.CrossRefGoogle Scholar
Latest Facts & Figures Report|Alzheimer's Association. (2016). Latest Facts & Figures Report|Alzheimer's Association. [ONLINE]. Available at: http://www.alz.org/facts/overview.asp; last accessed 15 December 2016.Google Scholar
Sales, M. V., Suemoto, C. K., Nitrini, R., Jacob-Filho, W. and Morillo, L. S. (2012). A useful and brief cognitive assessment for advanced dementia in a population with low levels of education. Dementia and Geriatric Cognitive Disorders, 32, 295300.CrossRefGoogle Scholar
Saxton, J., McGonigle-Gibson, K. L., Swihart, A. A., Miller, V. J. and Boller, F. (1990). Assessment of the severely impaired patient: description and validation of a new neuropsychological test battery. Psychological Assessment: A Journal of Consulting and Clinical Psychology, 2, 298.CrossRefGoogle Scholar
Schmitt, F. A. et al. (1997). The severe impairment battery: concurrent validity and the assessment of longitudinal change in Alzheimer's disease. Alzheimer Disease & Associated Disorders, 11, 5156.CrossRefGoogle Scholar
Schmitt, F. A., Saxton, J., Ferris, S. H., Mackell, J. and Sun, Y. (2013). Evaluation of an 8-item severe impairment battery (SIB-8) vs. the full SIB in moderate to severe Alzheimer's disease patients participating in a donepezil study. International Journal of Clinical Practice, 67, 10501056.CrossRefGoogle Scholar
Schmitt, F. A. et al. (2009). A brief instrument to assess treatment response in the patient with advanced Alzheimer disease. Alzheimer Disease & Associated Disorders, 23, 377383.CrossRefGoogle ScholarPubMed
Wajman, J. R. and Bertolucci, P. H. F. (2006). Comparison between neuropsychological evaluation instruments for severe dementia. Arquivos De Neuro-Psiquiatria, 64, 736740.CrossRefGoogle ScholarPubMed
Wild, K. V. and Kaye, J. A. (1998). The rate of progression of Alzheimer's disease in the later stages: evidence from the severe impairment battery. Journal of the International Neuropsychological Society, 4, 512516.CrossRefGoogle ScholarPubMed
3
Cited by

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

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

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

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

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

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

Reply to: Submit a response

Please enter your response.

Your details

Please enter a valid email address.

Conflicting interests

Do you have any conflicting interests? *