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Attended With and Head-Turning Sign can be clinical markers of cognitive impairment in older adults

Published online by Cambridge University Press:  29 June 2017

Pinar Soysal ,
Cansu Usarel ,
Gul Ispirli  and
Ahmet Turan Isik
Pinar Soysal
Affiliation:
Kayseri Education and Research Hospital, Geriatric Center, Kayseri, Turkey
Cansu Usarel
Affiliation:
Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey
Gul Ispirli
Affiliation:
Department of Internal Medicine, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey
Ahmet Turan Isik*
Affiliation:
Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey
*
Correspondence should be addressed to: Prof. Dr. Ahmet Turan Isik, Yaşlanan Beyin ve Demans Unitesi, Geriatri Bilim Dalı, Dokuz Eylul Universitesi Tıp Fakultesi, 35340 Balcova, Izmir, Turkey. Phone: + 90 232 412 43 41; Fax: + 90 232 412 43 49. Email: atisik@yahoo.com.
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Abstract

Background:

Comprehensive neurocognitive assessment may not be performed in clinical practice, as it takes too much time and requires special training. Development of easily applicable, time-saving, and cost effective screening methods has allowed identifying the individuals that require further evaluation. The aim of present study was to assess the diagnostic value of the Attended With (AW) and Head-Turning Sign (HTS) for screening cognitive impairment (CI).

Methods:

Comprehensive geriatric assessment was performed in 529 elderly outpatients, and the presence or absence of AW and HTS was investigated in them all.

Results:

Of the 529 patients, of whom the mean age was 75.67 ± 8.29 years, 126 patients were considered as CI (102 dementia, 24 mild CI). The patients with positive AW had significantly lower scores on Mini-Mental State Examination, Cognitive State Test, and Montreal Cognitive Assessment, and activities of daily living compared to AW (−) patients (p < 0.001). Similar significant findings were obtained in the patients with positive and negative HTS (p < 0.001). The sensitivity, specificity, positive predictive value, and negative predictive value of AW in detecting CI were 92%, 37%, 31.4%, and 93.7%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of HTS were 80%, 64%, 41.8%, and 91.5%, respectively. The area under the receiver-operating characteristics curve was 0.90 for AW and 0.82 for HTS.

Conclusion:

AW and HTS are fast, simple, effective, and sensitive methods for detecting CI. Therefore, they can be used for older adults attending the primary care settings with memory loss. Those with positive AW or HTS can be referred to the relevant centers for detailed cognitive assessment.

Keywords

Attended Withcognitive impairmentdementiaHead-Turning Signolder adults
Type
Paper of the Month
Information
International Psychogeriatrics , Volume 29 , Issue 11 , November 2017 , pp. 1763 - 1769
Copyright
Copyright © International Psychogeriatric Association 2017 

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