Search

Objective: To demonstrate the validity of the Symbol Match in a diverse clinical setting. Background: To improve detection of cognitive impairment in older primary care patients, our team developed the 5-Cog, a 5-minute cognitive assessment and decision tree paradigm that can be administered by non-clinicians. The Symbol Match is a new 90-second oral symbol and digit substitution task that is one of the three tests in the 5-Cog that assesses processing speed and executive function. Methods: 50 participants (66% female; 44% Hispanic, 38% Non-Hispanic Black; 36% evaluated in Spanish) with a mean age of 77.84 ± 7.3, and 12 ± 4.7 mean years of education. Participants were recruited following clinical evaluations at the Montefiore Memory Disorder Centers and had confirmed clinical diagnoses of dementia, mild cognitive impairment (MCI), or subjective cognitive concerns (SCC). Results: Symbol Match scores were significantly different (p < 0.001) between participants with SCC (N = 5, M = 48 ± 9.7), MCI (N = 14, M = 31.7 ± 14.3), and dementia (N = 28, M = 9.6 ± 11.5). Age (p = 0.004) and education (p < 0.001) were correlated with Symbol Match score in the overall sample. Symbol Match scores were significantly different between the 3 disease states (p < 0.001) even when controlling for age and education. The Symbol Match was highly correlated (r = 0.843, p < 0.001) with the Symbol Digit Modalities Test (SDMT), an established neuropsychological measure of processing speed and executive function. Conclusion: This study provides initial validation of the Symbol Match and its utility in a clinical population. Further research on psychometric properties and construct validity of this new tool is needed. [ABSTRACT FROM AUTHOR]

Objective: The Symbol Digit Modalities Test (SDMT) is a task of processing speed and executive functioning that is widely used to evaluate individuals with Multiple Sclerosis (MS) and has been shown to predict various instrumental activities of daily living. The relationship between SDMT and daily functioning has not been well explored in the aging population. The Activities of Daily Living-Prevention Instrument (ADL-PI) is a self-report measure that assesses changes in functioning and instrumental activities of daily living (IADLs). We evaluate the relationship between SDMT and ADL-PI in older adults with subjective cognitive complaints in an urban, multi-ethnic, primary care population in Bronx, New York. Methods: 300 participants (50.7% Hispanic, 43.7% non-Hispanic Black; 37% assessed in Spanish) completed the SDMT and ADL-PI as part of a larger study seeking to improve detection of cognitive impairment in primary care. The mean age of the sample was 71.35 ± 5.76 years and participants had a mean 12.26 ± 3.76 years of education. Pearson correlations were used to examine the relationship between SDMT and IADLs. Results: SDMT performance was weakly albeit significantly correlated with self-report of functional difficulties on the ADL-PI (r = −0.312, p < 0.001). The relationship between SDMT (Range = 1–51, M = 25.39) and ADL-PI was significant in both English (p < 0.0011) and Spanish (p = 0.004) speaking participants and remained significant when controlling for age, education, and depression (p = 0.002). Conclusion: Consistent with MS literature, the SDMT is a useful tool for predicting self-report of instrumental activities of daily living of older adults with cognitive concerns. [ABSTRACT FROM AUTHOR]