Search

Background: There are numerous scales for screening cognitive performance and thus identification of any potential deficits, but in spite of the vulnerability of the prison population to such problems, there has been no adequate validation of screening tools specifically for use with prisoners or others in the criminal justice system. Aim: To validate the Montreal Cognitive Assessment (MoCA) for use with prisoners. Methods: 100 adult prisoners in one Portuguese prison were randomly invited by clinicians to take part in this study. A same size sample of community‐living adult non‐offenders of similar age was selected from the MoCA's normative study database in Portugal. For both groups, the key inclusion criterion was fluency in the Portuguese language. All participants completed the Mini Mental State Examination (MMSE) and the MoCA, both in Portuguese translation. Cronbach's alpha coefficient was calculated as an index of internal consistency and Pearson's r correlations calculated. Group performances were compared using independent samples t‐test. Covariance analysis (ANCOVA) was computed with level of education as covariate. To measure the magnitude of the effect, ηp2 ${\eta }_{p}^{2}$ was used. A receiver operating characteristics curve analysis was computed to evaluate the discriminatory accuracy of MoCA and MMSE. Results: The MoCA showed a 'reasonable' internal consistency index (α = 0.75) as well as positive and significant correlations with the MMSE. As a cognitive measure, however, the MoCA showed consistently superior psychometric properties and higher discriminatory accuracy (MoCA = 89%) than the MMSE (65%). According to the Youden index, the optimal cut‐off point for the MoCA is below 24 points, whereas for the MMSE, it is below 27. Conclusions: The MoCA is a valid cognitive screening tool for use with prisoners. Further validations against detailed cognitive evaluation would be a useful next step. [ABSTRACT FROM AUTHOR]

Introduction: The CDR Dementia Staging Instrument PLUS National Alzheimer's Coordinating Center (CDR plus NACC FTLD) was developed by adding to the standard CDR two extra domains focused on the main features of frontotemporal lobar degeneration (FTLD): language and behavior/personality. We intended to perform the validation studies for the European‐Portuguese population. Methods: A total of 105 participants matched for age, education, and disease staging (35 bvFTD, 35 AD, and 35 controls) were included. A translated‐version of the CDR and the two added domains was administered by a neuropsychologist who was blinded to the diagnosis. Results: The bvFTD group had higher baseline CDR plus NACC FTLD scores compared to the AD and controls. Only the sum‐of‐boxes (SB) score, the behavior/personality, and language domains were able to distinguish between clinical groups. Logistic regression analyses showed that adding the behavior/personality domain with or without language significantly enhanced the discriminating ability. Discussion: Results show that the CDR plus NACC FTLD is a reliable tool in the diagnostic process of bvFTD patients and has an added value in distinguishing them from patients with AD. [ABSTRACT FROM AUTHOR]

Amnestic mild cognitive impairment (aMCI) patients carry a greater risk of conversion to Alzheimer's disease (AD). Therefore, the International Working Group (IWG) on AD aims to consider some cases of aMCI as symptomatic prodromal AD. The core diagnostic marker of AD is a significant and progressive memory deficit, and the Free and Cued Selective Reminding Test (FCSRT) was recommended by the IWG to test memory in cases of possible prodromal AD. This study aims to investigate whether the performance on the FCSRT would enhance the ability to predict conversion to AD in an aMCI group. A longitudinal study was conducted on 88 aMCI patients, and neuropsychological tests were analysed on the relative risk of conversion to AD. During follow-up (23.82 months), 33% of the aMCI population converted to AD. An impaired FCSRT TR was significantly associated with the risk of conversion to dementia, with a mean time to conversion of 25 months. The FCSRT demonstrates utility for detecting AD at its prodromal stage, thus supporting its use as a valid clinical marker. [ABSTRACT FROM AUTHOR]

The International Working Group on Alzheimer's disease ( AD) suggested the free and cued selective reminding test ( FCSRT) to assess memory, as it showed high sensitivity and specificity in the differentiation of AD from healthy controls and other dementias. The FCSRT involves the use of selective reminding with semantic cueing in memory assessment. This study aims to validate the FCSRT for mild cognitive impairment ( MCI) and AD through the analysis of the diagnostic accuracy and the suggestion of cut-off scores. Patients were classified into two groups according to standard criteria: MCI ( n = 100) and AD ( n = 70). A matched control group ( n = 101) of cognitively healthy subjects was included. The reliability and the validity of the FCSRT were analysed on the immediate ( IR) and delayed ( DR) recalls. The Cronbach's alpha was 0.915 for the IR and 0.879 for the DR. The total recall measures revealed good areas under the curve for MCI ( IR: .818; DR: .828) and excellent for AD ( IR: .987; DR: .991). Furthermore, the MCI group was subdivided with respect to a non-similar/similar AD pattern of impairment, with almost half of the subjects showing an AD-like decline. This analysis represents a novel contribution regarding the properties of the FCSRT in illustrating the heterogeneity of MCI at baseline. The FCSRT has proved to be a very useful tool in the characterization of the memory impairment of the AD spectrum. [ABSTRACT FROM AUTHOR]

This study analysed the performance of phonological processing, the diagnostic accuracy and the influence on reading in children who were native speakers of an orthography of intermediate depth. Portuguese children with developmental dyslexia (DD; N = 24; aged 10-12 years), chronological age (CA)-matched controls ( N = 24; aged 10-12 years) and reading level (RL)-matched controls ( N = 24; aged 7-9 years) were tested on measures of phonological processing (phonological awareness, naming speed and verbal short-term memory) and reading. The results indicated that the children with DD performed significantly poorer in all measures compared with the CA and RL. Phonological awareness and naming speed showed a high accuracy (receiver operating characteristics curve analysis) for discriminating the children with DD from the CA and RL, whereas the presence of abnormally low scores in phonological awareness and naming speed was more frequent in the DD group than in the controls and the normative population. Hierarchical linear regression analyses revealed that phonological awareness was the most important predictor of all reading accuracy measures, whereas naming speed was particularly related to text reading fluency. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objectives To present the validation study of the European Portuguese version of the Family Confusion Assessment Method ( FAM- CAM) and to assess the level of psychological distress in families and caregivers of elderly hospitalized adults with delirium. Design Validation study. Setting Intermediate care unit of the Intensive Medicine Service of the São João Hospital Center, Porto, Portugal. Participants Families and caregivers of elderly hospitalized adults (≥48 hours). Inclusion criteria were sufficient knowledge about the individual to enable reporting on his or her mental and physical abilities and staying at the individual's bedside daily during hospitalization. Families and caregivers younger than 18 and those who did not speak Portuguese were excluded. Measurements A trained researcher translated the FAM- CAM according to International Society For Pharmacoeconomics and Outcomes Research guidelines. All individuals were assessed using the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision ( DSM- IV- TR) (reference standard) and the Confusion Assessment Method ( CAM). A trained researcher administered the FAM- CAM to families and caregivers. The level of family-perceived distress was evaluated on a numerical rating scale from 0 to 4. Results The sample included 40 families and caregivers (58% adult children). According to the DSM- IV- TR, 20% of individuals had delirium. The FAM- CAM had moderate sensitivity (75%) and good specificity (91%) when assessed against the DSM- IV- TR and better sensitivity (86%) and specificity (91%) than the CAM. Fifty-seven percent of families and caregivers classified delirium as an extremely distressing experience. Conclusion These preliminary results suggest that FAM- CAM is a sensitive screening tool for family detection of delirium in elderly hospitalized adults. The high level of psychological distress found corroborated previous studies. Future studies with larger samples will be needed for further validation and to allow the analysis of other psychometric properties. [ABSTRACT FROM AUTHOR]

This study analysed the usefulness of the Wechsler Intelligence Scale for Children-Third Edition in identifying specific cognitive impairments that are linked to developmental dyslexia (DD) and the diagnostic utility of the most common profiles in a sample of 100 Portuguese children (50 dyslexic and 50 normal readers) between the ages of 8 and 12 years. Children with DD exhibited significantly lower scores in the Verbal Comprehension Index (except the Vocabulary subtest), Freedom from Distractibility Index (FDI) and Processing Speed Index subtests, with larger effect sizes than normal readers in Information, Arithmetic and Digit Span. The Verbal-Performance IQs discrepancies, Bannatyne pattern and the presence of FDI; Arithmetic, Coding, Information and Digit Span subtests (ACID) and Symbol Search, Coding, Arithmetic and Digit Span subtests (SCAD) profiles (full or partial) in the lowest subtests revealed a low diagnostic utility. However, the receiver operating characteristic curve and the optimal cut-off score analyses of the composite ACID; FDI and SCAD profiles scores showed moderate accuracy in correctly discriminating dyslexic readers from normal ones. These results suggested that in the context of a comprehensive assessment, the Wechsler Intelligence Scale for Children-Third Edition provides some useful information about the presence of specific cognitive disabilities in DD. Copyright © 2013 John Wiley & Sons, Ltd. Practitioner Points Children with developmental dyslexia revealed significant deficits in the Wechsler Intelligence Scale for Children-Third Edition subtests that rely on verbal abilities, processing speed and working memory., The composite Arithmetic, Coding, Information and Digit Span subtests (ACID); Freedom from Distractibility Index and Symbol Search, Coding, Arithmetic and Digit Span subtests (SCAD) profile scores showed moderate accuracy in correctly discriminating dyslexics from normal readers., Wechsler Intelligence Scale for Children-Third Edition may provide some useful information about the presence of specific cognitive disabilities in developmental dyslexia. [ABSTRACT FROM AUTHOR]