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Background: The Brain Health Test‐7 (BHT‐7) was developed to identify patients with mild cognitive impairment (MCI) and early dementia. Here we report the validity of the BHT‐7 versus the Mini‐Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) in subjects of different psychiatry or neurology clinics. Method: Patients with the chief complaint of memory decline were recruited in this study from the outpatient clinic of psychiatry or neurology in 3 different kinds of hospitals between November 2017 to December 2020. All patients underwent the evaluation of the BHT‐7, MMSE, MoCA, and CDR by trained research assistants or board‐certified psychologists. The final clinical diagnosis (normal, MCI, dementia) was made by consensus meeting, taking into account all available data, including clinical history and symptoms, brain image, cognitive tests, and CDR. Demographic data (age, gender, and education level) and the scores of the MMSE, MoCA, and BHT‐7 between groups were compared. Logistic regression was adopted for analysis of optimal cutoff values, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the area under the ROC curve. Result: We enrolled a total of 1090 subjects (normal 402, MCI 317, dementia 371); of them, 705 (64.7%) were female. There was a statistically significant difference in age, years of education, and 3 cognitive test scores among the 3 groups of subjects. Compared with the MMSE and MoCA, the BHT‐7 performed slightly better in differentiating MCI and dementia. In sub‐group analysis (divided based on 6 years of education), the BHT‐7 still performed slightly better than MMSE and MoCA. The testing time for the BHT‐7 was about 5‐7 minutes, shorter than that of the MMSE and MoCA. For BHT‐7, the cutoff point was 17 between normal and MCI, and 14 between normal and dementia. These cutoff points of BHT‐7 were consistent through 3 different settings (medical center's psychiatry and neurology clinics, and outpatient clinic of a psychiatry center). In contrast, the cutoff points were inconsistent for MMSE and MoCA in different settings. Conclusion: The results support that BHT‐7 may be a useful cognitive screening tool for MCI or early dementia in various clinic settings. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions Older‐age bipolar disorder (OABD) is commonly defined as bipolar disorder in individuals aged 60 or more. There have been no studies to examine temporal trends in the pharmacological treatment of OABD. We aimed to investigate prescription changes among OABD patients discharged from two public mental hospitals in Taiwan from 2006 to 2019.OABD patients discharged from the two study hospitals, from 1 January 2006 to 31 December 2019 (n = 1072), entered the analysis. Prescribed drugs at discharge, including mood stabilisers (i.e., lithium, valproate, carbamazepine, and lamotrigine), antipsychotics (i.e., second‐ and first‐generation antipsychotics (SGAs and FGAs)), and antidepressants, were investigated. Complex polypharmacy was defined as the use of three or more agents among the prescribed drugs. Temporal trends of each prescribing pattern were analyzed using the Cochran‐Armitage Trend test.The most commonly prescribed drugs were SGAs (72.0%), followed by valproate (48.4%) and antidepressants (21.7%). The prescription rates of SGAs, antidepressants, antidepressants without mood stabilisers, and complex polypharmacy significantly increased over time, whereas the prescription rates of mood stabilisers, lithium, FGAs, and antidepressants plus mood stabilisers significantly decreased.Prescribing patterns changed remarkably for OABD patients over a 14‐year period. The decreased use of lithium and increased use of antidepressants did not reflect bipolar treatment guidelines. Future research should examine whether such prescribing patterns are associated with adverse clinical outcomes. [ABSTRACT FROM AUTHOR]