RESUMEN
The Alzheimer's Disease Assessment Scale (ADAS-Cog) has become the de facto gold-standard for assessing the efficacy of putative anti-dementia treatments. There has been an increasing interest in providing greater standardization, automation, and administration consistency to the scale. Recently, electronic versions of the ADAS-Cog (eADAS-Cog) have been utilized in clinical trials and demonstrated significant reductions in frequency of rater error as compared to paper. In order to establish validity of the electronic version (eADAS-Cog), 20 subjects who had received a diagnosis of probable Alzheimer's disease (AD) at a private US Memory Clinic completed a single-center, randomized, counterbalanced, prospective trial comparing a version of the eADAS-Cog to the standard paper scale. Interclass Correlation Coefficient on total scores and Kappa analysis on domain scores yielded high agreement (0.88 - 0.99). Effects of order and mode of administration on ADAS-Cog total scores did not demonstrate a significant main effect. Overall, this study establishes adequate concurrent validity between the ADAS-Cog and eADAS-Cog among an adult population with diagnosed AD.
Asunto(s)
Enfermedad de Alzheimer/psicología , Progresión de la Enfermedad , Pruebas de Estado Mental y Demencia , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/diagnóstico , Enfermedad de Alzheimer/fisiopatología , Computadoras de Mano , Femenino , Humanos , Masculino , Estudios Prospectivos , Psicometría , Distribución Aleatoria , Reproducibilidad de los ResultadosRESUMEN
OBJECTIVE: Eye movement difficulties in multiple sclerosis (MS) are common and may influence performance on cognitive tests. The following studies examined associations between a new measure of speedy eye movement speed and visual/nonvisual cognitive tests. METHOD: In Experiment 1, MS patients (N = 71) were administered cognitive tests and the Speedy Eyes Test (SET) as a measure of purposeful speedy eye movements under timed conditions. Experiment 2 was composed of MS patients (n = 60) and a neurologically healthy comparison group (n = 31) and examined group differences in an abbreviated version of the SET. RESULTS: In both studies, slower eye movements were significantly associated with poorer performance on cognitive tests with a large effect size in Experiment 1 and a medium effect size in Experiment 2. Analyses in Experiment 2 also revealed significant group differences in an abbreviated measure of the SET, where MS patients had slower eye movements than the comparison group. CONCLUSIONS: Pending further research, the SET, a brief, inexpensive, and nontechnical measure of speedy eye movement, may serve as a visual/oculomotor indicator of cognitive impairment in multiple sclerosis.
Asunto(s)
Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/etiología , Esclerosis Múltiple/complicaciones , Trastornos de la Motilidad Ocular/diagnóstico , Trastornos de la Motilidad Ocular/etiología , Adolescente , Adulto , Anciano , Asociación , Humanos , Persona de Mediana Edad , Pruebas Neuropsicológicas , Estimulación Luminosa , Aprendizaje Verbal , Pruebas de Visión , Percepción Visual/fisiología , Adulto JovenRESUMEN
Both vision and cognitive problems are commonplace in multiple sclerosis. Previous research suggests that MS patients with compromised near vision perform more poorly on visually mediated cognitive tests. Consequently it has been recommended that neuropsychologists who evaluate MS patients with poor corrected near vision should rely primarily on auditory neuropsychological tests. However, no research has examined the association between vision problems and performance on non-visual neuropsychological tests in MS. Moreover, little if any research has examined the association between more sensitive measures of vision impairment and cognitive difficulties in MS. The objective of this study was to examine the relationship between visual acuity and cognition in MS. A total of 65 MS patients were administered a visual and neuropsychological evaluation. Visual examination included an assessment of visual acuity, low-contrast visual acuity (5%, 2.5%, and 1.25% illuminated charts) and near visual acuity. Poorer high-contrast, near, and low-contrast visual acuity were significantly associated with poorer performance on visual, non-visual, and motor-based neuropsychological tests. Neuropsychologists should be aware that poor corrected vision in MS is associated with poor performance in all cognitive and motor domains. Results suggest the need for further exploration of visual acuity biomarkers of disease progression in MS.
Asunto(s)
Trastornos del Conocimiento/etiología , Esclerosis Múltiple/complicaciones , Pruebas Neuropsicológicas , Trastornos de la Visión/etiología , Pruebas de Visión , Agudeza Visual/fisiología , Adulto , Trastornos del Conocimiento/diagnóstico , Sensibilidad de Contraste , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Actividad Motora , Estimulación Luminosa/métodos , Índice de Severidad de la Enfermedad , Trastornos de la Visión/diagnósticoRESUMEN
OBJECTIVES: To determine consultants' compliance with motor traffic regulations on recall to hospital to attend emergencies, and ownership and use of green warning lights (GWLs). To determine the views of senior police officers on consultants complying with traffic regulations on emergency recall with and without GWLs. METHOD: Questionnaire survey of all consultants in obstetrics and gynaecology, paediatrics and emergency medicine in the Yorkshire Deanery, UK, and members of the Association of Chief Police Officers (ACPO). RESULTS: 220 consultant questionnaires were distributed and 166 replies were received; 21% of respondents owned a GWL. Almost 50% of consultants would consider exceeding speed limits when returning to an emergency. Between 43% and 80% consultants would cross red traffic lights; driving habits varied with usage and ownership of a GWL. 12.7% (21) of respondents had been stopped for traffic violations attending emergencies, 2.4% (4) had been prosecuted and 4.8% (8) had been involved in accidents. The ACPO advised that consultants should observe all traffic regulations at all times. CONCLUSION: Consultants recalled to their hospitals for emergencies disregard speed restrictions and traffic light signals both with and without GWLs and risk both accident and prosecution for ignoring traffic legislation. They should consider using a GWL to ease their progress through traffic when attending an emergency and observe all traffic laws.