Search

ObjectiveThe early and efficacious detection of neurocognitive disorders poses a key diagnostic challenge. We examined how bedside cognitive tests perform across the spectrum of delirium and motor subtypes.MethodsThe performance on a battery of bedside cognitive tests were compared in elderly medical inpatients with DSM-IV delirium, subsyndromal delirium, and no neuro cognitive disorder and in motor subtypes.ResultsOne hundred and ninety-eight patients (mean age 79.14 ± 8.26) were assessed with no delirium (n = 43), subsyndromal delirium (n = 45), and full syndromal delirium (n = 110). The ability to meaningfully engage with the tests varied from 59% for vigilance B test to 85% for Spatial Span forward test and was found to be least in the full syndromal delirium group. The no delirium group was distinguished from the delirium groups for all the tests and from the full syndromal delirium group for the vigilance B test and global visuospatial function test. The subsyndromal delirium group differed from the full syndromal delirium group in respect of global visuospatial function test, spatial span backwards and vigilance A tests. Patients with full syndromal delirium were best identified using the interlocking pentagons test and clock drawing test whereas those with subsyndromal delirium were best identified using interlocking pentagons test and months backwards test. Those with subsyndromal delirium were significantly better in their ability to engage than those with full syndromal delirium.ConclusionsSimple bedside tests of attention, vigilance, and visuospatial ability are useful to help to distinguish neurocognitive disorders namely subsyndromal delirium from other presentations.Disclosure of interestThe author haS not supplied his/her declaration of competing interest.

Introduction The cerebrovascular disorders, traumatic brain injury and epilepsy lead to the development of dementia, which requires a psychometric verification of cognitive disorders. Objectives In patients with dementia due to vascular brain diseases, traumatic brain injury and epilepsy was analyzed psychometric indicators of cognitive impairment. Aim Was studied the severity psychometric characteristics of cognitions in patients with dementia due to vascular diseases of the brain, brain injury and epilepsy. Materials 5 groups patients with dementia: F01.00 - 14 patients (mean age 55 years), F01.1 + F01.3 - 14 patients (mean age 60 years), F01.8 - 14 patients (mean age 65 years), F02.802 - 21 patients (mean age 50 years), F02.803 - 15 patients (mean age 38.5 years). Methods The psychometric methods: MMSE, FAB, Schulte, the clock drawing test, nonparametric statistical methods. Table of results:. Diagnosis MMSE FAB Table Schulte (seconds) Clock drawing test F02.803 19,93±3,73 13,30±2,17 83,5±49,5 6,27±1,90 F02.802 20,04±4,12 10,47±4,15 97,5±53 6,66±2,18 F01.00 20,90±2,98 10,27±3,37 105±46 4,72±2,05 F01.8 17,66±6,20 10,11±3,33 122±59 3,77±2,68 F01.1+F01.3 17,40±6,53 8,30±3,33 188±117 5,12±1,45 [Psychometric indicators of dementia] Conclusion Severity of cognitive impairment is increasing in the following order: 1) dementia due to epilepsy; 2) dementia due to brain injury; 3) acute post-stroke dementia; 4) atherosclerotic, vascular dementia unspecified; 5) multi-stroke, mixed cortical and subcortical vascular dementia. Disorders of frontal functions dominate in the structure of cognitive impairment in all dementias.

Introduction Dementia is severe mental disorder which should be treated both with pharmacological and nonpharmacological approaches. Objectives, aims To evaluate the effectiveness of non-pharmacological approaches influencing cognitive functions we used in routine practice in inpatient women psychogeriatric ward in Mental hospital in Kromeriz and satisfaction with these activities in hospitalised patients. Methods At the beginning and at the end of hospitalisation was used range of Mini-Mental State Examination (MMSE) and Clock Drawing Test (CDT) to make an indicative assessment of cognitive functions, and at the end of hospitalization was used a controlled interview. Results At the end of hospitalisation there was no significant evidence of improving cognitive functions (short period of research is the most probable reason). Nevertheless, psychotherapeutic activities were evaluated by clients positively. Conclusion Non-pharmacological approaches have important position in treatment of dementia, together with pharmacological and support therapy.

Introduction The treatment of dementia should involve both pharmacological and nonpharmacological modalities (Jirak R, 2004, Lužný J, 2010). The effective treatment may lead to partial improvement of symptoms and may stop further deterioration of dementia at least for a time (Pidrman V, 2007, Lužný J, 2009, Lužný J, 2011). Objectives Our study monitored the efficiency of nonpharmacological approaches in treating patient with mild and moderate dementia who have been hospitalized in Mental hospital Kroměřiž. Aims Evaluation of the effectiveness of nonpharmacological approaches influencing cognitive functions which are used in practice in psychogeriatric ward in Mental hospital in Kromeriz and evaluation of satisfaction with these activities by hospitalized clients. Methods and design Cross-sectional study, done in November 2011. Instruments: Mini-Mental State Examination (MMSE) and Clock Drawing Test (CDT). Results At the end of hospitalization significant improvement in cognitive functions was observed in studied semple of patients. Conclusion Nonpharmacological approaches have important position in treatment of dementia, they assist in restoring cognitive functions, they help in patients self-esteem and activization.

Mild Cognitive Impairment (MCI)is the most obvious decrease mental function, considered to be a potential transitional stage between normal cognitive function and dementia. The number of older people is growing rapidly worldwide and the fact that elderly people are also apparently living longer, dementia, the most common cause of cognitive impairment is getting to be a greater public health problem.ObjectiveThe aim of this study is to evaluate the correlation between clinical features and imaging aspects at patient diagnosed with MCI.Material and methodsThe study comprises a number of 45 elderly patients diagnosed with MCI. MMSE score between 28-21 points is considered mild cognitive impairment. The patients were evaluated with MMSE (Mini Mental State Evaluation), clock drawing test (CDT), Raven QI test and computer tomography.ResultsThe average of MMSE was 23.88. The most affected items of MMSE were attention, concentration and recall. The results CDT was reduced on average by 2.57 points from the maximum of 4 points. Raven test showed that almost all the patient included presented QI under 90 points, an intelligence level under limits. The patients with lower MMSE score have more than one imaging change. All the patients with low CDT score have cortical atrophy.ConclusionsIn general imaging changes are correlated with MMSE and CDT scores: as the scores are lower the tomography changes are more severe.AcknowledgmentThe work reported in this paper was supported by grant PNCDI2-41-057/2007 from the Romanian Ministry of Education and Research.

Objectives:To estimate the prevalence of depression and of depressive symptoms among older people living in retirement homes within Penacova county. to estimate the percentage of elderly depressed people receiving adequate treatment. to study associations between recorded clinical variables and depression.Method:We visited all the retirement homes of Penacova County to interview institutionalized men and women older than 64 years, applying a semi-structured protocol that included GDS (geriatric depression screening scale), MMSE, pain scale, Clock Drawing Test, Barthel Index and BSI (Brief Symptom Inventory).Results:We included 78 subjects (22 Men and 56 Women) with a mean age of 81.3 years. among them 29 were illiterate, 34 had < 4 years of education, 13 had 4 years of education and 2 had a university degree. 56 were widowers and 49 were born in Penacova. the mean GDS value was 17.27. 19,2% were not depressed, 46.1% were depressed and 34,6% were severely depressed.Conclusion:These results suggest that depression is a common problem affecting older people living in retirement homes. A significant percentage of depressed patients were not adequately treated. This study highlights the importance of screening this population for depression.

Alcohol- Induced Persisting Dementia (AIPD) can occur because of both the direct effects of alcohol and specific vitamin deficiencies, and the indirect influence of genetic or neurochemical predisposition.Aim of this study was to ascertain the efficiency of the rivastigmine therapy in the treatment of AIPD.Methods:The prospective clinical study included 101 patients diagnosed in accordance with DSM IV criteria for AIPD. Patients were monitored for 3 months in hospital and outpatient conditions, according to specially designed protocol, which included MMSE, BPRS, CGI1-4 scales, and clock drawing test (CDT). Both the control and the experimental groups were treated with conventional therapy and in addition the experimental group treatment was supplemented with rivastigmine (3-12 mg/24 h).Results:The participants were in the same age range, predominantly male, with an similar average illness duration. Average daily rivastigmine dose was 9.76±2.014 mg. An average pretrial MMSE score was around 19, BPRS score was around 50, CGI1 score was around 4.6, and CDT score around 5. Statistically significant differences among the C and E group begin to show after 14th (in BPRS scores)and 28th day of therapy(in MMSE,CDT,and CGI1 scores) (p>0.1) and to become more apparently significant after two and three months of treatment (p>0.5).Conclusion:MMSE and CDT scores are significantly higher, and BPRS, CGI1-3 scores significantly lower in rivastigmine group from 14th and 28thday of treatment. Rivastigmine has statistically significant effect in treatment of AIPD.

Objective:The aim of this study is to identify the correlation between mild cognitive impairment (MCI), educational status and intellectual activity in elderly patients.Material and methods:The study comprises 40 elderly patients diagnosed with MCI. the diagnosis of MCI was established applying to all patients MMSE (Mini Mental State Evaluation). Also a Clock Drawing Test (CDT) was applied. A MMSE score between 28-21points was considered as MCI.We consider that a patient has intellectual activities if he performs at least one of the following: reading a book or a newspaper, solving puzzles or mind games.The exclusion criteria were: patients with moderate and severe cognitive impairment and patients with no educational level.Results and discussions:The average of age was 69.65 years. the average of MMSE score was 24.65 points. the correlation between MMSE and CDT is significant at the 0.01 level. the MMSE and CDT scores are smaller as the educational level is lower. 3 subjects have fourth grade education, 17 subjects have eighth grade education, 16 subjects have high-school education and 4subjects have college education. the patients with small scores at cognitive evaluation have no intellectual activity in the present. the intellectual activity is in direct relationship with high educational level; patients with high-school and college education are performing intellectual activities in the present.Conclusions:Patients with actual intellectual activity have the highest MMSE and CDT scores.Intellectual activities are protective factors against cognitive impairment.This paper represents the screening part of a grant PNCDI2 41-057/2007 from the Romanian Ministry of Education and Research.