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Objective: The Halstead Category Test (HCT) has been demonstrated to be sensitive to executive dysfunction in adults and children. Children with a history of significant prenatal alcohol exposure (...

A prospective longitudinal mixed-method study was undertaken to evaluate an intergenerational community program involving older adults and school aged-children. Data were collected from nine childr...

Background: The primary objective of this systematic review was to determine effective interventions to improve gait (speed, stride length, double limb support) in older adults with cogniti...

Enriched living environments that contain a wide array of personal memorabilia and memory-stimulating cues have the potential to support cognitive functioning. The purpose of this ethnograp...

Objective: Performance validity tests (PVTs) are essential in neuropsychological evaluations; however, it has been questioned how PVTs function in the context of cognitive impairment, and whether cognitive impairment alone is sufficient to cause PVT failure. Further, there is concern that some clinicians will disregard failed PVTs due to their perception that failures represent false-positive errors secondary to cognitive impairment. This study examined patterns associated with cognitively impaired versus noncredible performance across a battery of PVTs and neuropsychological tests. Additionally, the impact of VA service-connection and disability-seeking status on test validity was investigated.Method: A mixed-clinical sample of 103 veterans were administered six PVTs and neuropsychological tests. Performance was compared across three groups: valid-cognitively unimpaired, valid-cognitively impaired, and noncredible.Results: Significant PVT score differences and failure rates emerged across the thr...

Introduction: Prevalence of central auditory processing disorders (CAPD) increases with age. Central auditory dysfunction is also more prevalent in older people with mild memory impairment ...

Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) Reliable Digit Span (RDS), RDS-revised (RDS-R), and age-corrected scaled score (ACSS) are validated and commonly used embedded performance validity tests (PVTs), though existing validation studies have largely examined younger (approximate ages 19-35) patients with mild traumatic brain injury or those without cognitive impairment. This study compared the classification accuracy of RDS, RDS-R, and ACSS in a mixed clinical sample of relatively older (M age = 54.61) veterans with and without neurocognitive impairment.During a comprehensive neuropsychological evaluation, 113 clinically-referred veterans completed the WAIS-IV Digit Span subtest and the following criterion PVTs: Dot Counting Test, Word Choice Test, and Test of Memory Malingering. Those with ≤1 criterion PVT failure were classified as valid (n = 87), whereas those with ≥2 failures were classified as noncredible (n = 26). Among valid participants, 49% were cognitively impaired.RDS, RDS-R, and ACSS all significantly predicted validity group membership with respective areas under the curve (AUCs) of .79, .81, and .85, and optimal cut scores of RDS ≤ 5, RDS-R ≤ 9, and ACSS ≤ 5. Lower accuracy and AUCs were observed for the valid-cognitively impaired subsample across indices, but to a greater degree for traditional RDS. ACSS evidenced maximal sensitivity/specificity for the total sample (≤5; .62/.87), cognitively unimpaired subsample (≤5; .62/.95), and cognitively impaired subsample (≤4; .39/.86).ACSS yielded better classification accuracy and sensitivity/specificity than RDS and RDS-R. While all three indices have utility as embedded PVTs, ACSS ≤ 5 may be most robust to cognitive impairment while identifying noncredible performance.

This study examined the moderating effect of domestic helpers on distress of offspring caring for parents with cognitive impairments and with or without behavioural problems.This secondary analysis of data involved 5086 Hong Kong Chinese adults aged 60 or older applying for public long-term care services from 2010 to 2012. All variables were measured using the mandatory Hong Kong version of the Minimum Data Set-Home Care 2.0.Regarding taking care of parents with cognitive impairments, 10.7% of offspring primary caregivers were aided by domestic helpers, 55.54% reported distress, and 75.70% lived with their parents. Assistance from domestic helpers reduced offspring caregiver distress if the offspring provided psychological support to parents (ratio of OR = 0.655, p.05) and were not living with parents (ratio of OR = 1.183, p.01).These findings might suggest: a) the positive effects of audience on psychological responses to stress; b) caregiving is usually less stressful for informal caregivers not residing with care recipients. Conversely, having a domestic helper could add to caregiving distress if offspring caregivers live with their parents, most likely because offspring may witness difficulties that domestic helpers face in providing dementia care.

Edited byJacquelyn H. Flaskerud, RN, PhD, FAANUniversity of California-Los Angeles, School of Nursing, Los Angeles, California, USAThe room was silent and dimly lit. Mary, her eyes closed, lay quie...

To examine how stable the sense of coherence (SOC) is over a five-year period among residents of nursing homes (NH) who are not cognitively impaired and whether components of social support influence SOC.Many studies have investigated the stability of SOC, and the findings have been inconsistent. Social support is a crucial resource in developing SOC. Few researchers have studied the stability of SOC and how various social support dimensions influence changes in SOC among older NH residents who are cognitively intact.The study was prospective and included baseline assessment and five-year follow-up.The sample comprised 52 cognitively intact NH residents (Clinical Dementia Rating score ≤0.5). We obtained data through direct interviews using the Social Provisions Scale and Sense of Coherence Scale.SOC increased statistically significantly from baseline to follow-up. The social support subdimension reassurance of worth predicted change in SOC after adjustment for sociodemographic factors. When controlled for baseline SOC, attachment was associated with change in SOC, but reassurance of worth was not.The study indicates that the change in SOC over time during the 5 years of follow-up and the social support dimension attachment appear to be important components of change in SOC. Nursing personnel should be aware of the residents' individual needs for attachment and the importance of emotional support for personal strength and ability to cope.

Executive dysfunction is common in early stage Parkinson's disease (PD). We evaluated the relationship between self- and informant-report measurement of real-world executive functions as well as performance-based neuropsychological measures in mildly cognitively impaired individuals with PD and healthy controls. The PD group reported more difficulty with initiation of complex tasks compared to caregiver ratings, and processing speed was a strong predictor of self-reported executive dysfunction for the PD group, followed by depression. Processing speed and semantic verbal fluency predicted informant-reported executive dysfunction in PD. These findings highlight the contribution of speeded processing for performance of everyday executive tasks in PD.

For individuals providing care for older people the issue of risk is a well-established concern, especially in the context of the older person's declining functional abilities and cognitive skills....

Some competent political actors, primarily young people and the cognitively impaired, are excluded from political participation by modern liberal democratic states. This exclusion occurs because the means utilized by states to distinguish between competent citizens (who must be included) and incompetent ones (who may be excluded) are imperfect. They include age restrictions on enfranchisement and, commonly, legal restrictions on enfranchisement for those with cognitive disabilities. Capacity-testing provides a means to improve on these existing mechanisms for exclusion. It is not, however, often suggested, nor seen as viable. Here, I argue that we should utilize capacity-testing to more effectively include capable citizens in our democratic practice. I defend a particular scope and kind of capacity-testing against common objections.

Background: Antipsychotic use for behavioural and psychological symptoms of dementia (BPSD) is controversial. Guidelines advise to reduce antipsychotics given the adverse effects and limited efficacy, to limit dose and treatment duration as well as to undertake discontinuation. Methods: A pilot study with 40 hospitalised geriatric cognitively impaired patients, in which the effects of abrupt antipsychotic discontinuation were investigated, using neuropsychiatric inventory (NPI) scores before and one month after discontinuation. Withdrawal symptoms were monitored thrice a day with a checklist during five consecutive days. Results: Participants (n¼40) had a mean age of 84 years (range 6795) and 53% were male. The total mean baseline NPI score was 21 (SD 12) with predominantly behavioural rather than psychological disturbances. After abrupt discontinuation, mild withdrawal symptoms were observed in 72% of the patients, with frequencies of symptoms peaking on day 2 (53%) and day 3 (48%). After one month, 31 patients (85%) were still off antipsychotics and improved on the majority of NPI domains, with a total mean NPI score decreasing from 18 (SD 13) to 12 (SD 8, p¼0.003). In the relapse group, there was no deterioration associated with the abrupt discontinuation and subsequent resumption of therapy with a total mean NPI score decreasing from 31 (SD 12) at baseline to 27 (SD 8) at one-month follow-up (p¼0.345). Conclusion: Abrupt antipsychotic discontinuation appears to be feasible in older individuals with BPSD. Systematically performed discontinuation efforts in clinical practice are needed to differentiate between patients where antipsychotics have no added value and patients where the benefits outweigh the risks.

The purpose of this brief note is to present a discussion of the first two sessions of a poetry group conducted with moderately to severely cognitively impaired adults in a nursing home. Exercises and techniques used with this population are discussed. Poetry groups such as this may provide joy those who suffer, a chance to re-experience memories, to connect to others, and the creation of moments of increased value and meaning.

In order to maintain and improve the quality of life in the homes of people with dementia, we must elaborate assistive technologies that will alleviate the effects of cognitive decline, such as those erroneous behaviors associated with carrying on activities of daily living (ADL). In order to provide adequate assistive services at the opportune moment, it is necessary to recognize the occupant behavior from sensor events of the smart home. To address this challenge, this paper presents a formal model of activity recognition in smart homes based on possibility theory and environmental contexts. This activity recognition model is able to take into account coherent and erroneous behaviors that may result from the cognitive decline of the occupant. An implementation of this model was validated in a smart home laboratory with valid sensor data from coherent and erroneous realizations of an ADL scenario.

Eight participants with probable Alzheimer's disease (AD) were trained to recall names of countries using the spaced-retrieval memory intervention. Six training sessions were administered on alternate days over a 2-week period. Half of the participants studied a target country alone and the other half studied a target country along with eight distractor countries. Training stimuli appeared in text-only format in half of the sessions and text with a color photograph of the country in the other sessions. On each trial, participants selected the target at increasingly longer retention intervals, contingent upon successful recall. Results indicated that the mean proportion of correct trials and longest duration achieved increased across training sessions, confirming the success of the spaced-retrieval intervention. Pictorial illustrations enhanced explicit memory for target country names. Implications of these data for current views on memory remediation in cognitively impaired older adults are discussed.

Many older individuals have cohort-specific knowledge that may not be known by young caregivers. By providing familiar information, using Montessori principles that key into the remaining abilities of those with dementia, it is possible for the younger caregivers to successfully facilitate satisfying, interactive programs. Forty activity directors and staff, age 25–50, in long-term care settings interacted with residents age 56–100 in groups of 10 or more in both an activity intervention and standard activities. The younger caregivers indicated positive responses to the activity intervention and demonstrated increases in positive attitudes toward cognitively impaired, elderly residents, which was due to the intervention that provides the structure and materials to overcome both the skills gap and intergenerational knowledge gap for those staff that have them.

In some older artists with neurodegenerative dementia, the emergence of a new artistic style has been described (“Sick-Style”). “Old-Age-Style” characterizes the artistic development with aging. We sought to determine whether “Sick-Style” and “Old-Age-Style” are different or overlapping entities by two approaches: Five art historians were asked to rate the development from early to late works of seven older, cognitive healthy visual artists and three painters with Alzheimer's disease on a visual analogue scale for 18 criteria from the literature (7 for “Sick-Style,” 11 for “Old-Age-Style”). The works of the three artists with dementia reached significantly higher ratings on the “Sick-Style” items. The scoring for the “Old-Age-Style” criteria, however, varied widely for the different artists. They did not show differences between artists with and without dementia.

EDITOR'S ABSTRACTAssessment and management of pain in patients with dementia is described. How cognitively impaired patients communicate pain is addressed. Inability to express pain verbally, pain cues, and behavioral disturbances are described. Discomfort, agitation, and dementia behavior are described.

This article presents a novel modular adaptive artful intelligent assistance system for cognitively and/or memory impaired people engaged in the realisation of their activities of daily living (ADLs). The goal of this assistance system is to help disabled persons moving/evolving within a controlled environment in order to provide logistic support in achieving their ADLs. Empirical results of practical tests are presented and interpreted. Some deductions about the key features that represent originalities of the assistance system are drawn and future works are announced.

The Personal Social Services Research Unit (PSSRU) is undertaking an evaluation of 19 extra care schemes that were allocated funding in the first two rounds of the Extra Care Housing Fund. All but two of the schemes indicated that they were making provision for people suffering from dementia, ranging from five designed to make specific provision to four that would meet the needs of residents who developed dementia after they moved in. This paper draws on information collected from 15 schemes that had opened during 2006–07, and a recent comparable study of residents admitted to care homes providing personal care. Overall, the people who moved into extra care were much less physically and cognitively impaired than those who moved into care homes, even in schemes designed specifically to provide for residents with dementia, and exhibited less change in functioning during the first six months. However, levels of cognitive impairment in schemes were generally consistent with the approach of each scheme...

SUMMARY Dementia and delirium, the most common causes of cognitive impairment (CI) among hospitalized older adults, are associated with higher mortality rates, increased morbidity and higher health care costs. A growing body of science suggests that these older adults and their caregivers are particularly vulnerable to systems of care that either do not recognize or meet their needs. The consequences can be devastating for these older adults and add to the burden of hospital staff and care-givers, especially during the transition from hospital to home. Unfortunately, little evidence exists to guide optimal care of this patient group. Available research findings suggest that hospitalized cognitively impaired elders may benefit from interventions aimed at improving care management of both CI and co-morbid conditions but the exact nature and intensity of interventions needed are not known. This article will explore the need for improved transitional care for this vulnerable population and their caregivers.

This research examined whether an Enhanced Cognitive Interview (ECI) and a Modified Cognitive Interview (MCI) improved 75- to 96-year-old adults' recall for a video-taped event. Specifically, we examined the effectiveness of these interviews in relation to a Structured Interview (control), and compared the performance of older adults who scored high or low on the Mini-Mental State Examination (MMSE), which is a test to assess cognitive functioning. Participants with low MMSE scores recalled fewer correct details, and were less accurate than those with high scores. Nevertheless, both high and low MMSE groups reported substantially more correct information about Action, Person, Object, and Surrounding details with the MCI and ECI than with the SI. No corresponding increase in the amount of incorrect and confabulated information was found. Furthermore, recall accuracy for both groups was greater with the ECI and MCI than with the Structured Interview. Overall, findings suggest that older individuals, including those with reduced cognitive ability can benefit from the use of Cognitive Interview protocols.

This study examined the relationship between patients' cognitive status, deficit awareness, medication management skills, and actual medication adherence. Twenty-seven persons with Alzheimer's disease and 20 healthy controls were evaluated for their predicted and objective performance on tasks related to medication management. Caregivers were also evaluated for their prediction of the care recipient's management abilities. A pill count was taken at the initial interview and 30 days later. MMSE and deficit awareness were related to amount of help received from a family member, suggesting that caregivers tend to accurately assess their relatives' medication management abilities. Adherence rates were acceptable, but some intervention strategies selected by caregivers were not effective in assuring adequate adherence. Additional study is needed to determine the effectiveness of various strategies adopted by informal caregivers.

This study determined the differences in demographic and sleep characteristics in cognitively impaired nursing home residents with and without severe sleep/wake pattern inefficiency. Identification of characteristics associated with severe sleep/wake pattern inefficiency will allow health care providers to make the best cost effective use of finite resources because they can target interventions towards those most likely to need them. This article reports the baseline characteristics of the total sample, compares the demographic and sleep characteristics of the subgroups with and without severe sleep/wake pattern inefficiency, and reviews related literature.

In order to validate the adapted version of the Mini-Mental State Examination (MMSE) in Spanish, 203 participants aged at least 60 years were interviewed and clinically evaluated. Factor analysis and ROC curves were used to evaluate the instrument. From the clinical evaluation, it was found that 34.5% of the participants were cognitively impaired. Spatial orientation, Orientation in time plus registration, Language plus attention and calculation, and Naming objects were the four components that explained 60.6% of the variance from the factor analysis. The ROC curve showed 23/24 as the optimal cut-off point, with a sensitivity of 0.97 and specificity of 0.88. Differences by number of years in education were also found, but adjusting the scoring for those individuals with a low level of education improved the performance of the instrument.

The primary objective of the present investigation was to characterize the neuropsychological test performance of a large sample of clinic-referred individuals diagnosed as Cognitively-Impaired-Not-Demented (CIND). Participants classified as Not-Cognitively-Impaired (NCI; n = 68) differed from CIND individuals (n = 205) on a number of demographic, clinical, and neuropsychological measures. A backward stepwise logistic regression analysis revealed that measures of learning and memory, visuoconstruction abilities, and cognitive flexibility provided the best discrimination between NCI and CIND participants. Clinical comparison data for CIND participants were generated for various demographically defined groups. The amount of inter-test scatter (highest minus lowest sample-based z-score) and the overall number of cognitive impairments (impairment being defined as performance equal to or greater than 1 standard deviation below the sample mean) in CIND individuals are reported. The results support the impression that CIND is a cognitively heterogeneous condition.

This article describes a method of facilitated communication for extending the well-known benefits of reminiscence by recording the words of nursing home residents and creating a concrete memory resource. Reminiscence sessions were conducted with five cognitively impaired older adults, whose words and phrases were arranged into poetry, revealing the essence of each person. Information gained was used to construct personal Remembering Boxes filled with meaningful objects and writings. As communication tools, the poems and Remembering Boxes helped staff learn more about residents, proving useful when residents were sleepless or agitated. Remembering Boxes offered residents enhanced interactions with their families and staff and greater control of those interactions. These tools can affirm the personhood of the residents amid their confusion and cognitive decline.

This study investigated the clinical utility of the Mattis Dementia Rating Scale (DRS), using a sample of 138 cognitively intact and 151 cognitively impaired patients at an urban medical center. The 172 young-old patients (ages 60-79) and the 117 older-old patients (ages 80 and above) were predominantly African American elders who had completed significantly less education than had Mattis’s normative samples. Results show that, despite lower mean scores in our sample versus Mattis’s normative samples, the best cut-off score is nearly identical to Mattis’s in the young-old patients, while a lower cut score provided optimal classification for the older-old patients.

Spaced-retrieval (SR) is a memory intervention strategy that involves repetition priming to successfully elicit target behaviors at increasingly longer intervals. SR has proven effective with various groups of cognitively impaired individuals when conducted face-to face. In this study, three persons with dementia in an assisted living facility were trained to recall target information using SR delivered over the telephone. The results from this study suggest that this method of delivering the SR intervention can be successful, and has potential as an intervention for persons whose hearing is normal and who cannot travel to therapists for regular treatment sessions. This research was conducted in partial fulfillment of the Master of Arts degree for A. Joltin, Department of Psychology, Cleveland State University. This study was supported in part by grant R01 AG-17908 from the National Institute on Aging to Dr. Camp.

This paper compares employed and non-employed caregivers of cognitively impaired elderly family members. Using two competing positions derived from role theory, role conflict and role expansion, we explored whether holding the positions of both caregiver and worker led to greater role overload and psychological role conflict, or provided an outlet that helps caregivers better manage the demands placed on them. We found no differences between employed and non-employed caregivers on measures of role overload, worry and strain, and depression. For working caregivers, however, greater conflict on the job was associated with higher role overload and worry and strain while beneficial work experiences were only weakly associated with lower role overload and worry and strain. There was an interaction effect between positive work experiences and role overload when predicting depressive symptoms. These results provide some support for role conflict, but also suggest that caregivers may vary considerably in how they adapt to multiple roles.

Our purpose was to determine whether we could predict, from among seniors with cognitive impairment who lived alone, those at highest risk of experiencing harm or needing emergency services. Specif...

The Seashore Rhythm Test (SRT) is sensitive to musical talent. The possibility that this reduces its clinical sensitivity in cognitively impaired persons with musical experience was investigated. Subjects were 101 referrals to the neuropsychology service of a large medical center. The results indicate that patients with a substantial amount of musical experience tend to perform normally on the SRT, even when overall performance on a neuropsychological test battery suggests cognitive impairment. This finding suggests caution in interpreting normal SRT results in those with a musical background.

The relative importance of elders' and caregivers' characteristics, represented in a model predicting institutional risk, was examined in a sample of 331 Adult Day Health Care (ADHC) participants in New York State. Results suggested several risk factors for institutional placement: being white; having a daughter as a primary caregiver; being cognitively impaired and behavior disordered; receiving more informal support, and having caregivers who are burdened and in poor health. The key risk factors were: having cognitive impairment; burdened care-givers, and being white. When the model was tested for non-Latino White and African-American ADHC participants separately, a different pattern of relationships among the constructs predicting institutional risk emerged for each of the two groups. Implications are discussed in terms of both theory and social work practice.

Dysphagia resulting from focal lesions and degenerative neurologic conditions has been widely reported. Few studies address oropharyngeal dysphagia associated with multiple strokes and vascular dementia, despite the fact that most individuals with severe dementia are eventually unable to participate in the eating process. Dysphagia management strategies used with other cognitively impaired populations would appear to have application to those with vascular dementia. Dysphagia evaluation and management strategies with the vascular dementia population are suggested, with emphasis on the role of the caregiver in dysphagia management. For patients with advanced dementia of all types, provision of nutrition by way of tube feeding is common practice. This controversial issue is explored.

Home health care practice with cognitively impaired elders and their families often raises difficult clinical and ethical issues for social workers. This descriptive study examined the influence of safety, caregiver burden, and diagnostic labels on social workers' support for autonomy. All three factors were found to be significantly related to support for autonomy. There were also interactive effects between safety, caregiver burden and diagnosis. Especially important was the identification of the influence of diagnostic labels on social workers' support for autonomy. Respondents supported less autonomy for elders depicted as diagnosed with Alzheimer's disease than those diagnosed with stroke.

This paper reports the prevalence of psychiatric morbidity in a cohort of elderly new admissions to nursing and residential homes. Three hundred and eight people aged over 65 were assessed within two weeks of admission to 30 nursing or residential homes in north-west England, using screening measures of cognitive impairment, depression and dependency. Population 'casemix' data were collected from homes. Almost two-thirds of the cohort, and 61% of those in residential, as opposed to nursing, homes showed clinically significant cognitive impairment. Just under 45% were identified as depression 'cases'. More respondents in the lower of two social class categories were found in both cognitively impaired and depressed groups. The high level of psychiatric morbidity in this new admission cohort raises questions about the availability of specialist expertise for this population, for both treatment and pre-admission assessment.

Researchers have noted the usefulness of an abbreviated form of the Wechsler Memory Scale-Revised. A number of studies have suggested that estimating General Memory and Delayed Recall scores using 3-subtest or 2-subtest equations decreases testing time without sacrificing reliability or clinical accuracy. The purpose of this study was to cross-validate previous results in a mixed clinical sample, as well as to examine the validity of the 2-subtest equations. Results of this study provide support for the use of the 3-subtest short form to estimate memory ability in normal and cognitively impaired patients. However, using only 2 subtests to estimate index scores resulted in a decline in predictive accuracy.

While all types of elder abuse and neglect are serious problems affecting thousands of vulnerable elders, financial exploitation has especially serious implications for the victims’ economic well-being and quality of life, because it may deprive the victims of their life savings and assets and thus their economic foundation for independence. In this study, data from the case files of a county adult protective services program were analyzed to identify risk factors associated with financial exploitation of and mismanagement by elders. The elders who were financially exploited were, on average, in their late seventies and tended to be cognitively impaired. We also found that owner-occupant elders were especially vulnerable to exploitation and that financial mismanagement and exploitation often occurred together. Approximately 60% of the perpetrators were relatives of the elderly victims, mostly their adult children, and the rest of the perpetrators were not related to the victims. Implications for ...

This qualitative study explored women's perceptions of barriers to support during family caregiving in a Canadian setting. Twenty mothers of premature infants and twenty women caring for an older person who is cognitively impaired were interviewed in-depth over 18 months. Both groups of women preferred that support be offered to them and identified numerous barriers to requesting support. Perceived barriers included an obligation to provide care, loss of independence and self-esteem, concern for burden on others, the desire to excuse others from providing support, the inability to reciprocate support, fear of refusal or exposure, nonsupportive actions, the time and effort needed to coach others to provide effective support, and the lack of available, competent help. Some of these barriers reflect personal costs to the woman caregiver. Other barriers reflect societal norms that family caregiving is the responsibility of women.

Neuropsychologists use a variety of stimuli to investigate semantic memory functioning. Methodological concerns limit interpretation of performance differences between patients and nonpatient controls. The present study describes the development of a brief measure of semantic memory. Results indicate that this measure of semantic priming provides a brief, yet sensitive, measure of semantic memory. It may prove useful for researchers interested in examining semantic memory processes in cognitively impaired individuals.

The Mattis Dementia Rating Scale (DRS) is an instrument that is widely used to screen for dementia. The relationship of the DRS to demographic variables, however, has not been examined, and previous normative work is largely based on small or poorly described samples. In addition, there is no normative work that has been conducted with older medical patients. The present study utilized 90 cognitively intact and 105 cognitively impaired patients to examine the relationship of the DRS to demographic variables, and to test the clinical utility of the instrument. Within the intact group, age and education significantly correlated with DRS Total Score (DRS-T), but only age predicted unique DRS-T variance. Logistic regression was used to correctly classify 87% of patients overall. We concluded that the results affirmed the importance of considering demographic factors when interpreting DRS results. In addition, the DRS appears to be a useful instrument in screening for dementia among urban medical pati...

Cognitive-Behavioral Group therapy is used to decrease inappropriate sexual behaviors among male adolescents who are mildly and moderately cognitively impaired.

(1993). The Effectiveness of Cueing on Anagram Solving by Cognitively Impaired Nursing Home Elderly. Loss, Grief & Care: Vol. 6, No. 4, pp. 107-116.

Alcohol Use Disorders are thought to be underdiagnosed in the geriatric population. A retrospective medical record review was performed on 383 patients who presented for outpatient geriatric assessment from 1985-1990. The record review included data on the alcohol consumption history, age, sex, presence of alcoholic beverages in the home, geriatric psychiatry evaluation, and alcohol-related diagnoses. Alcohol Use Disorders were recognized as contributing to medical problems in 10% of patients having a mean age of 78 years. All except one patient were found to be cognitively impaired. In addition, 9% of patients consumed alcohol on a regular basis and this consumption was not considered in the diagnosis, despite the presence of cognitive impairment. Twenty-five percent of cognitively impaired patients were consuming alcohol at the time of evaluation. These results indicate that alcohol consumption and AUD are common in cognitively impaired patients presenting for geriatric assessment. Recognition of Alcohol Use Disorders is essential, as chronic alcohol toxicity represents one cause of potentially reversible dementia. Because there are no validated instruments for alcoholism screening in cognitively impaired elderly patients, evaluation should include a past and present consumption history, a search for alcoholic beverages at the home visit, and possible psychiatric referral.

Approximately 5 percent of the population over 65, and close to 20 percent of those over 75, have some degree of clinically detectable impairment in cognitive function. Appropriate diagnosis and management of this population is vital to their ability to function independently. This article highlights the importance of the occupational therapist's role within the interdisciplinary team when performing comprehensive cognitive and functional assessments. A case study validates the role of occupational therapy and demonstrates the need for health care professionals to keep the values and wishes of the patients first and foremost.