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Objective: To harmonize measures of cognitive performance using item response theory (IRT) across two international aging studies. Method: Data for persons ≥65 years from the Health and Retirement Study (HRS, N = 9,471) and the English Longitudinal Study of Aging (ELSA, N = 5,444). Cognitive performance measures varied (HRS fielded 25, ELSA 13); 9 were in common. Measurement precision was examined for IRT scores based on (a) common items, (b) common items adjusted for differential item functioning (DIF), and (c) DIF-adjusted all items. Results: Three common items (day of date, immediate word recall, and delayed word recall) demonstrated DIF by survey. Adding survey-specific items improved precision but mainly for HRS respondents at lower cognitive levels. Discussion: IRT offers a feasible strategy for harmonizing cognitive performance measures across other surveys and for other multi-item constructs of interest in studies of aging. Practical implications depend on sample distribution and the difficulty mix of in-common and survey-specific items. [ABSTRACT FROM AUTHOR]

Background: Reports of low-velocity knee dislocations have focused primarily on dislocations occurring during athletic competition. The authors identified a subset of patients with low-velocity knee dislocations that occurred during activities of daily living, such as stepping off a curb, stepping off a stair, or simply falling while walking (ultra-low-velocity dislocations).Hypothesis: Ultra-low-velocity knee dislocations are common in obese individuals and are associated with more complications than high-velocity knee dislocations.Study Design: Case series; Level of evidence, 4.Methods: A review of records identified 17 patients with knee dislocations that occurred during daily activities. All 17 were clinically obese, with an average body mass index (BMI) of 48 (BMI <25 is normal; ≥40 is severe obesity). Ligament injuries occurred in all 17 patients, neurologic injuries in 7, and popliteal artery injuries in 7. Thirteen (76.4%) of the 17 dislocations were anterior, 2 (11.8%) were posterior, and 2 (11.8%) were lateral. All dislocations were reduced closed and stabilized with splints, crossed pins, or external fixation; ligament reconstructions were done in 8 patients and popliteal artery repairs in 7. Above-knee amputations were required in 2 patients with vascular repairs because of tissue ischemia; 1 patient died from cardiac arrest 7 days after injury; and 3 were lost to follow-up. Of the 11 remaining patients, 6 had ligament reconstructions and 5 did not.Results: Four standardized knee scoring systems (International Knee Documentation Committee [IKDC], Hospital for Special Surgery [HSS], Lysholm, Tegner) were used to evaluate outcome at an average follow-up of 28.5 months. Although scores were low in all patients, those with ligamentous reconstruction had better outcomes (“fair”: 74 ± 22) than those without reconstruction (“poor”: 21 ± 8.5), with a statistically significant (P = .013) difference in HSS scores. Lysholm scores also were higher in those with reconstruction (average 67) than in those without (average 53), but the difference was not statistically significant (P = .45).Conclusion: These results indicate that (1) neurovascular injuries are frequent with these ultra-low-velocity dislocations in severely obese patients, (2) the likelihood of combined neurovascular injury tends to increase as BMI increases, and (3) surgical ligament reconstruction with emphasis on posterolateral corner repair appears to improve outcomes. [ABSTRACT FROM PUBLISHER]

Although televisions are commonplace in many long-term care facilities for people with dementia, little research has been done on the possible effects of television viewing on residents' behaviors. The authors' study aims were to document observable behaviors and activities of residents before, during, and after viewing television programs and to determine whether programs had an observable effect on behaviors. The authors enrolled 22 residents in a residential dementia care facility (4 to 5 people in each of the five residential wings). Two raters completed systematic observations for 5 consecutive days at baseline, during the presentation of eight television programs, and for 30 minutes following the program. The authors found that "dozing" was the most common activity during program viewing. In addition, many participants remained in the television area, "watching" a blank television screen in the 30 minutes following the program viewing. Further investigation on television's effect on sleep or participation in other social activities is needed. [ABSTRACT FROM AUTHOR]

The relationship between the Dementia Rating Scale (DRS) and the Mini-Mental State Examination (MMSE) was examined in 50 patients referred for neuropsychological assessment. The correlation between these two tests was moderately high (ρ=.72; Pearson r=.78), supporting previous findings. Linear regression analysis yielded equations that allow prediction of scores from one test to the other. Neither age nor education correlated significantly with these two tests. Examination of the five DRS subscales and the eleven MMSE items revealed some unexpected relationships. These results suggest that these two cognitive screening instruments evaluate some overlapping mental abilities; however, the validity of the individual items and subscales is not well supported. [ABSTRACT FROM PUBLISHER]

The present study demonstrates the limitation of the Mini-Mental State Examination (MMSE) for detecting the amnestic syndrome. Although neuropsychological testing yielded severe memory deficits in all of the 11 amnesic patients tested, six of the patients obtained total MMSE scores above the standard cutoff score of 24. Further, only six patients completely failed the MMSE recall item, and three patients performed errorlessly on this item. Results from one postencephalitic patient are presented in detail. She performed the serial sevens task very quickly and subsequently recalled all three of the to-be-remembered words. Her performance on other memory tests confirmed that a longer retention interval than that provided by the MMSE is necessary to elicit her memory disorder. (J Geriatr Psychiatry Neurol 1992;5:233–237). [ABSTRACT FROM PUBLISHER]

Progressive cognitive impairment is a defining feature of the dementia of Alzheimer's disease (AD), yet disagreement exists over which abilities decline most precipitously and which cognitive tests are most sensitive. In this study, 51 AD patients in the early to middle stages of illness and 22 age-matched normal controls were administered a battery of neu ropsychological tests at 6-month intervals over a 2-year period. While the performance of the normal controls remained stable over the 2 years, the AD patients displayed progressive decline on all tests. The greatest declines occurred on tests requiring lexical/semantic processing (Boston Naming Test) and comprehension of syntactic relationships (Token Test). Performance on visuospatial tests (Wechsler Adult Intelligence Scale-Revised Block Design, Benton Visual Retention Test, Spatial Delayed Recognition Span Test) declined less rapidly. The findings support previous reports that language impairment may be central to the dementia of AD, and that confrontation naming is particularly sensitive to decline in this illness. [ABSTRACT FROM PUBLISHER]