The assessment of dementia severity using non-verbal cognitive tests

Khan, Sobia T. (2010) The assessment of dementia severity using non-verbal cognitive tests. DClinPsy thesis, University of Nottingham.

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Objective: To explore the utility of cognitive tests, that did not rely on spoken language from participants for decision making about eligibility for treatment with Anti-cholinesterase Inhibitors (AchI).

Methods: A cross-sectional design was used. Data was collected from 20 participants, aged 65 to 90 years (M, 77.6: SD, 7.2), with dementia, or cognitive difficulties. The sample comprised of eleven males and nine females. The Mini-Mental State Examination (MMSE), and six alternative cognitive tests were administered, these were; the Rey Complex Figure Test (RCFT), Ravens Colour Progressive Matrices (RCPM), Symbol Digit Modalities Test (SDMT), Brixton Test, Clock Drawing Test (CDT), and Colour Trails Test (CTT).

Results: There was statistically significant correlations between the MMSE and the following cognitive tests: RCFT visual construction subtest(r= .609; P<.006), the RCFT recognition subtest (r= .496; P<.031), RCPM (r= .452; p<.045), the SDMT (r=.670; P<.001), the CTT 1 (Rho=-.576; P<.012) and the CDT (r=-.577; P<.008).

The area under the ROC curve values were as follows: RCFT visual construction (0.750, 95%, CI .524 - .976), RCFT recognition memory (0.801, 95%, CI .590 – 1.012), RCPM (0.573, 95%, CI 0.298 – 0.848), SDMT (0.708, 95%, CI 0.469 – 0.947), CTT1 (0.818, 95%, CI 0.610 – 1.027) and the CDT (0.734, 95%, CI 0.479 – 0.990). Cut-off scores with adequate sensitivity and specificity were identified for all the above measures apart from the RCPM, which had predictive accuracy that was equal to chance.

Conclusions: Cognitive tests which do not require spoken language have utility in differentiating between those who are and are not eligible for treatment with AchI, as defined by the cut-off (<20) on the MMSE in the National Institute for Clinical Excellence guidelines (NICE, 2007).

Item Type: Thesis (University of Nottingham only) (DClinPsy)
Supervisors: Nair, R.D.
Connelly, D.
Philpott, H.
Keywords: Non verbal tests, Measurement of cognitive function, Treatment eligibility, Mini-Mental State Examination, Rey Complex Figure Test, Raven‟s Colour Progressive Matrices, Symbol Digit Modalities Test, Brixton test, Clock Drawing Test, Colour Trails Test, Dementia assessment
Subjects: R Medicine > RC Internal medicine
Faculties/Schools: UK Campuses > Faculty of Social Sciences, Law and Education > Institute of Work, Health and Organisations
Item ID: 11907
Depositing User: EP, Services
Date Deposited: 23 Jul 2012 10:50
Last Modified: 15 Dec 2017 23:16

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