Cognitive Assessment Tools for Screening Older Adults With Low Levels of Education: A Critical Review

Tavares-Júnior, José Wagner Leonel; Souza, Ana Célia Caetano de; Alves, Gilberto Sousa; Bonfadini, Janine de Carvalho; Siqueira-Neto, José Ibiapina; Braga‐Neto, Pedro

doi:10.3389/fpsyt.2019.00878

Cited by 30 publications

(41 citation statements)

References 66 publications

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“…Similarly, studies using MoCA in populations of Brazilian (Apolinario et al, 2018 ), Turkish (Yancar and Öscan, 2015 ), and Chinese (Zhang et al, 2019 ) origin have reported the influence of education level on MoCA cut-off points. A systematic review on the cultural validity of MoCA (O'Driscoll and Shaikh, 2017 ) and a critical review on BCS for older adults with low levels of education (Tavares-Júnior et al, 2019 ) suggest different cut-off points of MoCA according to education level. In this sense, taking into account the high proportion of people with low education and illiteracy in Latin America (UNESCO, 2015 , 2017 ), certain MoCA tasks (drawing of the cube, denomination of dromedary and rhinoceros, and subtract backwards by seven from 100) could not be completed easily, increasing the real suspicion of cases with cognitive impairment.…”

Section: Discussionmentioning

confidence: 99%

Systematic Review of the Diagnostic Validity of Brief Cognitive Screenings for Early Dementia Detection in Spanish-Speaking Adults in Latin America

Custodio

Duque²,

Montesinos

et al. 2020

Front. Aging Neurosci.

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The aim of this study was to evaluate the validity of brief cognitive screening (BCS) tools designed to diagnose mild cognitive impairment (MCI) or dementia in Spanish-speaking individuals over the age of 50 years from Latin America (LA). Methods: A systematic search of titles and abstracts in Medline, Biomed Central, Embase, Scopus, Scirus, PsycINFO, LILACS, and SciELO was conducted. Inclusion criteria were papers written in English or Spanish involving samples from Spanish-speaking Latin American individuals published until 2018. Standard procedures were applied for reviewing the literature. The data related to the study sample, methodology, and procedures applied, as well as the performance obtained with the corresponding BCS, were collected and systematized. Results: Thirteen of 211 articles met the inclusion criteria. The studies primarily involved memory clinic-based samples, with the exception of two studies from an adult day-care center, one from a primary care clinic, and one from a community-based sample. All the studies originated from five of the 20 countries of LA and all used standardized diagnostic criteria for the diagnosis of dementia and MCI; however, the diagnostic protocols applied differed. Most studies reported samples with an average of 10 years of education and only one reported a sample with an average of <5 years of education. No publication to date has included an illiterate population. Although the Montreal cognitive assessment (MoCA) is the most widely-used BCS tool in LA, it is significantly influenced by education level. Conclusions: Although evidence is still limited, the findings from studies on LA populations suggest that MoCA requires cultural adaptations and different cutoff points according to education level. Moreover, the diagnostic validity of the INECO frontal Custodio et al. Brief Cognitive Screenings to Dementia in Latin-America screening (IFS) test should be evaluated in populations with a low level of education. Given the heterogeneity that exists in the levels of education in LA, more studies involving illiterate and indigenous populations are required.

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Section: Discussionmentioning

confidence: 99%

Systematic Review of the Diagnostic Validity of Brief Cognitive Screenings for Early Dementia Detection in Spanish-Speaking Adults in Latin America

Custodio

Duque²,

Montesinos

et al. 2020

Front. Aging Neurosci.

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“…Additionally, those below 60 years of age and who are unwilling to finish the questionnaire will be excluded. A six-item screener will be used to measure the cognitive impairment of potential study participants as it is brief, reliable, and easy to administer [ 29 , 30 ]. Besides, auditory and visual assessments of the participants will also be conducted.…”

Section: Methodsmentioning

confidence: 99%

Impact of video-led educational intervention on the uptake of influenza vaccine among adults aged 60 years and above in China: a study protocol for a randomized controlled trial

Hayat

Jiang

et al. 2021

BMC Public Health

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Background Influenza is a global health threat to older adults, and the influenza vaccine is the most effective approach to prevent influenza infection. However, influenza vaccination coverage among Chinese older adults is far less than in developed countries such as the United States (4.0% vs. 64.9%). This study aims to increase influenza vaccination coverage in Chinese adults ≥60 years using a video-led educational intervention conducted by medical students. Methods A cluster randomized controlled trial will be conducted in 4 districts of Xi’an city, Shaanxi Province, China, using a stratified sampling approach. Adults aged ≥60 years will be recruited from 8 community hospitals. A self-administered questionnaire of knowledge, attitudes, and practices (KAP) will be employed to record the KAP score. During the 6-month interventional period, participants in the intervention group will receive educational videos focused on influenza and influenza vaccination, coupled with a group discussion conducted by the medical students. For those in the control group, no intervention will be provided. The outcomes measured in both groups will be the influenza vaccination coverage and the KAP scores of all participants. Discussion Medical students are more likely to educate older adults about scientific knowledge of influenza and its vaccine compared to clinical practitioners, who, most of the time, remain over-occupied due to the extensive workload. Video-led counseling and education could be a useful option to optimize older adults’ understanding of influenza and influenza vaccination. This eventually could improve the uptake of influenza vaccine among Chinese older adults. Trial registration Chinese Clinical Trial Registry; ChiCTR2000034330; Registered 3rd July 2019.

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“…Different tests have been proposed to evaluate cognitive function including memory, orientation, attention, reasoning and judgment, language skills, and attention [17,18,19]. Examples of such tools include the Eight-item Informant Interview to Differentiate Aging and Dementia (AD8), Annual Wellness Visit (AWV), General Practitioner Assessment of Cognition (GPCOG) and Health Risk Assessment (HRA), Memory Impairment Screen (MIS) (i.e., it is for testing verbal memory capability), Short Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), Montreal Cognitive Assessment (MoCA) (i.e., it consists of a 30points scales [20] to identify subjects with MCI) [21], Addenbrooke's Cognitive Assessment (ACE) [22,23], and the Alzheimer's Disease Assessment Scale-Cognitive Subscale ADAS-Cog [24,25] (i.e., it examines attention, orientation, memory, language, visual perception, and visuospatial skills), the test can detect cognitive impairment that is related to AD and fronto-temporal dementia.…”

Section: Cognitive and Neuropsychological Assessmentsmentioning

confidence: 99%

“…Another essential attribute that might affect the fairness of ML-based LA tools is the level of education. It has been shown that some LA tools cannot provide accurate diagnostic when there are subjects with low levels of education among the population of study [19]. ML-based LA tools require a set of mechanisms to ensure that end-users trust in their performances and know how the system provides output.…”

Section: Generalization -Selecting Meaningful Featuresmentioning

confidence: 99%

Machine Learning to Assess Language Impairments in Older Adults

Parsa¹,

Alam²,

Mihailidis³

2020

Preprint

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Objectives: The main objective of this paper is to propose a methodology based on machine learning classifiers for assessing language impairments associated with dementia in older adults. To do so, we compare the impact of different types of language tasks, features, and recording media on our ML-based methodology’s efficiency. Methodology: The methodology encompasses the following steps: 1) Extracting linguistic and acoustic features from subjects’ speeches which have been collected from subjects with dementia ( N =9) and subjects without dementia ( N =13); 2) Employing feature selection methods to rank informative features; 3) Training ML classifiers using extracted features to recognize subjects with dementia from subjects without dementia; 4) Evaluating the classifiers; 5) Selecting the most accurate classifiers to develop the languages assessment tools. Results: Our results indicate that 1) we can find more predictive linguistic markers to distinguish language impairment associated with dementia from participants’ speech produced during the picture description language task than the story recall task. 2) a phone-based recording interface provides a more high-quality language dataset than the web-based recording systems; 3) classifiers trained with selected features from acoustic features or linguistic features show higher performance than the classifiers trained with pure features. Conclusion: Our results show that the tree-based classifiers that have been trained using the PD dataset can be used to develop an ML-based language assessment tool that can detect language impairment associated with dementia as quickly as possible.

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Cognitive Assessment Tools for Screening Older Adults With Low Levels of Education: A Critical Review

Cited by 30 publications

References 66 publications

Systematic Review of the Diagnostic Validity of Brief Cognitive Screenings for Early Dementia Detection in Spanish-Speaking Adults in Latin America

Systematic Review of the Diagnostic Validity of Brief Cognitive Screenings for Early Dementia Detection in Spanish-Speaking Adults in Latin America

Impact of video-led educational intervention on the uptake of influenza vaccine among adults aged 60 years and above in China: a study protocol for a randomized controlled trial

Machine Learning to Assess Language Impairments in Older Adults

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