The factorial structure of the mini mental state examination (MMSE) in Japanese dementia patients

<p>Abstract</p> <p>Background</p> <p>The Mini-Mental State Examination (MMSE) is one of the most commonly used instruments in the evaluation of global cognitive status. Few studies have investigated the relationship among its components in terms of factorial structure in Japanese individuals suffering from dementia. The aims of this study were: 1) to analyze the factorial structure of MMSE in Japanese dementia patients, 2) to clarify the MMSE static structure in identifying different cognitive profiles and understanding how these profiles are related to levels of dysfunction in subsets of dementia patients.</p> <p>Methods</p> <p>30,895 consecutive outpatients with dementia were evaluated. The 11 subtests composing the MMSE and the global MMSE score were analyzed. Factor analysis based on principal component analysis with Promax rotation was applied to the data representing the frequency of failures in each subtest as identified by the MMSE.</p> <p>Results</p> <p>Factor analysis identified three factors that explained approximately 44.57% of the total variance. The first factor, immediate memory, essentially constituted a simple index of the reading and writing subtests. The second factor, orientation and delayed recall, expressed the ability to handle new information. The third factor, working memory, was most closely related to the severity of dementia at the time of test administration.</p> <p>Conclusions</p> <p>Japanese dementia patients appear to develop difficulty handling new information in the early stages of their disease. This finding, and our finding that there is a factor associated with disease severity, suggest that understanding the specific factors related to subtest items, which underlie the total MMSE score may be useful to clinicians in planning interventions for Japanese patients in the early stages of dementia.</p

Visual versus semi-quantitative analysis of 18F-FDG-PET in amnestic MCI. An European Alzheimer\u27s Disease Consortium (EADC) project

We aimed to investigate the accuracy of FDG-PET to detect the Alzheimer\u27s disease (AD) brain glucose hypometabolic pattern in 142 patients with amnestic mild cognitive impairment (aMCI) and 109 healthy controls. aMCI patients were followed for at least two years or until conversion to dementia. Images were evaluated by means of visual read by either moderately-skilled or expert readers, and by means of a summary metric of AD-like hypometabolism (PALZ score). Seventy-seven patients converted to AD-dementia after 28.6?19.3 months of follow-up. Expert reading was the most accurate tool to detect these MCI converters from healthy controls (sensitivity 89.6%, specificity 89.0%, accuracy 89.2%) while two moderately-skilled readers were less (p < 0.05) specific (sensitivity 85.7%, specificity 79.8%, accuracy 82.3%) and PALZ scorewas less (p < 0.001) sensitive (sensitivity 62.3%, specificity 91.7%, accuracy 79.6%). Among the remaining 67 aMCI patients, 50 were confirmed as aMCI after an average of 42.3 months, 12 developed other dementia, and 3 reverted to normalcy. In 30/50 persistent MCI patients, the expert recognized the AD hypometabolic pattern. In 13/50 aMCI, both the expert and PALZ score were negative while in 7/50, only the PALZ score was positive due to sparse hypometabolic clusters mainly in frontal lobes. Visual FDG-PET reads by an expert is the most accurate method but an automated, validated system may be particularly helpful to moderately-skilled readers because of high specificity, and should be mandatory when even a moderately-skilled reader is unavailable

Officina della parola. Dalla notizia al romanzo: guida all'uso di stili e registri di scrittura

E' un volume che in modo divulgativo fa il punto su una serie di acquisizioni che riguardano la stilistica, la retorica, la narratologia, la linguistica. Tali conoscenza vengono messe a disposizione di un pubblico di studenti e non solo interessato a scrivere, comunicare, argomentare, ecc

La modernidad periférica: ecos del "Gattopardo" de Tomasi de Lampedusa en "La guerra de la fin del mundo" de Mario Vargas Llosa

Si individuano influenze di Tomasi su Vargas Llosa all'interno della più generale questione della letteratura delle periferie e cioè di quella letteratura che ci racconta le modernità periferiche