11 research outputs found
COGNITIVE SEQUELAE OF RIGHT CEREBROVASCULAR ACCIDENT: ISSUES OF VERBAL DEFICIT AND SEX DIFFERENTIAL PATTERNS IN VISUOSPATIAL AND VERBAL PERFORMANCE
The purpose of the current study was to (1) determine whether verbal/linguistic deficits are indeed present in right brain damage (RBD) patients and (2) identify sex differential patterns in visuospatial and/or verbal/linguistic performance in this patient population. The subject sample consisted of 64 rehabilitation patients with RBD secondary to a cerebrovascular accident (CVA), and 50 neurologically-normal control subjects accessed from a variety of community organizations. All subjects were clinically rated for the presence of hemiparesis and hemianopia. In the visuospatial domain, the psychometric measures included: WAIS Block Design, WAIS Object Assembly, Raven\u27s Coloured Progressive Matrices, yielding both a measure of number of items correct as well as a measure of spatial bias; WMS Visual Reproduction; and Letter Cancellation Test. The verbal/linguistic tests were: WAIS Vocabulary; WAIS Similarities; Conceptual Level Analogies Test; WMS Logical Memory, yielding both a traditional score and a newly-created index of circumlocution; and Word Fluency--FAS and JU. The finding of an RBD-related visuospatial decrement was consistent with prevailing neuropsychological theories. However, in contrast to a number of studies in which RBD-related verbal defects have been only marginally confirmed, the data of this study showed a clearcut RBD verbal/linguistic defect on all measures except Logical Memory. These verbal defects were independent of visual scanning ability, suggesting the presence of an RBD-related verbal cognitive defect, separable from a visuospatial disturbance. The data marginally supported a sex differential pattern of greater male RBD decrements in visuospatial processing and greater female RBD decrements in verbal/linguistic processing only in the limited case of higher-order cognitive variables, as represented in this study by the WAIS subtests. However, a subanalysis by hemianopic ratings suggested that the presence of a visual field cut may mask an RBD-related sex differential pattern in visuospatial performance. Future sex difference studies of RBD patients with normal visual fields is recommended
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Participant satisfaction with dementia prevention research: Results from Home-Based Assessment trial.
IntroductionLittle is known about factors affecting motivation and satisfaction of participants in dementia prevention trials.MethodsA Research Satisfaction Survey was administered to 422 nondemented older adults who participated in the Home-Based Assessment trial.ResultsOverall satisfaction was high, with means of all individual items near to above a value of 3 on a scale from 1 (worst) to 4 (best). Greater satisfaction was associated with staff-administered interviews versus automated technologies. The most liked aspects of research participation were volunteerism, opportunity to challenge and improve mental function, and positive interactions with staff. The least liked aspect was repetitiveness of the assessments. Participants requested more contact with staff and other older adults and more feedback on performance.DiscussionOlder adults' participation in research was primarily motivated by altruism. Methodologies that facilitate human contact, encourage feedback and novelty of tasks should be incorporated into future trial design
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A randomized clinical trial to evaluate home-based assessment of people over 75Â years old.
IntroductionThere is an unmet need for effective methods for conducting dementia prevention trials.MethodsHome-based assessment study compared feasibility and efficiency, ability to capture change over time using in-home instruments, and ability to predict cognitive conversion using predefined triggers in a randomized clinical trial in (1) mail-in questionnaire/live telephone interviews, (2) automated telephone/interactive voice recognition, and (3) internet-based computer Kiosk technologies. Primary endpoint was defined as cognitive conversion.ResultsAnalysis followed a modified intent-to-treat principle. Dropout rates were low and similar across technologies but participants in Kiosk were more likely to dropout earlier. Staff resources needed were higher in Kiosk. In-home instruments distinguished conversion and stable groups. Cognitively stable group showed improvement in cognitive measures. Triggering was associated with higher likelihood of conversion but statistically significant only in mail-in questionnaire/live telephone interviews.DiscussionRelatively low efficiency of internet-based assessment compared with testing by live-assessors has implications for internet-based recruitment and assessment efforts currently proposed for diverse populations
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A randomized clinical trial to evaluate home-based assessment of people over 75 years old.
IntroductionThere is an unmet need for effective methods for conducting dementia prevention trials.MethodsHome-based assessment study compared feasibility and efficiency, ability to capture change over time using in-home instruments, and ability to predict cognitive conversion using predefined triggers in a randomized clinical trial in (1) mail-in questionnaire/live telephone interviews, (2) automated telephone/interactive voice recognition, and (3) internet-based computer Kiosk technologies. Primary endpoint was defined as cognitive conversion.ResultsAnalysis followed a modified intent-to-treat principle. Dropout rates were low and similar across technologies but participants in Kiosk were more likely to dropout earlier. Staff resources needed were higher in Kiosk. In-home instruments distinguished conversion and stable groups. Cognitively stable group showed improvement in cognitive measures. Triggering was associated with higher likelihood of conversion but statistically significant only in mail-in questionnaire/live telephone interviews.DiscussionRelatively low efficiency of internet-based assessment compared with testing by live-assessors has implications for internet-based recruitment and assessment efforts currently proposed for diverse populations