Cross-cultural cognitive assessment of dementia: a meta-analysis of the impact of illiteracy on dementia screening and an evaluation of a transcultural short-term memory assessment

Introduction: A major challenge in detecting dementia is that many of the tools used to screen for dementia are affected by linguistic, cultural, and educational factors. As the prevalence of dementia is expected to rise, exploring suitable methods of assessing dementia in diverse populations is becoming increasingly important. Aims: The first aim of this thesis was to assess research on dementia screening tools in literate and illiterate individuals to evaluate the impact of illiteracy on these tools, through a systematic review and meta-analysis. The second aim was to assess the predictive ability and construct validity of the Visual Short-Term Memory Binding Task (VSTMBT), a proposed transcultural tool. Methods: A systematic review identified 37 studies, 27 of which were included in a meta-analysis. In addition, data from a longitudinal study, which involved assessing older adults at three time points over two years, were examined. Data were collected from 72 healthy control participants and 82 participants with a diagnosis of Mild Cognitive Impairment (MCI). Linear mixed models and logistic regression models were used to assess how well the VSTMBT and other baseline measures of cognition predicted future cognitive decline and the development of Alzheimer’s Disease (AD). Finally, partial correlations between baseline neuropsychological assessments were conducted to examine the construct validity of the VSTMBT. Results: In the meta-analysis, multi-level random effects models revealed that literate participants had a significant advantage over illiterate participants in dementia screening tools. In the longitudinal study, the VSTMBT did not significantly predict cognitive decline or conversion from MCI to AD. Partial correlation analyses showed that the VSTMBT did not significantly correlate with other measures of memory and failed to discriminate between measures of executive function, processing speed and visuospatial ability. Conclusions: The meta-analysis highlighted the unsuitability of traditional dementia screening tools for individuals who are illiterate, emphasising the need for the screening tools that consider varying levels of literacy. The results of the longitudinal study were in line with the idea that the VSTMBT has higher predictive value at the preclinical stage compared to the MCI stage of AD. This study highlighted the need for different cognitive tests at different stages of AD progression

Cognitive impairment in sporadic cerebral small vessel disease:A systematic review and meta-analysis

This paper is a proposal for an update on the characterization of cognitive impairments associated with sporadic cerebral small vessel disease (SVD). We pose a series of questions about the nature of SVD-related cognitive impairments and provide answers based on a comprehensive review and meta-analysis of published data from 69 studies. Although SVD is thought primarily to affect executive function and processing speed, we hypothesize that SVD affects all major domains of cognitive ability. We also identify low levels of education as a potentially modifiable risk factor for SVD-related cognitive impairment. Therefore, we propose the use of comprehensive cognitive assessments and the measurement of educational level both in clinics and research settings, and suggest several recommendations for future research

Social functioning of children after epilepsy surgery : A literature review

This literature review on social functioning of children after epilepsy surgery is based on 24 papers addressing two categories of social functioning: social cognition (n = 4)and general social functioning (n = 20). Overall, studies that compared with healthy peers revealed children who had undergone epilepsy surgery to have more problems in both social cognition and general social functioning. Half of the studies found some improvement in social functioning in the first year(s)after epilepsy surgery, but this pertained to general social functioning, not to social cognition. The persistence of the problems in social cognition after surgery may be related to the critical period of brain maturation, lacking improvement of impairments in related cognitive domains or to a defective underlying brain condition — rather than to the epilepsy. Problems in general social functioning may be explained by the adjustments the children and their families had to make because of the child's drug-resistant epilepsy and difficulties to adjust to the new situation after surgery. The neurological and behavioral explanations are likely to be interrelated in light of the multifaceted and complex nature of social functioning. Epilepsy surgery does not appear to solve the problems in social functioning associated with having had drug-resistant epilepsy. As social functioning is an important aspect of healthy development, it should be assessed comprehensively in order to obtain a knowledge base that allows 1)proper treatment of children with epilepsy (CwE)and 2)counseling patients and families prior to and after epilepsy surgery