A new promising screening method for cognitive functioning in elderly patients

Contains fulltext : 23785.pdf (publisher's version ) (Open Access)The Mini Mental State Examination (MMSE) is frequently used as a screening method to detect cognitive dysfunctioning. However, the MMSE has limited sensitivity to detect mild impairment. We aimed to develop a new screening method to discriminate between normal and mild cognitive functioning in older subjects. Methods: Based on the literature, we selected several test-items related to the diagnostic criteria (DSM-IV) for dementia. This new composed instrument for Screening Cognitive Functions (SCOF) is a brief, 15-minutes approach with questions on orientation, serial attention test, recall of five words, clockdrawmg, language comprehension and reading, word fluency test, visual design reproduction, alternating sequences test, picture arrangement test, and overlapping figure test. The SCOF, MMSE, and complete neuropsychological examination (NPE) was administered, in random order, to 20 patients (mean age 78 � 6 yrs) admitted to the Dept. of Geriatric Medicine. Results: After deleting one question about orientation (which season), the internal consistancy of the SCOF was 0.80 (chronbach's alpha). Based on the NPE, we divided the subjects in 3 groups: mild (35%), moderate (60%) and serious cognitive impairrment (5%). The SCOF detected significantly (p<0.05) better mild cognitive impairment than the MMSE (cut off point was 24). Conclusions: SCOF is an useful bedside screening test and these preliminary findings suggest a valid and reliable instrument. In elderly patients, SCOF showed a better detection of mild cognitive impairment compared to MMSE Although SCOF is a promising method for screening cognitive functions, further research is needed

Apathy and health-related quality of life in nursing home residents

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Shared Action for Breaking through Apathy (SABA)

In an action research project the psychosocial intervention SABA was developed with people with dementia living in nursing homes in the Netherlands, their informal and formal caregivers. For this purpose, (focusgroup)interviews were held to gather information on people's view on apathy and their needs in helping people with dementia and apathy. Topic guides of these interviews are uploaded (fase 1). During the first COVID-19 lockdown we gathered information on the effect of the lockdown measures on apathy in people with dementia, by interviewing formal caregivers. The topic guide of these interviews is uploaded (fase 2). After this, a pilot was performed, followed by a process evaluation for which informal and formal caregivers were interviewed. The topic guides are uploaded (fase 3). Once the qualitative data are analysed in Atlas.ti and published, the lists of codes and themes will be uploaded as well

Shared-Action-for-Breaking-through-Apathy: a new program to identify and manage apathyin people with dementia in nursing homes

Objective: Explore experiences in identifying and managing apathy in nursing homes from the perspective of residents withdementia and apathy (residents), family caregivers (FCs) and professional caregivers (PCs), and develop and evaluate aprogram for identifying and managing apathy in nursing homes.Methods: Qualitative study with semi-structured interviews with residents (n=2), FCs (n=4), PCs (n= 23) and focus groups(n=12 PCs). Using thematic analyses, themes were identified relevant for the identification and management of apathy.Hereafter, an intervention was developed applying intervention mapping together with caregivers, and tested in a feasibilitystudy using interviews (n=7 FCs, n=4 PCs), and focus groups (n=11 PCs).Results: Identified themes were: 1) relevance of signals, 2) impact on wellbeing, 3) skills and capabilities. Participants haddifficulties appraising signals of apathy and the impact of apathy varied per stakeholder. Apathy was experienced challengingwhen it reduced the well-being of residents or when caregivers had negative feelings. Managing apathy required adjustingone’s expectations, appreciating little successes, and striving for meaningful contact.The Shared-Action-for-Breaking-through-Apathy-program (SABA) was developed. According to caregivers, SABA enabled themto increase knowledge and awareness for recognizing apathy and increased their apathy-management skills through focusingon small-scale activities and appreciation of small successes. Perceived facilitators to implementing SABA were the content,form and accessibility of SABA’s materials and procedures. Their practical use and compatibility were satisfying. Expertise andinvolvement of stakeholders, stimulating physical environment with small-scale living room, access to supplies for activities alsowere facilitating. Perceived barriers were suboptimal collaboration, not prioritizing apathy, staff discontinuity and Covid-19.Conclusions: It is important to consider that apathy negatively influences the well-being of people with dementia and especiallytheir caregivers. SABA empowers FCs and PCs to identify and manage apathy. For implementing SABA, it is important toconsider the found facilitators and barriers

The development, pilot and evaluation of a psychosocial intervention for (in)formal caregivers to reduce apathy in people with dementia living in nursing homes in the Netherlands

In an action research project the psychosocial intervention SABA was developed with people with dementia living in nursing homes in the Netherlands, their informal and formal caregivers. For this purpose, (focusgroup)interviews were held to gather information on people's view on apathy and their needs in helping people with dementia and apathy. Topic guides of these interviews are uploaded (fase 1). During the first COVID-19 lockdown we gathered information on the effect of the lockdown measures on apathy in people with dementia, by interviewing formal caregivers. The topic guide of these interviews is uploaded (fase 2). After this, a pilot was performed, followed by a process evaluation for which informal and formal caregivers were interviewed. The topic guides are uploaded (fase 3). Once the qualitative data are analysed in Atlas.ti and published, the lists of codes and themes will be uploaded as well