BACKGROUND: Early detection and diagnosis are critical to dementia care. However, many early cases remain undiagnosed as a result of the impracticality of neuropsychological testing, particularly in primary care. Mindstreams is an office-based computerized system for measuring cognitive function in multiple domains, with demonstrated validity, test-retest reliability, and sensitivity to treatment effects. This study evaluated its feasibility for assessment of the elderly. METHODS: Usability data were collected after each of 2,888 consecutive initial-visit testing sessions at the first 11 clinical centers to use Mindstreams. The chi(2) goodness-of-fit test was employed to determine whether patients and supervisors more often rated tests easy versus hard to use. Separate analyses were run for non-computer users, patients older than 75 years, and poor performers (< or =1 standard deviation on overall battery performance). RESULTS: For all patients (n = 2,888; age, 64.7 +/- 18.2 years), 83% rated the tests easy to use (P < .001). Seventy-three percent of non-computer users, 70% of patients older than 75, and 69% of poor performers rated them easy to use (Ps < .001). Supervisor ratings and ease of understandability ratings were similar. For all patients, 76% of supervisor ratings indicated no patient frustration (P < .001). Seventy-eight percent of ratings for non-computer users, 76% for patients older than 75, and 74% for poor performers indicated no frustration (Ps < .001). CONCLUSIONS: Mindstreams was easily employed, including in patients with considerable cognitive impairment, supporting its practicality for in-office cognitive assessment of the elderly. The availability of such valid and practical assessment suggests the feasibility of integrating the technology within a clinical algorithm for improved detection of cognitive decline.
BACKGROUND: Early detection and diagnosis are critical to dementia care. However, many early cases remain undiagnosed as a result of the impracticality of neuropsychological testing, particularly in primary care. Mindstreams is an office-based computerized system for measuring cognitive function in multiple domains, with demonstrated validity, test-retest reliability, and sensitivity to treatment effects. This study evaluated its feasibility for assessment of the elderly. METHODS: Usability data were collected after each of 2,888 consecutive initial-visit testing sessions at the first 11 clinical centers to use Mindstreams. The chi(2) goodness-of-fit test was employed to determine whether patients and supervisors more often rated tests easy versus hard to use. Separate analyses were run for non-computer users, patients older than 75 years, and poor performers (< or =1 standard deviation on overall battery performance). RESULTS: For all patients (n = 2,888; age, 64.7 +/- 18.2 years), 83% rated the tests easy to use (P < .001). Seventy-three percent of non-computer users, 70% of patients older than 75, and 69% of poor performers rated them easy to use (Ps < .001). Supervisor ratings and ease of understandability ratings were similar. For all patients, 76% of supervisor ratings indicated no patient frustration (P < .001). Seventy-eight percent of ratings for non-computer users, 76% for patients older than 75, and 74% for poor performers indicated no frustration (Ps < .001). CONCLUSIONS: Mindstreams was easily employed, including in patients with considerable cognitive impairment, supporting its practicality for in-office cognitive assessment of the elderly. The availability of such valid and practical assessment suggests the feasibility of integrating the technology within a clinical algorithm for improved detection of cognitive decline.
Authors: Mark A Espeland; Jeffrey A Katula; Julia Rushing; Arthur F Kramer; Janine M Jennings; Kaycee M Sink; Neelesh K Nadkarni; Kieran F Reid; Cynthia M Castro; Timothy Church; Diana R Kerwin; Jeff D Williamson; Richard A Marottoli; Scott Rushing; Michael Marsiske; Stephen R Rapp Journal: Int J Geriatr Psychiatry Date: 2013-04-16 Impact factor: 3.485
Authors: Elisa Di Rosa; Caoimhe Hannigan; Sabina Brennan; Richard Reilly; Viliam Rapčan; Ian H Robertson Journal: Front Aging Neurosci Date: 2014-03-06 Impact factor: 5.750