Different Levels Of Cognitive Functioning Research Articles

Different Generations Review One Flew Over the Cuckoo's Nest Miloš Forman (Director)

Different Generations Review <i>One Flew Over the Cuckoo's Nest</i> Miloš Forman (Director)

Construct Validity of the Wisconsin Card Sorting Test-64 in Patients with Stroke

This study examined the factor structure and contrasted-group validity of the Wisconsin Card Sorting Test-64 (WCST-64) in a stroke sample (n = 112). Confirmatory factor analyses were used to compare five different models suggested by prior factor analyses. The results indicated that the WCST-64 was best represented by a three-dimensional model comprising response inflexibility (factor 1), ineffective hypothesis-testing strategy (factor 2), and set maintenance (factor 3). A significant overall multivariate effect for group (F = 2.87, df = 18,495.46, p < .001) was found in a multivariate analysis of covariance with WCST scores as dependent variables and four different groups (three stroke subgroups with different levels of cognitive function and a normal control group) as independent variable, after controlling for gender. The results of discriminant analysis supported the use of the WCST-64 in stroke patients with cognitive impairment.

Neuropsychiatric Symptoms and Quality of Life in Alzheimer Disease

Authors examined the impact of neuropsychiatric symptoms in Alzheimer disease (AD) patients' and caregivers' quality of life (QOL) and assessed the relationship of caregiver distress to neuropsychiatric symptoms and caregiver QOL. Sixty-two patients with probable or possible AD and their caregivers participated. Neuropsychiatric symptoms of patients were assessed with the Neuropsychiatric Inventory (NPI). QOL of both patients and caregivers was assessed using the QOL-Alzheimer's Disease (QOL-AD) scale. Each patient and caregiver completed patient QOL ratings; caregivers also completed caregiver QOL assessments. Caregiver QOL-AD was negatively correlated with agitation/aggression, anxiety, disinhibition, irritability/lability, and total NPI score. Patient QOL on both patient and caregiver ratings was negatively correlated with depression. Patient-reported QOL-AD ratings at different levels of cognitive functioning were not correlated with caregiver-reported ratings. The lack of relationship between patient and caregiver assessments of patient QOL was evident in both mildly and moderately affected patients. Caregiver QOL was negatively correlated with distress related to agitation/aggression, disinhibition, irritability/lability, and total NPI distress. Neuropsychiatric symptoms of AD patients adversely affect both patient and caregiver QOL. These results suggest that identifying and treating neuropsychiatric symptoms in AD may improve both patient and caregiver QOL.

Motor performance deteriorates with simultaneously performed cognitive tasks in geriatric patients

Hauer K, Marburger, C, Oster P. Motor performance deteriorates with simultaneously performed cognitive tasks in geriatric patients. Arch Phys Med Rehabil 2002;83:217-23. Objective: To investigate whether simultaneous cognitive tasks influence maximal motor performance in frail geriatric patients with a history of injurious falls and different levels of cognitive function. Design: Experimental 3-group design. Setting: Geriatric rehabilitation hospital. Participants: Twenty-two healthy, young adults (mean age ± standard deviation, 27.7 ± 9y) and 23 geriatric patients (mean age, 80.9 ± 5.4y) with a history of injurious falls with (Mini-Mental State Examination [MMSE] score, 20.5 ± 1.6) and without (MMSE score, 28.1 ± 1.2) cognitive impairment. Interventions: Not applicable. Main Outcome Measure: Motor performance: peak and integral of maximal isometric strength of leg extensors. Cognition: semiautomated calculation steps (serial 2 forward) and nonautomated calculation steps derived from the MMSE (serial 7 retro). Motor and cognitive performances were examined as single and dual tasks. Results: In frail geriatric patients, especially in patients with cognitive impairment, maximal motor performance decreased significantly during all dual tasks. Cognitive performance was reduced, depending on the task and group. Conclusion: In frail or cognitively impaired geriatric patients, additional tasks can substantially decrease maximal motor performance. Insufficient resources on dual tasking may thus be a link in connecting the high incidence of falls with frailty and cognitive impairment in geriatric patients with a history of injurious falls. © 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Parent and professional agreement on cognitive level of children with autism.

The aim of the study was to compare the extent of agreement between parents and professional evaluators regarding the cognitive level of children with autism. We sought to determine the degree of parent and standardized test agreement about the child's cognitive level for children at different levels of cognitive functioning. Information regarding parental view of cognitive levels was collected from the questionnaires used during the initial evaluation. These levels were compared with age equivalencies obtained by professionals from standardized intellectual measures. Significant difference between parental perception and professional assessment of the child's cognitive level was found. In addition, there was significant correlation between the level of agreement and cognitive functioning; agreement increased as the level of cognitive functioning increased.

Cognitive Assessment in the Acute Care Setting: Reliability and Validity of the Levels of Cognitive Functioning Assessment Scale (LOCFAS)

Nurses have responsibility for accurate assessment of cognitive functioning for traumatic brain injured (TBI) patients early in the posttrauma period to enhance rehabilitation with appropriate care planning. To meet this need the Levels of Cognitive Functioning Assessment Scale (LOCFAS) was adapted from the Rancho Los Amigo Levels of Cognitive Functioning instrument. One validity and three reliability studies were conducted using videotapes of five TBI patients at different levels of cognitive functioning. Interrater and intrarater reliability was assessed using coefficient kappa. With raters experienced in assessing cognitive functioning, agreement among cognitive levels was 1.00 with a mean agreement of .997 (SD = .006) for individual items. With inexperienced raters in cognitive assessment, mean agreement for levels was .839 (SD = .120) and for individual items, .830 (SD = .052) Intrarater reliability, after a two-week interval, yielded a mean agreement of .860 (SD = .088) for levels. Criterion-related validity of the LOCFAS was demonstrated by correlating it with the Rancho Los Amigos Levels of Cognitive Functioning scale. The resultant Pearson r correlation was .929. Implications for nursing practice and nursing education are discussed.

Handedness patterns in autism suggest subtypes.

The present study reports preliminary data from two unselected samples of carefully diagnosed autistic subjects (children and adults) and an assessment procedure that includes a large sample of items, appropriate for lower-functioning autistic subjects, with multiple presentations within and between sessions 1 week apart. The study seeks to determine (1) whether a raised incidence of non-right-handedness exists in these samples (2) if so, what constructs best represent this shift in the handedness distribution (i.e., phenotype and CNS substrate) and (3) whether these handedness phenotypes are associated with different levels of cognitive functioning. The results reveal a dramatic shift away from right-handedness in both autistic samples, due to a raised incidence of two phenotypes, manifest left-handedness and ambiguous handedness. The ambiguously handed, who were postulated to represent substantial bilateral CNS pathology due to early brain injury, were found to have much lower intellectual scores in one of the study samples.

Performance and Reflection: Young Children’s Concept of Word

AbstractFour tasks that measure performance- and reflective-based knowledge of the structural and significative features of words were administered to subjects at two different levels of cognitive functioning as determined by Piagetian assessment tasks. A priori tests of hypothesized relations within and between cognitive levels revealed no significant differences. Post hoc analyses revealed a significantly greater ability to identify whether or not aurally-presented phrases and words (nouns, verbs, functors) were in fact words than to discuss words metalinguistically. Results question a strict Piagetian cognitive-stage position which maintains that language performance must precede metalinguistic knowledge and support instead an interactionist position which holds that the two work in concert toward developing children’s concepts of wordness.