Drawing Test Research Articles

Methods of examination in physical therapy, and occupational therapy of people after stroke (clinical case)

the prognosis of recovery of patients after acute cerebrovascular accident depends on the type, severity, and area of brain damage. This article highlights standardized tests and scales for physical therapy and occupational therapy for patients after stroke. An example is given of a clinical case of a patient with stroke consequences, with right-sided spastic hemiplegia. Medical rehabilitation was provided in April 2023 at the Municipal Non-Profit Enterprise "Consultative and Diagnostic Center", branch №6, Sviatoshynskyi district, Kyiv, Department of Physical and Rehabilitation Medicine. After the patient visited the outpatient department of physical and rehabilitation medicine, the examination was conducted by the attending physician. A multidisciplinary team of a physical therapist and an occupational therapist was involved. An important step is the use of standardized tests and scales in physical therapy and occupational therapy. Based on the results of the examinations, the patient's goals are determined, and an individual rehabilitation program is built using evidence-based physical therapy and occupational therapy methods to provide a high-quality and effective rehabilitation cycle. Description of the objective. The standardized tests and scales in physical therapy, and occupational therapy are analyzed on the example of a clinical case of a patient after a stroke with right-sided spastic hemiplegia. Materials and methods. The clinician's handbook for 2020 on stroke rehabilitation was analyzed, with the justification of standardized tests and scales for physical therapy, and occupational therapy. A systematic review of the PubMed database was conducted, which included 44 scientific randomized trials and meta-analyses with accurate diagnoses of tests and scales for physical therapy and occupational therapy. The National Institutes of Health Stroke Scale (NIHSS) and the Modified Rankin Scale (mRS) were used to assess stroke. Modified Ashworth Scale for the assessment of spastic muscles in patients with neurological disorders. To determine cognitive outcomes and complications after stroke: Montreal Outcome Cognitive Assessment (MOCA); Modified Barthel Index (BI); Line Drawing Test. For motor function: Fugl-Meyer Assessment (FMA); Chedoke Arm and Hand Activity Instrument (CAHAI). Berg Balance Assessment; Morse Fall Risk Test; Stand and Walk Test. Results. The results of the initial examination in physical therapy and occupational therapy determined the patient's functional and cognitive state, consequences, and limitations arising after a stroke. The intermediate examination summarizes the effectiveness of the selected rehabilitation measures. If the patient's results remain unchanged, the physical and occupational therapist changes the approach and methods to achieve the goals. The final examination analyzes the dynamics of restoration of impaired functions, and achievement of goals by the end of the rehabilitation cycle. Therefore, we used the patient's clinical case to compare the initial, intermediate, and final examinations. This allowed us to analyze the results and determine the effectiveness of the selected individual rehabilitation program. Conclusions. The main principle of providing quality rehabilitation measures is the examination in the clinical practice of a physical therapist, and occupational therapist, which is used to measure the goals and compare the results achieved.

A Network Analysis of Digital Clock Drawing for Command and Copy Conditions.

Graphomotor and time-based variables from the digital Clock Drawing Test (dCDT) characterize cognitive functions. However, no prior publications have quantified the strength of the associations between digital clock variables as they are produced. We hypothesized that analysis of the production of clock features and their interrelationships, as suggested, will differ between the command and copy test conditions. Older adults aged 65+ completed a digital clock drawing to command and copy conditions. Using a Bayesian hill-climbing algorithm and bootstrapping (10,000 samples), we derived directed acyclic graphs (DAGs) to examine network structure for command and copy dCDT variables. Although the command condition showed moderate associations between variables (= 0.34) relative to the copy condition ( = 0.25), the copy condition network had more connections (18/18 versus 15/18 command). Network connectivity across command and copy was most influenced by five of the 18 variables. The direction of dependencies followed the order of instructions better in the command condition network. Digitally acquired clock variables relate to one another but differ in network structure when derived from command or copy conditions. Continued analyses of clock drawing production should improve understanding of quintessential normal features to aid in early neurodegenerative disease detection.

Efforts to Improve Motivation and Learning Outcomes with the Use of Powerpoint Media


 
 
 The purpose of this study was to determine the use of powerpoint media to increase motivation and learning outcomes of art and culture with materials for drawing decorative flora and fauna for class VIIIA students of SMP Negeri 02 Padangsidimpuan in the second semester of the academic year 2022/2023. This research was conducted in the second semester of the academic year 2022/2023. The research subjects were 36 students of class VIIIA of SMP Negeri 02 Padangsidimpuan. With the research target is the motivation and learning outcomes of art and culture materials for drawing decorative flora and fauna. Tool to collect data by observation to determine student learning motivation, learning outcomes of art and culture carried out a performance drawing test. This study uses 3 data analyzes, namely initial conditions, cycle 1 data, and cycle 2 data analyzed using comparative description techniques followed by reflection. The method used is to form large groups, small groups using powerpoint media are carried out by drawing performance tests to determine the increase in learning outcomes. This research model uses 4 stages of action: planning, action, observation, and reflection. Based on the results of the study, it was concluded that there had been an increase in the motivation indicator data for cycle 1, indicator 1) 81%, 2) 82%, 3) 87, cycle 2 increased to indicator 1) 83%, 2) 84%, 3) 90%. While the data on learning outcomes in cycle 1, the lowest score was 70, the highest score was 87, the average value was 77, there were 2 students who had not completed, cycle 2 the lowest score was 76, the highest score was 90, the average value was 79, and all the students completed.
 
 

조기발병 치매환자의 사회참여 활성화를 위한 캘리그래피 중심 집단미술치료 사례연구

Objectives The purpose of this study was to analyze how group art therapy using calligraphy impacts the social engagement activation of early onset dementia patients.
 Methods The group therapy was conducted for six early-onset dementia patients who were registered at the S Metropolitan Center for Dementia. The program consisted of eleven sessions and ran once a week from July 31, 2023, to November 6, 2023. The group art therapy program involved education and learning in each session to enable early-onset dementia patients to use the medium themselves and complete artworks. Based on this, participants were guided to complete artistic works. The research data were collected and analyzed using pre- and post-data (CIST and SGDS-K), therapist's session evaluations, observation notes, pre- and post-DAS (The Draw-a-Story) drawing test, and in-depth interviews with 2 participants and partners of 3 participants. The results of the in-depth interviews were cross-analyzed and categorized by two researchers under supervision to derive the findings.
 Results As a result, firstly, most of the patients who participated in the program maintained or developed their cognitive skills and lowered their depression inventory. Second, participants indicated improvement in their social skills and an increase in awareness and experience related to social engagement. Based on the experience of the art therapy group, participants’ showed positive changes in awareness of social engagement
 Conclusions This study is meaningful in confirming the impact of group art therapy using calligraphy on alleviating difficulties and promoting social engagement in early-onset dementia patients. Therefore, it is expected to contribute to the activation of social engagement for early-onset dementia patients.

Digital clock drawing test reflects visuospatial ability of older drivers.

To keep older drivers safe, it is necessary to assess their fitness to drive. We developed a touch screen-based digital Clock Drawing Test (dCDT) and examined the relationship between the dCDT scores and on-road driving performance of older drivers in a community-setting. One hundred and forty-one community-dwelling older drivers (range; 64-88 years old) who participated in this study were included in the analysis. Participants completed the dCDT, the Mini-Mental State Examination-Japanese (MMSE-J), and an on-road driving assessment. We examined the relationship between dCDT scores using the method by Rouleau et al. (maximum 10 points) and the on-road driving performance based on a driving assessment system originally developed by Nagoya University. Multiple regression analyses showed that errors in the driving test were associated with dCDT score for the items "confirmation," "turning left" and "maintains driving lane position". This study confirmed the relationship between the dCDT score and driving errors, such as confirmation, turning left and maintaining driving lane position. The increase in these errors indicates a decline in visuospatial ability while driving. The dCDT score may reflect older drivers' visuospatial abilities while driving.

Higher purpose in life and education were associated with better cognition among older adults.

With aging, some cognitive abilities change because of neurobiological processes. Cognition may also be influenced by psychosocial aspects. To describe the relationship between a measure of neuroticism, depression symptoms, purpose in life, and cognitive performance in community-dwelling older adults. This was a cross-sectional analysis based on the data from the second wave of the Frailty in Brazilian Older Adults (FIBRA) study, carried out between 2016 and 2017. The sample consisted of 419 older people (≥ 72 years old) cognitively unimpaired and mostly with low education. The variables of interest were sociodemographic, Neuroticism domain from the NEO-PI-R, Geriatric Depression Scale (GDS), Purpose in Life (PiL) scale, and a cognitive composite score which included the Mini-Mental State Examination (MMSE), and the scores for the sub-items of the Mini-Addenbrooke's Cognitive Examination (M-ACE), namely, Verbal Fluency (VF) - Animal, Clock Drawing Test (CDT), Episodic Memory (name and address). There was a greater number of women (70%), with older age (median = 80 years, IQR = 77-82), and low education (median = 4 years, IQR = 2-5). In the bivariate correlations, years of education (ρ = 0.415; p < 0.001) and PiL (ρ = 0.220; p < 0.001) were positively associated with cognition. Neuroticism (ρ = -0.175; p < 0.001) and depression symptoms (ρ = -0.185; p < 0.001) were negatively associated with cognition. In the logistic regression, after including confounding variables, the associations between cognition and PiL (OR = 2.04; p = 0.007) and education (OR = 1.32; p < 0.001) remained significant. Low PiL and low education levels were associated with worse cognition among older adults. Such results may be of relevance in programs that aim to improve cognition among older adults.

Spectrum and frequency of non-motor disorders in Parkinson’s patients in the Kursk Region

Introduction. Parkinson's disease (PD) is characterized by a long period of latent neurodegenerative process. Some patients experience non-motor manifestations in the form of autonomic (constipation, dizziness, fainting, and sleep, smell, and urination disorders), mental (anxiety and depression), and cognitive disorders that occur several years before the onset of motor symptoms [1]. Purpose of the study: to determine the spectrum and frequency of non-motor disorders in patients with Parkinson’s disease in the Kursk Region, as well as to assess the degree of their severit y. Materials and method. We examined 32 patients (18 women and 14 men) with an established diagnosis of PD (mixed type), who were treated at the Kursk Regional Multidisciplinary Clinical Hospital. The age of the patients ranged from 59 to 76 years. The mean age was 69.03±5.71 years, and the duration of the disease was 6.93±8.08 years. Non-motor symptoms and their severity were assessed using the UPDRS (Part I) and the NMSS-PD. Sleep disturbances were assessed according to the Epworth Sleepiness Scale (ESS). The Hospital Anxiety and Depression Scale (HADS) was used to study the neuropsychological status of the patients. Cognitive status was assessed according to the MMSE, Frontal Assessment Battery, and the clock drawing test. Results. Non-motor symptoms occurred in 87.5 % of the patients in the study population and are an equally significant part of the PD clinical picture. These manifestations are most often represented by autonomic (87.5 %), mental (68.7 %), and cognitive (72 %) disorders, which have a different spectrum and frequency in this group of patients. Conclusion. Non-motor manifestations of PD require special attention from a neurologist. The clinical picture of such disorders is varied. Early detection and adequate correction of non-motor disorders contributes to the main goal of PD therapy — to improve the qualit y of life of patients.

Psychological Correlates of Epilepsy

The main objective of the present research was to investigate the vulnerability of epileptics towards various psychological disorders. It was hypothesized that epileptics are significantly different from non-epileptics in terms of their vulnerability to psychological disorders. The sample included 30 epileptics (i.e. grandmal, myoclonic, primary partial seizures, temporal lobe) from Institute ofNeurosciences, Hayat Shaheed Teaching Hospital and Mental Hospital Peshawar and 30 non-epileptics volunteers were selected from the population of Peshawar University. Human Figure Drawing Test (HFDT) and Minnesota Multiphasic Personality Inventory (MMPI-1) were administered individually on each participant. Results indicated significant qualitative and quantitative differences between epileptics and non-epileptics. Epileptics scored higher than non-epileptics on several clinical scales of MMPI: Among epileptics, patients with temporal lobe epilepsy showed higher mean scores on emotional indicators (of HFDT) as compared to other epileptics and non-epileptics suggesting that epileptic group may have more emotional problems. Therefore, it was concluded that epileptic patients were more anxious, aggressive, insecure and on the whole had poor self- concept and more symptoms of depression.

Trajectories of cognitive decline in different domains prior to AD onset in persons with mild cognitive impairment

ObjectivesTo explore the trajectories and the change-points of global and five domain-specific cognitive functions before the onset of Alzheimer's disease (AD). MethodsData was retrieved from the Alzheimer's Disease Neuroimaging Initiative with follow-up from 2005 to 2022. Participants with mild cognitive impairment (MCI) at baseline and those who progressed to AD during follow-up were included. The time of AD onset was defined as the visit time when participant was first diagnosed as AD during follow-up. Global and five domain-specific cognitive functions (immediate memory, visuospatial ability, language, processing speed and executive function) were assessed by Mini-Mental State Examination, Immediate recalling trials of Rey Auditory Verbal Learning Test, Clock Drawing Test, Animal Fluency Test, Part A and B of Trail Making Test, respectively. Their trajectories and change-points before AD onset were explored by generalized additive mixed models and piecewise linear regression models, respectively. Results349 participants were diagnosed as MCI at baseline and converted to AD during follow-up, who were included in this study. They had been visited on an average of 4.6 times (SD = 2.1, range = 2.0–13.0), with a total of 1593 visits. Their mean baseline age and AD onset age were 74.4 (SD = 6.4, range = 60.0–88.4) and 77.0 (SD = 6.8, range = 60.5–94.7) years, respectively. Baseline age and educational year were significantly associated with global cognitive, immediate memory, language and executive function. Men presented better global cognitive function (β = 0.54, p < 0.05) but poorer immediate memory (β = −1.72, p < 0.05) than women. Immediate memory and visuospatial ability showed the earliest change-points at 4 years before the onset of AD (Note as T-4years), followed by language (T-3.5years), executive function (T-2.5 years), processing speed (T-2.0 years), and finally the global cognitive function (T-1.5years). ConclusionsThe trajectories of the six neuropsychological scores were non-linear and showed deterioration in functions over time. Immediate memory and visuospatial ability showed the earliest change-points prior to AD onset.

The Comparison of the Multi-Layer Artificial Neural Network Training Methods in Terms of the Predictive Quality of the Coefficient of Friction of 1.0338 (DC04) Steel Sheet.

Friction is one of the main phenomena accompanying sheet metal forming methods, affecting the surface quality of products and the formability of the sheet metal. The most basic and cheapest way to reduce friction is to use lubricants, which should ensure the highest lubrication efficiency and at the same time be environmentally friendly. Due to the trend towards sustainable production, vegetable oils have been used in research as an alternative to petroleum-based lubricants. The analysis of friction in sheet metal forming requires an appropriate tribotester simulating the friction conditions in a specific area of the sheet metal being formed. Research has used a special strip drawing tribometer, enabling the determination the value of the coefficient of friction in the blankholder zone in the deep drawing process. Quantitative analysis of the friction phenomenon is necessary at the stage of designing the technological process and selecting technological parameters, including blankholder pressure. This article presents the results of friction testing of 1.0338 (DC04) steel sheets using a strip drawing test. The experimental tests involved pulling a strip of sheet metal between two countersamples with a rounded surface. The tests were carried out on countersamples with different levels of roughness for the range of contact pressures occurring in the blankholder zone in the deep drawing process (1.7-5 MPa). The values of the coefficient of friction determined under dry friction conditions were compared with the results for edible (corn, sunflower and rapeseed) and non-edible (Moringa, Karanja) vegetable lubricants. The tested oils are the most commonly used vegetable-based biolubricants in metal forming operations. Multi-layer artificial neural networks were used to determine the relationship between the value of the contact pressure, the roughness of the countersamples, the oil viscosity and density, and the value of the coefficient of friction. Rapeseed oil provided the best lubrication efficiency during friction testing for all of the tested samples, with an average surface roughness of Sa 0.44-1.34 μm. At the same time, as the roughness of the countersamples increased, a decrease in lubrication efficiency was observed. The lowest root mean squared error value was observed for the MLP-4-8-1 network trained with the quasi-Newton algorithm. Most of the analysed networks with different architectures trained using the various algorithms showed that the kinematic viscosity of the oil was the most important aspect in assessing the friction of the sheets tested. The influence of kinematic viscosity on the value of the coefficient of friction is strongly dependent on the surface roughness of the countersamples.

코로나19 팬데믹 시기 가족 사별을 경험한 대학생의 VR기반 애도 미술치료 사례연구

Objectives The purpose of this study is to identify VR-based mourning art therapy experiences for college stu-dents who have experienced family bereavement during the COVID-19 pandemic and seek directions for art psy-chological support for college students who have experienced bereavement.&#x0D; Methods This study divided four college students into preliminary research and research, and conducted four ses-sions of VR-based art therapy and PITR drawing tests(pre-, post-, and last post- test). The final VR-based mourning art therapy program was completed through a report on the experience of a preliminary study in which the researcher directly participated and a revision process through the expert's supervision. This study was con-ducted on two college students who expressed their willingness to participate in the future. The qualitative results of art therapy cases collected in this study were cross-analyzed and categorized by four researchers to derive results.&#x0D; Results First of all, three areas, seven themes, and 75 corresponding meaning statements were derived as a result of VR-based mourning art therapy, and it was confirmed that it provided meaningful mourning experiences to col-lege students who experienced bereavement during the COVID-19 pandemic. Second of all, it was reported that VR-based mourning art therapy had the effect of confirming the present self in the PITR drawing tests(pre-, post-, and last post- test).&#x0D; Conclusions The results of this study are significant in that they confirmed the experiences of college students who experienced bereavement during the COVID-19 pandemic through VR-based art therapy, and we hope to contribute to expanding the support base and academic development of VR-based mourning art therapy.

Mindful aging: an insightful examination of cognitive impairment in the elderly population of Chengalpattu, Tamil Nadu, using Mini-Cog scale

Background: By 2050, United Nations projects that one in five Indians would be 60 years of age or older. This demographic transition is likely to be accompanied by substantial rise in prevalence of cognitive problems, which will have an impact on quality of life among elderly people. Effective screening at primary level would help in identification of burden of diseases and better planning at secondary and tertiary level. Methods: A community-based cross-sectional study over a period of three months was conducted at Pulipakkam in Chengalpattu district. The estimated sample size was 215, and simple random sampling method was used. Elderly people aged 60 years and above who consented to participate were included in the study. After obtaining informed consent, they were screened using the Mini-Cog tool which combines a short memory test with a simple clock- drawing test followed by a recall component. Results: The 215 participants in total were screened. The mean age of participants was 66.02±3.83 years. The prevalence of cognitive impairment (CI) based on Mini-Cog scale was 44.2%. Females (44.8%) had marginally higher prevalence than males (43.8%). CI was more prevalent among people over 65 years (57.6%). The likelihood of experiencing CI was higher among those who lived without their spouse (59.4%), were unemployed (53.7%), and who were smokers / alcoholics (63.7%). Conclusions: Considering the high burden of CI, there is need for long term prospective research for a comprehensive profile of mental disorders at community level. Early assessment and detection of CI could help in improving quality of life of elderly. Implementing initiatives aimed at increasing awareness, reducing stigma, and conducting widespread screening using reliable tools.

Comprehensive assessment of fine motor movement and cognitive function among older adults in China: a cross-sectional study

BackgroundFine motor skills are closely related to cognitive function. However, there is currently no comprehensive assessment of fine motor movement and how it corresponds with cognitive function. To conduct a complete assessment of fine motor and clarify the relationship between various dimensions of fine motor and cognitive function.MethodsWe conducted a cross-sectional study with 267 community-based participants aged ≥ 60 years in Beijing, China. We assessed four tests performance and gathered detailed fine motor indicators using Micro-Electro-Mechanical System (MEMS) motion capture technology. The wearable MEMS device provided us with precise fine motion metrics, while Chinese version of the Montreal Cognitive Assessment (MoCA) was used to assess cognitive function. We adopted logistic regression to analyze the relationship between fine motor movement and cognitive function.Results129 (48.3%) of the participants had cognitive impairment. The vast majority of fine motor movements have independent linear correlations with MoCA-BJ scores. According to logistic regression analysis, completion time in the Same-pattern tapping test (OR = 1.033, 95%CI = 1.003–1.063), Completion time of non-dominant hand in the Pieces flipping test (OR = 1.006, 95%CI = 1.000-1.011), and trajectory distance of dominant hand in the Pegboard test (OR = 1.044, 95%CI = 1.010–1.068), which represents dexterity, are related to cognitive impairment. Coordination, represented by lag time between hands in the Same-pattern tapping (OR = 1.663, 95%CI = 1.131–2.444), is correlated with cognitive impairment. Coverage in the Dual-hand drawing test as an important indicator of stability is negatively correlated with cognitive function (OR = 0.709, 95%CI = 0.6501–0.959). Based on the above 5-feature model showed consistently high accuracy and sensitivity at the MoCA-BJ score (ACU = 0.80–0.87).ConclusionsThe results of a comprehensive fine-motor assessment that integrates dexterity, coordination, and stability are closely related to cognitive functioning. Fine motor movement has the potential to be a reliable predictor of cognitive impairment.

Montreal Cognitive Assessment and the Clock Drawing Test to Identify MCI and Predict Dementia in Isolated REM Sleep Behavior Disorder.

Patients with isolated/idiopathic REM sleep behavior disorder (iRBD) are at high risk for developing mild cognitive impairment (MCI) and dementia with Lewy bodies (DLB). However, there is a lack of scientific knowledge regarding the accuracy of cognitive screening tools to identify these conditions in iRBD. This study aimed to determine in iRBD the psychometrics of 2 screening tests to discriminate patients with MCI and those at risk of DLB. We retrospectively selected and followed 64 patients with polysomnography-confirmed iRBD seen in sleep clinic between 2006 and 2021, 32 with MCI (mean age 68.44 years, 72% men), 32 without MCI (67.78 years, 66% men), and 32 controls (69.84 years, 47% men). Participants underwent a neurologic evaluation and neuropsychological assessment for MCI diagnosis. They also completed the Montreal Cognitive Assessment (MoCA) and Clock Drawing Test (CDT). Fifty-three patients were followed (mean of 5.10 ± 2.64 years); 6 developed DLB, and 16 developed Parkinson disease. An independent cohort of 10 patients with iRBD who later developed DLB was also recruited and followed. Receiver operating characteristic curves with area under the curve (AUC) were performed assessing the discriminant value of the MoCA and CDT. The cut-off values that best differentiated patients who developed DLB from controls were on the MoCA total score (≤25/30 with 100% [95% CI 61%-100%] sensitivity and 78% [61%-89%] specificity, AUC = 0.888) and delayed recall (≤3/5 with 83% [44%-97%] sensitivity and 78% [61%-89%] specificity, AUC = 0.875). Both values yielded a sensitivity of 90% (60%-98%) to detect patients at risk of DLB in the independent cohort. Cutoffs that best discriminated patients with MCI from controls were: ≤25/30 (MoCA total score) with 72% [55%-84%] sensitivity, 78% [61%-89%] specificity, AUC = 0.803 and ≤2/5 (MoCA delayed recall) with 63% [45%-77%] sensitivity, 94% [80%-98%] specificity, AUC = 0.843. No acceptable optimal values were found for the CDT. In iRBD, the MoCA demonstrates adequate psychometric properties to identify patients most at risk of developing DLB and to screen for MCI, whereas the CDT does not. This study provides Class II evidence that the MoCA, but not the CDT, is useful in screening patients with iRBD for the risk of developing DLB.

The Application of the Formal Elements Art Therapy Scale in the Person-in-the-Rain Drawing Test

The Person-in-the-Rain (PITR) drawing scoring system primarily assesses stress, excluding consideration of color usage. In contrast, the Formal Elements Art Therapy Scale (FEATS) effectively evaluates psychopathological disorders and provides a comprehensive assessment of color usage. This study aimed to: (1) develop an alternative scoring system for PITR by modifying FEATS, (2) explore the clinical significance of color in PITR by examining its relationship with Depression Anxiety Stress Scales (DASS-21), and (3) determine if color mediates the relationship between DASS-21 and FEATS-based PITR ratings. We recruited 61 college students who completed PITR and DASS-21. PITR drawings were coded using modified FEATS. Findings suggest that the modified FEATS scoring system provides clinically meaningful information for assessing stress, coping mechanisms, anxiety, and depression.

Diagnostic Accuracy of the Swedish Version of the Multicultural Cognitive Examination for Cognitive Assessment in Swedish Memory Clinics.

Cognitive assessment for foreign-born individuals is suboptimal. The Multicultural Cognitive Examination (MCE) was developed for use in culturally, linguistically and educationally diverse populations. The MCE includes the Rowland Universal Dementia Assessment Scale (RUDAS) and performs assessment of memory, verbal fluency, and visuospatial function. To compare the psychometric properties of the Swedish version of the Multicultural Cognitive Examination (MCE-S) with the Swedish versions of the RUDAS (RUDAS-S), the Mini-Mental State Examination (MMSE-SR), and the Clock Drawing Test (CDT), and to explore the ability of the MCE-S test to differentiate patients with and without dementia in a multicultural population. 117 outpatients at four memory clinics were tested using the MCE-S to complement the routine cognitive assessment. Significant differences between patients with and without dementia were observed for all MCE-S components. There were significant differences between foreign-born and Swedish-born patients in the MMSE-SR, but not in the MCE-S or the RUDAS-S. The MCE-S, had good diagnostic performance for detecting dementia (AUC, 0.82), and was at least as good as the RUDAS-S alone (AUC, 0.79). The MCE-S also distinguished Alzheimer's disease (AD) from non-AD dementia. Contrary to expectations, the MCE-S was also at least as good as the MMSE-SR among the Swedish-born patients. The MCE-S is adequate for detecting dementia in both foreign-born and Swedish-born populations. Based on the cultural diversity of general society, adapted cognitive tests that can be used for everyone are practical and beneficial for both patients and health-care professionals. Further studies are needed within primary care.

A volunteer-supported walking programme to improve physical function in older people with restricted mobility (the POWER Study): a randomised controlled trial

BackgroundRegular physical activity has multiple health benefits, especially in older people. Therefore, the World Health Organization recommends at least 2.5 h of moderate physical activity per week. The aim of the POWER Study was to investigate whether volunteer-assisted walking improves the physical performance and health of older people.MethodsWe approached people aged 65 years and older with restricted mobility due to physical limitations and asked them to participate in this multicentre randomised controlled trial. The recruitment took place in nursing homes and the community setting. Participants randomly assigned to the intervention group were accompanied by volunteer companions for a 30–50 min walk up to three times a week for 6 months. Participants in the control group received two lectures that included health-related topics. The primary endpoint was physical function as measured with the Short Physical Performance Battery (SPPB) at baseline and 6 and 12 months. The secondary and safety endpoints were quality of life (EQ-5D-5L), fear of falling (Falls Efficacy Scale), cognitive executive function (the Clock Drawing Test), falls, hospitalisations and death.ResultsThe sample comprised 224 participants (79% female). We failed to show superiority of the intervention with regard to physical function (SPPB) or other health outcomes in the intention-to-treat analyses. However, additional exploratory analyses suggest benefits in those who undertook regular walks. The intervention appears to be safe regarding falls.ConclusionsRegular physical activity is essential to preserve function and to improve health and quality of life. Against the background of a smaller-than-planned sample size, resulting in low power, and the interference of the COVID-19 pandemic, we suggest that community based low-threshold interventions deserve further exploration.Trial registrationThe trial was registered with the German Clinical Trials Register (www.germanctr.de), with number DRKS00015188 on 31/08/2018.

Estimating dementia risk in an African American population using the DCTclock.

The prevalence of Alzheimer's disease (AD) and related dementias (ADRD) is increasing. African Americans are twice as likely to develop dementia than other ethnic populations. Traditional cognitive screening solutions lack the sensitivity to independently identify individuals at risk for cognitive decline. The DCTclock is a 3-min AI-enabled adaptation of the well-established clock drawing test. The DCTclock can estimate dementia risk for both general cognitive impairment and the presence of AD pathology. Here we performed a retrospective analysis to assess the performance of the DCTclock to estimate future conversion to ADRD in African American participants from the Rush Alzheimer's Disease Research Center Minority Aging Research Study (MARS) and African American Clinical Core (AACORE). We assessed baseline DCTclock scores in 646 participants (baseline median age = 78.0 ± 6.4, median years of education = 14.0 ± 3.2, 78% female) and found significantly lower baseline DCTclock scores in those who received a dementia diagnosis within 3 years. We also found that 16.4% of participants with a baseline DCTclock score less than 60 were significantly more likely to develop dementia in 5 years vs. those with the highest DCTclock scores (75-100). This research demonstrates the DCTclock's ability to estimate the 5-year risk of developing dementia in an African American population. Early detection of elevated dementia risk using the DCTclock could provide patients, caregivers, and clinicians opportunities to plan and intervene early to improve cognitive health trajectories. Early detection of dementia risk can also enhance participant selection in clinical trials while reducing screening costs.

Arterial Hypertension, Structural Damage of the Brain and Cognitive Test

The arterial hypertension cause brain vascular damage (white matter lesion) and the burden and progression determine their cognitive consequences. Therefore, arterial hypertension is considered the main modifiable vascular risk factor for cognitive impairment and dementia. Therefore, the aim of the current study was to evaluate the results of cognitive tests in a sample of hypertensive patients and to establish possible associations with structural brain lesions (atrophy, white matter lesions) identified by magnetic resonance imaging Were included 70 hypertensive patients from Heart-Brain study in Argentina with magnetic resonance imaging and cognitive test. Fazekas scale and the Global Cortical Atrophy were used to quantify the white matter lesions and the brain atrophy, respectively. The Mini-Mental Status Examination, Clock Drawing test and Mini-Boston Naming test were used to evaluate the cognitive status. average age 69.7 ± 10.6 years, 55.7% female). Based on the linear regression analysis, Fazekas scale and cognitive tests were inversely associated. For each grade of increase in Fazekas scale, the clock drawing test (Coef -0.56, CI 95% -1.01 -0.10, p=0.01) and the Mini-mental Status Examination (Coef -0.7, CI 95% -1.27 -0.13, p=0.01) scores decreased. The subcortical atrophy was significantly associated with the clock drawing test (OR 3.29, CI 95% 1.25-8.63; p=0.016). Conclusion: The cognitive tests, particularly the clock drawing test could be used (in the clinical routine practice) as “subrrogate” of the brain structural hypertension-mediated damage.

Early diagnosis of Parkinson disorder based on spiral drawing image modalities using hybrid transfer learning architecture

The Spiral Drawing Test (SDT) has become a prominent clinical marker for the early diagnosis of Parkinson’s Disorder (PD) by capturing tremor symptoms. The integration of AI algorithms into a PD diagnosis system has proven to be a breakthrough objective assessment that aids professionals in decision-making. However, there is a need for improvisation of the workflow architectures of AI models to optimize the diagnosis system by reducing the misdiagnosis rate. The proposed system presents PD prediction using a Spiral Drawing Test (SDT) image modality integrated with an Artificial Intelligence (AI) algorithm. The proposed study presents three hybrid workflow architectures formed by integrating three core layers: a data augmentation layer, Transfer Layer (TL)-based feature extraction layer, and Deep Learning (DL)-based classification layer. The results were analyzed by conducting 18 experiments based on the hyperparameter values and workflow architectures. The highest accuracy obtained by the proposed study is 98% for Hybrid Workflow Architecture II.