iPad Version Research Articles

Validation of an iPad version of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS).

The Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) is the most widely used screening tool for cognitive impairment in Multiple Sclerosis (MS). However, the administration and scoring procedures of the paper version are time consuming and prone to errors. Aim of our study was to develop a tablet version of BICAMS (iBICAMS), and to assess its reliability compared to the paper version. We administered both BICAMS and iBICAMS to 139 MS patients in two different sessions. We compared scores on both versions using a paired t-test. We used a repeated measures ANOVA to test the impact of rater, order of administration and test-retest time on test-retest performances. We used the Intraclass Correlation Coefficient (ICC) to assess the reliability between BICAMS and iBICAMS. All three sub-tests of the BICAMS (SDMT, CVLT-II and BVMT-R) were different between the paper and the tablet versions. Order of administration influenced test-retest performances at the SDMT (p<0.001), CVLT- II (p<0.001) and BVMT-R (p<0.001). Intraclass coefficient correlation (ICC) revealed a high level of agreement between the paper BICAMS and the iPad version for all three tests: SDMT (0.92), CVLT-II (0.83) and BVMT-R (0.82). We found a high reliability between BICAMS and iBICAMS. Considering the inherent advantages of automated scoring, digital storage of data, standardized timing, the iBICAMS could become a standard in clinical practice.

Validation of an iPad version of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) (P3-3.010)

Validation of an iPad version of the Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) (P3-3.010)

Environmental Factors Affecting Cognitive Function Among Community-dwelling Older Adults

Abstract Background Although neighborhood environmental factors have been found to be associated with cognitive decline, few longitudinal studies have focused on their effect among older adults living in rural areas. This longitudinal study aimed to investigate the effect of neighborhood environmental factors on cognitive decline among rural older adults. Methods The data of 503 older adults aged &amp;gt; 60 years who were living in Unnan City in Japan and had participated in two surveys conducted between 2014 and 2018 were analyzed. Cognitive function was assessed using the Cognitive Assessment for Dementia, iPad version 2. Elevation, hilliness, residential density, and proximity to a community center were measured using geographic information system. Logistic regression examined the effect of each neighborhood environmental factor (in quartiles: Q1-Q4) on cognitive decline. Results A total of 57 (11.3%) participants demonstrated a decrease in cognitive function at follow up. Elevation (Odds ratio (OR): 3.37, 95% Confidence Interval (CI): 1.11-10.20 for Q3 vs. Q1; OR: 5.43, 95% CI: 1.89-15.56 for Q4 vs. Q1) and hilliness (OR: 3.45, 95% CI: 1.46-8.11 for Q4 vs. Q1) were associated with a higher likelihood of cognitive decline. Residential density and distance to a community center were not associated with cognitive decline. Conclusions Elevated and hilly environments may increase risk of cognitive decline among rural older adults. Key messages Residents in mountainous regions tend to have limited accessibility to various living centers. Those who live in elevated and hilly areas within the mountainous regions may have further limited accessibility and availability of locations where they can interact with others.

The \u201cself\u201d in pain: high levels of schema-enmeshment worsen fibromyalgia impact

ObjectiveChronic pain can have detrimental effects on quality of life and a profound impact on one’s identity. The Pictorial Representation of Illness- and Self-Measure (PRISM), is a visual tool designed to measure the self-illness separation (SIS) that represents the degree of schema-enmeshment (i.e., the degree to which the self-schema and the illness-schema come to overlap). Our aim was to investigate the relationship between schema-enmeshment and pain-related outcomes in patients with fibromyalgia.MethodsIn this cross-sectional study, 114 patients with fibromyalgia completed self-report assessments of pain catastrophizing, pain severity and interference, impact of symptoms, anxiety, and depression. SIS was assessed using an iPad version of PRISM. Mediation analyses evaluated the mediating role of schema-enmeshment on the association between pain catastrophizing and fibromyalgia impact.ResultsA higher degree of schema-enmeshment was associated with greater pain catastrophizing, pain severity and interference, impact of symptoms, and depression. Moreover, a mediation analysis revealed that schema-enmeshment significantly mediated the association between pain catastrophizing and fibromyalgia impact (p < 0.001).ConclusionsOur results indicate that schema-enmeshment is associated with greater intrusiveness of chronic pain on everyday life, thereby posing significant limitations on the emotional and physical well-being of fibromyalgia patients. Schema-enmeshment also appears to partly account for the deleterious effect of pain catastrophizing on disease impact. The PRISM is a simple tool that may uniquely capture the extent to which chronic pain and illness infiltrates and affects one’s self-concept.

Environmental Factors Affecting Cognitive Function among Community-Dwelling Older Adults: A Longitudinal Study.

Although neighborhood environmental factors have been found to be associated with cognitive decline, few longitudinal studies have focused on their effect on older adults living in rural areas. This longitudinal study aimed to investigate the role of neighborhood environmental factors in cognitive decline among rural older adults. The data of 485 older adults aged ≥60 years who were living in Unnan City in Japan and had participated in two surveys conducted between 2014 and 2018 were analyzed. Cognitive function was assessed using the Cognitive Assessment for Dementia, iPad version 2. Elevation, hilliness, residential density, and proximity to a community center were determined using geographic information system. We applied a generalized estimating equation with odds ratios (OR) and 95% confidence intervals (CIs) of cognitive decline in the quartiles of neighborhood environmental factors. A total of 56 (11.6%) participants demonstrated a decrease in cognitive function at follow up. Elevation (adjusted OR 2.58, 95% CI (1.39, 4.77) for Q4 vs. Q1) and hilliness (adjusted OR 1.93, 95% CI (1.03, 3.63) for Q4 vs. Q1) were associated with a higher likelihood of cognitive decline. The second quartiles of residential density showed significantly lower likelihoods of cognitive decline compared with the first quartiles (adjusted OR 0.36, 95% CI (0.19, 0.71) for Q2 vs. Q1). Thus, an elevated hilly environment and residential density predicted cognitive decline among rural older adults.

An association analysis between hypertension, dementia, and depression and the phases of pre-sarcopenia to sarcopenia: A cross-sectional analysis.

Sarcopenia is intricately related to aging associated diseases, such as neuropsychiatric disorders, oral status, and chronic diseases. Dementia and depression are interconnected and also related to sarcopenia. The preliminary shift from robust to sarcopenia (i.e., pre-sarcopenia) is an important albeit underdiscussed stage and is the focus of this study. Identifying factors associated with pre-sarcopenia may lead to sarcopenia prevention. To separately examine the effects of dementia and depression on pre-sarcopenia/sarcopenia, we conducted multiple analyses. This cross-sectional study used health checkup data from a rural Japanese island. The participants were aged 60 years and above, and the data included muscle mass, gait speed, handgrip strength, oral status (teeth and denture), chronic diseases (e.g., hypertension), dementia (cognitive assessment for dementia, iPad Version), and depression (self-rating depression scale). A total of 753 older adult participants were divided into the sarcopenia (n = 30), pre-sarcopenia (n = 125), and robust (n = 598) groups. An ordered logit regression analysis indicated that age and depression were positively correlated with sarcopenia, while hypertension was negatively associated with it. A multiple logistic regression analysis between the robust and pre-sarcopenia groups showed significant associations between the same three variables. Depression was associated with pre-sarcopenia, but not dementia. There was also a significant association between hypertension and pre-sarcopenia. Further research is needed to reveal whether the management of these factors can prevent sarcopenia.

The effect of 24-week continuous intake of quercetin-rich onion on age-related cognitive decline in healthy elderly people: a randomized, double-blind, placebo-controlled, parallel-group comparative clinical trial.

Quercetin, a type of flavonoid, is believed to reduce age-related cognitive decline. To elucidate its potential function, we carried out a randomized, double-blind, placebo-controlled, parallel-group comparative clinical trial involving 24-week continuous intake of quercetin-rich onion compared to quercetin-free onion as a placebo. Seventy healthy Japanese individuals (aged 60 to 79 years old) were enrolled in this study. We examined the effect of quercetin-rich onion (the active test food) on cognitive function using the Mini-Mental State Examination, Cognitive Assessment for Dementia iPad version, and Neuropsychiatric Inventory Nursing Home version. The Mini-Mental State Examination scores were significantly improved in the active test food group (daily quercetin intake, 50 mg as aglycone equivalent) compared to the placebo food group after 24 weeks. On the Cognitive Assessment for Dementia iPad version for emotional function evaluation, we found that the scores of the active test food group were significantly improved, suggesting that quercetin prevents cognitive decline by improving depressive symptoms and elevating motivation. On the Neuropsychiatric Inventory Nursing Home version, we found significant effects on reducing the burden on study partners. Taking all the data together, we concluded that 24-week continuous intake of quercetin-rich onion reduces age-related cognitive decline, possibly by improving emotional conditions. Clinical trial register and their clinical registration number: This study was registered with UMIN (approval number UMIN000036276, 5 April 2019).

Influence of Ultra-High Hydrostatic Pressurizing Brown Rice on Cognitive Functions and Mental Health of Elderly Japanese Individuals: A 2-Year Randomized and Controlled Trial

Brown rice contains many ingredients that might protect against cognitive decline and Alzheimer's disease. However, brown rice is very hard, difficult to cook, and is poorly digested; thus, it is difficult to eat long-term. To solve these problems, ultra-high hydrostatic pressurizing brown rice (UHHPBR) was prepared. We investigated the effects of dietary UHHPBR administration for 24 mo on cognitive function and mental health in the elderly. Healthy elderly participants (n=52) were randomized into UHHPBR and polished white rice (WR) groups. The UHHPBR group consumed 100 g of UHHPBR per day for 24 mo and the WR group consumed white rice. At baseline, and after 12 and 24 mo, cognitive functions were assessed using the Revised Hasegawa's Dementia Scale, Mini-Mental State Examination, Frontal Assessment Battery (FAB), and the Cognitive Assessment for Dementia, iPad version (CADi). Mental health condition was also assessed using the Apathy Scale and the Zung Self-Rating Depression Scale, and serum biochemical parameters were determined. From baseline to month 24, the mean change in the FAB-sub item 1 scores was higher in the UHHPBR group compared to the WR group. Furthermore, apathy scores decreased, as well as the time required to answer all questions of the CADi, and plasma epinephrine levels increased. These results indicate that a 2-y oral consumption of UHHPBR increases information processing speed (as a measure of cognitive function) and improves apathy in the elderly, suggesting a protective effect of UHHPBR administration against age-related decline in brain cognition and motivation.

The Toronto Cognitive Assessment (TorCA): normative data and validation to detect amnestic mild cognitive impairment

BackgroundA need exists for easily administered assessment tools to detect mild cognitive changes that are more comprehensive than screening tests but shorter than a neuropsychological battery and that can be administered by physicians, as well as any health care professional or trained assistant in any medical setting. The Toronto Cognitive Assessment (TorCA) was developed to achieve these goals.MethodsWe obtained normative data on the TorCA (n = 303), determined test reliability, developed an iPad version, and validated the TorCA against neuropsychological assessment for detecting amnestic mild cognitive impairment (aMCI) (n = 50/57, aMCI/normal cognition). For the normative study, healthy volunteers were recruited from the Rotman Research Institute registry. For the validation study, the sample was comprised of participants with aMCI or normal cognition based on neuropsychological assessment. Cognitively normal participants were recruited from both healthy volunteers in the normative study sample and the community.ResultsThe TorCA provides a stable assessment of multiple cognitive domains. The total score correctly classified 79% of participants (sensitivity 80%; specificity 79%). In an exploratory logistic regression analysis, indices of Immediate Verbal Recall, Delayed Verbal and Visual Recall, Visuospatial Function, and Working Memory/Attention/Executive Control, a subset of the domains assessed by the TorCA, correctly classified 92% of participants (sensitivity 92%; specificity 91%). Paper and iPad version scores were equivalent.ConclusionsThe TorCA can improve resource utilization by identifying patients with aMCI who may not require more resource-intensive neuropsychological assessment. Future studies will focus on cross-validating the TorCA for aMCI, and validation for disorders other than aMCI.

Trail Making Test: Comparison of the PEBL and iPAD Versions

Trail Making Test: Comparison of the PEBL and iPAD Versions

Mobile Universal Lexicon Evaluation System (MULES) test: A new measure of rapid picture naming for concussion

ObjectiveThis study introduces a rapid picture naming test, the Mobile Universal Lexicon Evaluation System (MULES), as a novel, vision-based performance measure for concussion screening. The MULES is a visual-verbal task that includes 54 original photographs of fruits, objects and animals. We piloted MULES in a cohort of volunteers to determine feasibility, ranges of picture naming responses, and the relation of MULES time scores to those of King-Devick (K-D), a rapid number naming test. MethodsA convenience sample (n=20, age 34±10) underwent MULES and K-D (spiral bound, iPad versions). Administration order was randomized; MULES tests were audio-recorded to provide objective data on temporal variability and ranges of picture naming responses. ResultsScores for the best of two trials for all tests were 40–50s; average times required to name each MULES picture (0.72±0.14s) was greater than those needed for each K-D number ((spiral: 0.33±0.05s, iPad: 0.36±0.06s, 120 numbers), p<0.0001, paired t-test). MULES scores showed the greatest degree of improvement between trials (9.4±4.8s, p<0.0001 for trials 1 vs. 2), compared to K-D (spiral 1.5±3.3s, iPad 1.8±3.4s). Shorter MULES times demonstrated moderate and significant correlations with shorter iPad but not spiral K-D times (r=0.49, p=0.03). ConclusionThe MULES test is a rapid picture naming task that may engage more extensive neural systems than more commonly used rapid number naming tasks. Rapid picture naming may require additional processing devoted to color perception, object identification, and categorization. Both tests rely on initiation and sequencing of saccadic eye movements.

EQUIVALENCE OF IPAD AND PAPER VERSION OF THE BEHAVIOURAL NEUROLOGY ASSESSMENT-REVISED

EQUIVALENCE OF IPAD AND PAPER VERSION OF THE BEHAVIOURAL NEUROLOGY ASSESSMENT-REVISED

IPad colour vision apps for dyschromatopsia screening

Optic neuritis (ON) is a common and important cause of vision loss or vision disturbances in the community, particularly amongst the young, and it is often associated with a persistent dyschromatopsia. Traditionally screening for dyschromatopsia has been carried out using pseudo-isochromatic Ishihara plates. These colour plates were originally developed for testing of colour blindness, and indeed have only more recently been applied to ON. As the Ishihara plate books used for testing are expensive, unwieldy, and are not commonly available in many clinics or wards, many neurologists and ophthalmologists have taken to using untested and unstudied downloadable software packages on portable electronic devices for testing. This study compared the efficacy of printed and iPad (Apple, Cupertino, CA, USA) versions of the Ishihara plates in screening for dyschromatopsia in patients who were suspected of having ON. The main finding was that dyschromatopsia testing using a commercially available application on an iPad was comparable to using the current pragmatic clinical benchmark, the pseudo-isochromatic plates of Ishihara. These findings provide support for the increasingly common practice of screening for dyschromatopsia using the iPad.

Geographic Elevation and Cognitive Function among Elderly Residents in Rural Mountainous Areas: Shimane CoHRE Study.

The aim of this study was to test whether there is an association between elevation and cognitive function among elderly residents in rural mountainous areas. Data were collected in 2012 from a cross-sectional study conducted in Ohnan Town, which is located in a rural mountainous area in the southern part of Shimane Prefecture, Japan. Cognitive function was evaluated using CADi (Cognitive Assessment for Dementia, iPad version) and elevation was estimated by using Geographic Information Systems according to the participant’s address. After excluding subjects with missing data, 866 participants were analyzed. After adjustment for potential confounding factors, higher elevation was significantly associated with decreased cognitive function. This finding suggests that it is important to consider the physical environment, i.e., elevation, that would affect accessibility to health-promoting goods, services, and resources when seeking to maintain cognitive function in elderly people living in rural mountainous areas.

The propagation effect of paper version and the iPad version for periodicals

Purpose: Digital journal created a new development pattern . We use j ournal APP as an example to analyze how to migrat e the journal content to Internet and other kind of media. Based on the case study of GQ and other fashion magazines , through text analysis, control experiments, in-depth interviews and other research methods, the authors analyzed the differences and connections between the iPad App and print edition of magazines, discussed the approaches towards operation of new media, offer ed the tendency of mobile device platform development for China ’ s periodical publications . Design/methodology/approach: control experiment. Findings: The authors give a stance that the print edition of periodical publication will being alive still, and conclude that journal APP and printed version can be mutually beneficial and achieve a win-win state. And we believe that the journal APP is good at advertising propagation, which will accelerate the development of journal APP in such the information age, and such kind of media can integrate many information with variety of media forms. Research limitations/implications: Because of the limitation of technology, the authors only have the experiment on fashion magazine, which might to some degree simplify the issue under discussion. Practical implications: According to the conclusion of a series of experiments, we can imply the future of the media, and give the suggestion of both paper version and ipad version of the journal. Social implications: Since people can not live without media and media has to develope with the help of public, we have to give the new way of both sunrise media and sunset media. Originality/value: Based on the case study of GQ and other fashion magazines , through text analysis, control experiments, in-depth interviews and other research methods, the authors analyzed the differences and connections between the iPad App and print edition of magazines, discussed the approaches towards operation of new media, offer ed the tendency of mobile device platform development for China ’ s periodical publications .

Development of an iPad version of the Kessler 10+ for use in youth mental health outreach services

KESSLER 10 FOR USE IN YOUTH MENTAL HEALTH OUTREACH SERVICES Gareth Furber, PhD, Ann E Crago, Tom D Sheppard, Clive Skene (Clinical Psychology) Health Economics and Social Policy Group, School of Population Health, South Australian Health and Medical Research Institute (SAHMRI), North Terrace, Adelaide, SA, 5000; Bachelor of Nursing Youthlink, Women’s and Children’s Health Network, SA Health, GP Plus Health Care Centre Marion, 10 Milham Street, Oaklands Park, Adelaide, SA, 5046; Registered Nurse (Mental Health) Youthlink, Women’s and Children’s Health Network, SA Health, GP Plus Health Care Centre Marion, 10 Milham Street, Oaklands Park, Adelaide, SA, 5046; Master of Psychology CAMHS Executive, Level 1, 55 King William Road, North Adelaide, SA, 5006 Corresponding Author: E gareth.furber@unisa.edu.au

Revision of the Cognitive Assessment for Dementia, iPad version (CADi2).

Early detection of dementia is crucial because it is the time when intervention is most effective. Therefore, a simple and short test is necessary for primary mass screening in community-based medical facilities. We developed the Cognitive Assessment for Dementia, iPad version (CADi) which consists of 10 simple questions and is self-administered. In this paper we present a revised version which improves the detection of dementia. Two questions of the CADi were replaced in the latest version (CADi2). We examined the validity and reliability of the CADi2 in 27 Alzheimer’s disease patients and age-matched healthy controls. The Alzheimer’s disease patients had lower CADi2 scores and longer total response times to questions compared to the controls. The CADi2 had high sensitivity (0.85−0.96) and specificity (0.81−0.93), and showed significant correlations with existing standard neuropsychological tests. Cronbach’s alpha analysis revealed moderate consistency of the CADi2. These results support the utility of the CADi2 for primary screening for dementia.

C-46 * A New iPad Version of ImPACT is Resistant to "Sandbagging"

C-46 * A New iPad Version of ImPACT is Resistant to "Sandbagging"

When hope is lost: part 1.

Carrie M. Dameron, MSN, RNBC, is an advanced certified medical-surgical nurse and Assistant Professor of nursing at Ohlone College in Fremont, CA. She authors www.nurses4him.org, a resource for Christian nurses. The author reports no conflict of interest. Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the iPad version and HTML and PDF versions of this article on the journal's Web site.

Psychometric Equivalence of a Paper-Based and Computerized (iPad) Version of the Memory Orientation Screening Test (MOST®)

The Memory Orientation Screening Test (MOST®) is a 29-point scale for identifying and following mild and major neurocognitive disorders in older patients. Previous research demonstrated validity in separating patients with normal vs. impaired cognition and high correlations with tests of memory and attention. This study compares the original paper-based MOST® with a computerized (iPad app) version, the MOST®-96120, to determine the equivalence of formats. A total of 98 consecutive older patients were administered identical versions of the MOST and MOST-96120 in a random order, separated by 1 hour of interspersed testing, in a 3-hour neuropsychological evaluation. MOST and MOST-96120 scores were compared with each other, with global cognitive ratings, and with standardized tests of memory and attention. Both versions had equivalent means and standard deviations, very high inter-test correlation (r = .92, p < .001), and equal correlations with outcome measures. Both versions separated patients into normal vs. mild NCD vs. major NCD categories with equal accuracy. ANOVA showed no significant difference between versions or presentation order. Both versions correlated very highly with cognitive level and neuropsychological endpoints, confirming previous research. The MOST-96120 is a computerized neuropsychological assessment device that demonstrates equivalence with its paper-based original, allowing for confident reliance on the findings of previous research.