KOKMEN SHORT TEST OF MENTAL STATUS PDF

Clinical judgment and neuropsychological testing are integral in diagnosing MCI. For discriminating between prevalent MCI and AD, there was no difference in the performance of rest 2 tests. Tangalos, MD ; Bradley F. Sign in to download free article PDFs Sign in to access your subscriptions Sign in to your personal account. Create a personal account to register for email alerts with links to free full-text articles. The area under the receiver operating characteristic curve was modestly but significantly better for the STMS compared with the MMSE for discriminating between diagnostic groups stable normal cognition vs prevalent MCI.

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Road, Kolkata - , West Bengal, India. E-mail: moc. Abstract Context: Mild cognitive impairment MCI is an under-diagnosed health problem in the community. Cognitive screening tools are widely used for MCI detection, but many of them lack sensitivity and specificity in MCI detection. On the basis of literature review, Short test of mental status STMS was selected for the present purpose. Materials and Methods: Data were collected from community-living elderly people from the city of Kolkata using the purposive method of sampling.

Finally, STMS was administered. Descriptive statistics, receiver operating curve analysis, and binary logistic regression were used for statistical analysis of the data. It was also found to be more suited for the purpose than CDT. A score of An increasing interest on predementia clinical features of the cognitive degenerative disorders is on the rise with the hope that in the near future the earliest symptoms of the disorder will be evident long before the gross functional impairment becomes manifest.

This has lead to the emergence of the construct of mild cognitive impairment MCI which purports to describe the predementia phase of the cognitive dysfunction. The term MCI was introduced by Reisberg et al. The research in the field is still considered to be in its nascent phase and it is the source of one of the principal interest points of the clinical professionals and researchers working in the field of dementia.

MCI symptoms include almost normal general impairment in cognitive functioning thinking, understanding, and decision-making , near normal ADL, little or no changes in personality, subtle memory impairment as well as deterioration in other cognitive domains, and decision-making.

MCI is also difficult to differentiate from normative age-related cognitive changes posing a difficulty in differential diagnosis. In India, growing interest in MCI research is becoming apparent. Like other disorders with neurocognitive features, the diagnosis of MCI requires validating the clinical diagnosis with neuroimaging and neuropsychological findings. However, detailed neuropsychological testing is difficult to conduct due to monetary and time constraint.

Hence, the use of screening tests is largely popular in the diagnosis of degenerative cognitive impairment due to its brevity and the chance of bedside application in the patient population. In the community studies, screening test applications are preferred for the same reason.

STMS includes subtests that try to measure and screen for most of major cognitive functions that includes: orientation to self, time and place, attention, learning, memory, visuoconstructional ability, and executive functioning. STMS includes seven subtests; these subtests are orientation, attention, learning, arithmetic calculation, abstraction, information, construction, and recall.

Keeping in mind that MCI is a significant health problem under recognized and under diagnosed in the community; the present study purports to standardize STMS for using as a cognitive screening tool in the community-living elderly people in Kolkata. It also purports to compare the effectiveness of STMS as a screening tool with the clock-drawing test CDT , as CDT is also widely used as a cognitive screening tool for assessing cognitive functioning and screening for dementia, especially in the primary care setting.

All the cases have been selected from the upper middle class community-living male and female elderly people living within the jurisdiction of the city of Kolkata. Incidentally, all the cases selected belonged to the Bengali community. In the study, initially, we did not focus on the Bengali community of Kolkata only and hence, other communities were also approached.

Consent was obtained from some families, and a few data were also collected from different communities e. However, at the end of the study, those data were screened out during analysis as the scores of STMS were very low and indicative of the presence of dementing illness.

Hence, ultimately, the data included in the study were exclusively on Bengali elderly people. In future, the variation in cut-off score of STMS in other provincial communities living in Kolkata will be investigated. The study was commenced after the design was duly approved by the University Committee of Institutional Research Ethics. Cases with a history suggestive of the current or past psychiatric illness, presence of any physical and mental disability, congenital conditions or life-threatening illness any kind of terminal illness and complicated medical conditions, e.

Specifically, the inclusion and exclusion criteria of the study are presented as follows: Inclusion criteria Community-living male and female elderly people Aged between 60 and 80 years Minimum 10 years of education.

Exclusion criteria History suggestive of current or past psychiatric illness Presence of any physical and mental disability Presence of congenital conditions Instruments Semi structured Performa Sociodemographic schedule has been used for obtaining the sociodemographic details as well as the past and present clinical status. Orientation subtest of STMS enquires about: 1 Full name, 2 Address, current location, that is, 3 Building, 4 City, and 5 State and the current date, 6 Either the day of the week or the day of the month, 7 The month, and 8 The year.

Learning subtest requires learning four items through a maximum of four trials. Arithmetic calculation contains one item each for the functions: addition, subtraction, multiplication, and division. Abstraction subtest requires interpretation of similarities. Information subtest seeks general information about miscellaneous areas. Construction subtest requires a free clock-drawing task and a cube-copying task.

Recall subtests require remembering the four words learnt previously. The test requires giving general instruction to the patient initially and specific instruction is required for each subtest. Kokmen et al. In another analysis, it was found that in order to distinguish 76 patients with dementia and 33 patients without dementia all of whom were 60 years of age or older a score of 29 yielded a sensitivity of It is a very simple task; it requires auditory and visual comprehension, concentration, and memory and executive functioning such as planning and decision-making.

Moreover, we did not want to tax the subject unnecessarily. Groningen activity restriction scale The Groningen activity restriction scale GARS is a strong unidimensional hierarchical scale which contains 18 items. The reliability coefficient rho is The H coefficient of 0. GARS was found to be a valid scale with correlation ranging between 0. Hence, the tests used in the present study were used in their standard English version and were not translated. Procedure The study was conducted on elderly people living within the metropolitan area of Kolkata as well as the adjoining areas.

They were reached through different contacts e. Elderly people meeting the exclusion and inclusion criteria were approached. Verbal consent from the prospective test taker and his immediate family member were taken over the telephone.

With consent the screening interview was conducted. Initially, sociodemographic information was obtained using the schedule devised for the study. The presence of undiagnosed major psychiatric disorders was ruled out using the International Classification of Diseases diagnostic criteria. To identify undetected MCI, the subjective report of memory, ADL and IADL, the participants were assessed and the information was corroborated with at least one family member with whom the participant spends most of the time.

At the next level, STMS along with activity level questionnaire in original English format was administered other tests were also administered which do not fall in the purview of the present study. The obtained data were scored according to the standard method and subjected to statistical analysis. Descriptive statistics was used to analyze sociodemographic variables as well as test variables. RESULTS The data obtained from the sample of elderly participants from the community in the city of Kolkata wwas analyzed initially for the sociodemographic variables using descriptive statistics.

The analysis shows that the mean age of the total study group was The sample consisted of a total of 64 males Using the gold standard of the international diagnostic criteria of MCI diagnosis,[ 19 ] The mean age and mean education of the subsample diagnosed with MCI were The details of descriptive analysis are presented in Table 1. Table 1 Graphs showing the descriptive statistics of the total sample Variables.

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Short test of mental status in the detection of mild cognitive impairment in India

Road, Kolkata - , West Bengal, India. E-mail: moc. Abstract Context: Mild cognitive impairment MCI is an under-diagnosed health problem in the community. Cognitive screening tools are widely used for MCI detection, but many of them lack sensitivity and specificity in MCI detection. On the basis of literature review, Short test of mental status STMS was selected for the present purpose.

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A short test of mental status: description and preliminary results.

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