Here - American Geriatrics Society
Here - American Geriatrics Society
Here - American Geriatrics Society
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P OSTER<br />
A BSTRACTS<br />
C138<br />
Improvement in Functional Independence Measure (FIM) scores of<br />
dementia patients on a Medical Psychiatric Unit.<br />
C. A. Fabrizio, 1 C. G. Lyketsos, 2 E. S. Oh. 2 1. University of Medicine<br />
and Dentistry of New Jersey- School of Osteopathic Medicine,<br />
Stratford, NJ; 2. Psychiatry, Medicine, Pathology, The Johns Hopkins<br />
University School of Medicine, Baltimore, MD.<br />
Supported By: 2011 MSTAR Program at Johns Hopkins<br />
Background:Physical therapy may be effective for functional recovery<br />
in older patients with dementia, yet research on this topic has<br />
been limited. The goal of this study is to examine the association between<br />
number of physical therapy sessions and improvement in functional<br />
outcomes on an interdisciplinary medical psychiatry unit.<br />
Methods:Retrospective data (1/2008 to 6/2011) were collected<br />
from medical records. Patients were categorized as having movement<br />
disorder (MD, N=8) or “no movement disorder”(NMD,N=27). FIM<br />
scores included transfer (FIM BCW–Bed, Chair, Wheelchair:1-7),<br />
ambulation distance (FIM D–Distance:1-3), and level of independence<br />
in ambulation (FIM DS–Distance Score:1-7). Statistics were<br />
performed using GraphPad Prism and STATA.<br />
Results:Compared to the admission FIM scores, scores in all<br />
three categories significantly improved in both groups with exception<br />
of FIM BCW score in MD (Table 1). Linear regression adjusting for<br />
age, gender, number of physical therapy sessions, comorbidities, medication<br />
and MMSE scores did not change the effect sizes.<br />
Conclusion:Although dementia patients in our medical psychiatry<br />
unit improved in most measures of the FIM, we did not find a specific<br />
association between these outcomes and a number of clinical<br />
variables including the number of physical therapy sessions. Further<br />
analyses are being conducted to investigate the effects of other clinical<br />
variables at this time. However, these effects may also be the result<br />
of the comprehensive care that they receive from geriatricians,<br />
geriatric psychiatrists, therapists, and nurses on the interdisciplinary<br />
team, rather than one specific intervention.<br />
Table 1 Improvements in Functional Independence Measure Scores<br />
at Discharge<br />
C139<br />
Practice effects: A unique cognitive variable?<br />
C. Callister,K.Duff.Neurology, University of Utah, Salt Lake City, UT.<br />
Supported By: AFAR MSTAR Summer 2011 grant; National<br />
Institute on Aging<br />
BACKGROUND:<br />
Practice effects are improvements in cognitive performance due<br />
to repeat testing with the same materials. These improvements are<br />
present in cognitively normal older adults, but mostly absent in patients<br />
with dementia. Practice effects can also predict further decline<br />
in patients with Mild Cognitive Impairment. However, it is unclear<br />
what variables (e.g., demographic, patient characteristic, other cognitive<br />
abilities) moderate practice effects. We hypothesized that practice<br />
effects would be related to age, education, and baseline cognitive<br />
functioning.<br />
METHODS:<br />
268 community-dwelling older adults (mean age=77.3 years,<br />
mean education=15.3 years) participated in this study. During a baseline<br />
visit, demographic information (age, gender, education), patient<br />
characteristics (depression, premorbid IQ, global cognition), and<br />
baseline cognitive measures of memory, executive functioning, and<br />
processing speed were collected. The participants returned a week<br />
later and repeated the same battery of cognitive tests. To quantify<br />
practice effects, 1-week scores were divided by baseline scores. Correlates<br />
of practice effects and demographic, patient characteristic and<br />
other cognitive variables were examined with Pearson correlations<br />
and chi-square tests.<br />
RESULTS:<br />
Practice effects were not significantly related to age, gender, education,<br />
depression, cognitive status, or pre-morbid IQ. Overall,<br />
practice effects were also not related to baseline cognitive performances.<br />
CONCLUSIONS: Practice effects were not related to most demographics,<br />
patient characteristics, and baseline cognitive measures.<br />
This suggests that practice effects may be a unique cognitive variable<br />
that is not confounded by variables that typically influence other cognitive<br />
performances. Overall, this makes the interpretation of practice<br />
effects more straightforward.<br />
C140<br />
Validity of Computer-Based Mental Status Exam Screening in the<br />
Geriatric Population.<br />
C. L. Duncan, T. K. Malmstrom, G. T. Grossberg, J. E. Morley.<br />
Division of <strong>Geriatrics</strong> - Internal Medicine, Saint Louis University<br />
School of Medicine, St. Louis, MO.<br />
Supported By: Medical Student Training in Aging Research<br />
(MSTAR) program 2011 summer scholarship awarded by <strong>American</strong><br />
Federation for Aging Research (AFAR) to Catherine L. Duncan<br />
B.S. (SLU SOM MSII)<br />
Background: Dr. Oz developed a computerized mental status<br />
exam based on the Saint Louis University Mental Status (SLUMS)<br />
Exam and made it readily available on his website<br />
(http://www.doctoroz.com/quiz/memory-quiz). We have examined<br />
the validity of his screen against the SLUMS along with another<br />
computerized version developed by Saint Louis University (SLU)<br />
for the initial screening of cognitive impairment in the geriatric<br />
population.<br />
Methods: The SLUMS exam was administered to 100 participants<br />
recruited from SLU Geriatric Medicine and Geriatric Psychiatry<br />
clinics, followed by one of two randomly chosen computerized<br />
adaptations (50% given the Dr. Oz Memory Quiz and 50% given the<br />
Self-Administered VA-SLUMS Exam) to those scoring ≥ 12/30 on<br />
the SLUMS after a designated duration (minimum t=15 minutes, median<br />
t =65 minutes).<br />
Results: Neither computerized exam showed positive sensitivity<br />
or specificity compared to the paper SLUMS (AUC≤0.5), but positive<br />
correlations were seen between the total scores of both the Self-Administered<br />
VA-SLUMS and the Dr. Oz computerized versions compared<br />
to the paper SLUMS (r=0.726 and r=0.691, respectively). Additionally,<br />
the Self-Administered VA-SLUMS showed a modest<br />
increase in the weighted measures of agreement (κ=0.38) compared<br />
to the Dr. Oz Memory Quiz (κ=0.29).<br />
Conclusions: While neither computerized exam showed positive<br />
sensitivity or specificity compared to the paper SLUMS, positive correlations<br />
were seen between the total scores, with the Self-Administered<br />
VA-SLUMS showing a modest increase in both measure of<br />
agreement and correlation of total scores compared to the Dr. Oz<br />
Memory Quiz. Specific modifications to each computerized exam are<br />
recommended as well as an increase in sample size and in the duration<br />
of wait time between paper and computerized testing. Further<br />
study with implementation of the suggested changes is necessary with<br />
the hope of refining these computerized SLUMS exams to become<br />
valid and useful preliminary screens for cognitive impairment in the<br />
geriatric population.<br />
AGS 2012 ANNUAL MEETING<br />
S179
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