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A BSTRACTS
with the copy and 3 minute delayed recall portions of the RCFT using
the Meyers & Meyers (1995) scoring criteria and normative data (impairment
defined as performance ≤-1.5 SD below normative means).
We evaluated the effects of different scoring criteria and normative
data on diagnostic classification. A rater blinded to prior diagnoses
rescored RCFT figures using Taylor (1969) criteria, and participants
were reclassified as impaired or unimpaired using Boone et al. (1993)
and Van Gorp et al. (1990) norms. Concordances between different
diagnostic classifications were calculated using Cohen’s κ.
Results: The proportion of participants defined as having impaired
RCFT performance was dependent on which scoring criteria
and normative data were used. RCFT analyses using Taylor criteria
yielded higher rates of impairment with the Boone norms (copy:
31.8%; recall: 27.4%) than with the Van Gorp norms (copy: 17.0%; recall:
8.2%). Concordance between norms was moderate for RCFTcopy
(κ=0.47) and fair for RCFT-recall (κ=0.38). Use of the Meyers &
Meyers criteria and norms yielded intermediate rates of impairment
on the RCFT-copy (25.8%) and recall (21.9%) subtests.
Conclusions: Although the RCFT may be sensitive to cognitive
impairment, the use of different normative means yielded different
proportions of impaired participants. Differences seen with different
normative data sets were greater than differences seen with different
scoring criteria and may reflect subjective differences in scoring between
studies. Investigations of inter-rater reliability with this data set
are ongoing. These findings suggest that the RCFT may have limited
reliability when used in isolation to identify MCI.
A137
Normal aging, neuroinflammation, and the brain-a sheep in wolf’s
clothing?
T. Harris. University of Nebraska Medical Center, Omaha, NE.
Neuroinflammation is known to occur in clinically significant
neurodegenerative processes including Parkinson’s and Alzheimer’s
disease. Moreover, prior studies of aging and CNS transcriptome expression
have implicated neuroinflammation as a potential process
observed in normal CNS aging. Our earlier work has shown that
overexpression of immunne/defense-related gene transcripts may be
associated with age-related loss of important functional behaviors.
Since many of the gene trascripts showing age-related changes in expression
are well-known molecules used by the immune system (e.g.
complement, class I histocompatibility molecules, cytokines,
chemokines), this process has been assumed to be neuroinflammatory
as well. However, no studies have been performed to specifically
localize these molecules in the microglia-the resident immune cell-of
the aging brain. In the current study, I extracted and purified microglia
from the hypothalamus and cerebellum of C57BL/6 and
BALB/cBy mice in a minimally stressful manner. Using RT-qPCR, I
measured and analyzed the expression of several inflammatory genes
in microglia. I found that the expression of these genes remained similar
between young, middle-aged, and aged mice, with a few genes
even decreasing in expression. This finding suggests that even though
CNS aging is characterized by increased expression of multiple immune
transcripts, neuroinflammation is not the underlying etiology.
A138
Effects of Multimedia Fall Prevention Training in Persons with
Dementia.
V. Panzer, 1,2 J. Burleson, 1 F. Into, 2 H. Waite, 2 P. Atwood. 3 1.
Community Medicine & Health Care, University of Connecticut
Health Center, Farmington, CT; 2. Brookside Research &
Development, North Salem, NY; 3. Dementia Care, Hebrew Health
Care, West Hartford, CT.
Supported By: University of Connecticut TRIPP Center
Background: Persons with dementia (PwD) in long-term care
(LTC) experience 4.05 falls/year compared to 2.33 for those without
dementia. Falls are attributed to the lack of safety awareness and patient
education is the most common intervention attempted by LTC
nursing staff. We examined the influence of multimedia fall prevention
(MFP) training on safety awareness in PwD as demonstrated by
recognition of circumstances that could result in falls.
Methods: Ten LTC residents (age 77-95,mean(M)=88;MMSE
10-20,M=15; Katz ADL 1-4,M=2) with a history of falls were asked to
identify ‘Fall Threats’ that could make someone fall in 5 video clips.
Participants received 3-4 once-weekly 15 minute standardized MFP
training sessions, incorporating a total of 3-5 multimedia vignettes
which concerned daily activities and included common Fall Threats.
In post-tests 3-5 weeks AFTER the last training session, participants
were asked to identify Fall Threats in 5 novel video clips that did
NOT include circumstances featured in pre-test clips OR in the training
vignettes. Usual care nurses who were not involved in study procedures
recorded falls per state regulations. Repeated-measures
ANOVA was used to compare pre and post-test results and assess
awareness. Fall records were examined for 2 month periods prior to,
during (including the 3-5 week period before post-testing) and after
the study.
Results: Participants recognition of Fall Threats in 5 novel video
clips improved dramatically, (p