ABSTRACT
Cognitive decline, particularly in dementia, presents complex challenges in early detection and diagnosis. While Item Response Theory (IRT) has been instrumental in identifying patterns of cognitive impairment through psychometric tests, its parametric models often require large sample sizes and strict assumptions. This creates a need for more adaptable, less demanding analytical methods. This study aimed to evaluate the effectiveness of Mokken scale analysis (MSA), a nonparametric IRT model, in identifying hierarchical patterns of cognitive impairment from psychometric tests. Using data from 1164 adults over 60 years old, we applied MSA to the orientation subscale of ACE-III. Our analysis involved calculating scalability, monotone homogeneity, invariant item ordering (IIO) and response functions. The MSA effectively retrieved the hierarchical order of cognitive impairment patterns. Most items showed strong scalability and consistent patterns of cognitive performance. However, challenges with IIO were observed, particularly with items having adjacent difficulty parameters. The findings highlight MSA's potential as a practical alternative to parametric IRT models in cognitive impairment research. Its ability to provide valuable insights into patterns of cognitive deterioration, coupled with less stringent requirements, makes it a useful tool for clinicians and researchers.
ABSTRACT
Previous research has shown the benefits of early detection and treatment of dementia. This detection is usually performed manually by one or more clinicians based on reports and psychometric testing. Machine learning algorithms provide an alternative method of prediction that may contribute, with an automated process and insights, to the diagnosis and classification of the severity level of dementia. The aim of this study is to explore the use of neuropsychological data from a reduced version of the Addenbrooke's Cognitive Examination III (ACE-III) to predict absence or different levels of dementia severity using the Global Deterioration Scale (GDS) scores through the implementation of the kNN machine learning algorithm. A sample of 1164 elderly people over sixty years old were evaluated using a reduced version of the ACE-III and the GDS. The kNN classifier provided good accuracies using 15 items from the ACE-III and adequately differentiating people with absence and mild impairment, from those with more severe levels of impairment according to the GDS rating. Our results suggest that the kNN algorithm may be used to automate aspects of clinical cognitive impairment classification in the elderly population.
ABSTRACT
Introduction: The aim of this study is to determine prevalence and risk factors of Cognitive Impairment (CI) and its association with Type 2 Diabetes Mellitus (T2DM) in subjects aged 65 years and above. Additionally, we attempt to provide a cognitive profile for T2DM group. Methodology: A cross-sectional analytical study to assess CI was carried out. We evaluated a sample of community-dwelling residents from Chile. All participants underwent a general interview, lifestyle questionnaires and a comprehensive neuropsychological battery. Regression analyses were performed to evaluate risk of CI with T2DM and influencing factors. Results between groups in the different domains of the neuropsychological assessment were compared by Student's t-tests and MANOVA. Results: Among all 358 subjects, overall T2DM prevalence were 17.3%. The prevalence of CI was higher in T2DM group compared to the healthy participants (30.7%, p < 0.001). The risk of CI was 2.8 times higher in older people with T2DM compared to older people without the diagnosis. Multiple regression analysis, adjusted for age and gender, demonstrated that age, education, presence of dyslipidemia, and T2DM duration were the predictor variables significantly associated with CI. T2DM group performed worse on global cognitive performance, attention, language, verbal memory, visual memory, visual constructional ability, and executive function. After adjusting for significant covariates from multiple regression analysis, a relationship between "cognition" and T2DM is still observed. Amnesic multi-domain impairment was the specific cognitive identified pattern for T2DM group. Conclusion: The present study confirms the high prevalence of CI with T2DM among Chilean older adults in a community-based population. T2DM is significantly associated with a higher risk of CI, and age, education, presence of dyslipidemia, and duration of T2DM are risk factors. T2DM patients with CI are impaired in multiple cognitive domains, even after adjusting covariables, resulting in an amnesic multi-domain cognitive profile.
ABSTRACT
The Addenbrooke's Cognitive Examination III is one of the most widely used tests to assess cognitive impairment. Although previous studies have shown adequate levels of diagnostic utility to detect severe impairment, it has not shown sensitivity to detect mild decline. The aim of this study was to evaluate the psychometric properties of Addenbrooke's Cognitive Examination III in a large sample of elderly people through Item Response Theory, due to the lack of studies using this approach. A cross-sectional study was conducted with 1164 people from the age of 60 upwards, of which 63 had a prior diagnosis of Alzheimer dementia. The results showed that, globally, the Addenbrooke's Cognitive Examination III possesses adequate psychometrics properties. Furthermore, the information function test shows that the subscales have different sensitivity to different levels of impairment. These results can contribute to determining patterns of cognitive deterioration for the adequate detection of different levels of dementia. An optimized version is suggested which may be an economic alternative in the applied field.
Subject(s)
Mental Status and Dementia Tests , Aged , Alzheimer Disease/diagnosis , Cognitive Dysfunction/diagnosis , Cross-Sectional Studies , Dementia/diagnosis , Female , Humans , Male , Models, Theoretical , Psychometrics , Reproducibility of Results , Sensitivity and SpecificityABSTRACT
Resumen En Latinoamérica se han realizado estudios dirigidos a evaluar la insatisfacción corporal y los comportamientos alimentarios anómalos (CAA), sin embargo se han enfocado principalmente en adolescentes o estudiantes universitarios. El objetivo de esta investigación fue evaluar el porcentaje de insatisfacción con el peso corporal (INCP) en una muestra de hombres y mujeres adultos chilenos, analizando la relación de este factor con distintas variables sociodemográficas, psicológicas y conductuales, entre las que figuraron los CAA. Participaron 654 adultos de 18-64 años de edad (436 mujeres, 218 hombres ; con rango de edad de 18-64 años, índice de masa corporal promedio de 25.49 kg/m2), quienes fueron evaluados con base a una batería de cuestionarios de autoreporte. La INCP estuvo presente en 45.9% de la muestra, resultando significativamente mayor en las mujeres que en los varones. Fueron identificadas diferencias significativas en las escalas que evaluaron CAA, en función del índice de masa corporal y el sexo de los participantes, registrando puntuaciones significativamente mayores las mujeres y los participantes con obesidad. Al comparar entre participantes con vs. sin INCP, los primeros mostraron más CAA y menor actividad física. Los resultados de este estudio muestran que la INCP puede interactuar e influir sobre los hábitos alimentarios y la práctica de ejercicio físico.
Abstract The aims of this research were to estimate the percentage of body weight dissatisfaction in males and females Chilean adults, assessing its relationship with different sociodemographic, behavioral and psychological variables, and analyzing whether the presence of body weight dissatisfaction acts as a risk factor for some disordered eating behaviors. The 654 participants (436 women, 218 men; age range 18-64 years, mean body mass index [BMI] 25.49 kg/m2) were evaluated with a battery of self-administered questionnaires. The percentage of body weight dissatisfaction in the whole sample was 45.9% and significantly higher in women than men. Significant differences were observed in the clinical scales that evaluated disordered eating in function of the BMI of the participants; in those scales females also showed higher scores than males. Comparing participants with and without body weight dissatisfaction, the first one showed more unhealthy eating behaviors. The results of this study show how body weight dissatisfaction can interact and influence healthy habits, such as a daily eating behaviors and physical exercise.
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Resumen El estudio del bienestar ha cobrado creciente relevancia dada su relación con estados psicológicos como la ansiedad, depresión, estrés y también la salud. Sin embargo, se cuenta con pocas propuestas explicativas del bienestar, así como validación empírica transcultural de estos. El presente estudio evaluó el efecto de la inclusión de una variable contextual cultural sobre un modelo explicativo de bienestar, específicamente si las creencias religiosas moderan el efecto mediador de los afectos positivos sobre la relación optimismo y salud. La muestra de este estudio consistió en 529 participantes de dos países latinoamericanos (285 de Chile y 244 de Colombia). Los resultados indican que en ambos países hay un efecto significativo del optimismo sobre la percepción de salud mediado por los afectos positivos. Sin embargo, las creencias religiosas no ejercen un efecto significativo sobre la intensidad de las relaciones entre las variables del modelo de base. La importancia de los factores culturales y de los estudios transculturales sobre el bienestar son presentados y discutidos.
Abstract The study of well-being has gained increasing relevance given its relationship with psychological states such as anxiety, depression, stress, as well as health. Nonetheless, there are few explanatory proposals on well-being, or any empirical cross-cultural validation of these. The present study evaluated the effect of the inclusion of a cultural contextual variable on an explanatory model of well-being, specifically on whether religious beliefs moderate the mediating effect of the positive affects on the relationship between optimism and health. The sample of this study consisted of 529 participants from two Latin American countries (285 from Chile and 244 from Colombia). The results indicate that, in both countries, there is a significant effect of optimism on the perception of health mediated by positive affects. However, religious beliefs do not exert a significant effect on the intensity of the relationships between the variables of the base model. The importance of cultural factors and cross-cultural studies on well-being are presented and discussed.
Subject(s)
Religion , Optimism , Health , AffectABSTRACT
The perception of colour and its subjective effects are key issues to designing safe and enjoyable bike lanes. This paper addresses the relationship between the colours of bike lane interventions-in particular pavement painting and intersection design-and the subjective evaluation of liking, visual saliency, and perceived safety related to such an intervention. Utilising images of three real bike lane intersections modified by software to change their colour (five in total), this study recruited 538 participants to assess their perception of all fifteen colour-design combinations. A multivariate analysis of covariance (MANCOVA) with the Bonferroni post hoc test was performed to assess the effect of the main conditions (colour and design) on the dependent variables (liking towards the intervention, level of visual saliency of the intersection, and perceived safety of the bike lane). The results showed that the colour red was more positively associated to the outcome variables, followed by yellow and blue. Additionally, it was observed that the effect of colour widely outweighs the effect of design, suggesting that the right choice and use of colour would increase the effectiveness on bike-lanes pavement interventions. Limitations and future directions are discussed.
