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
Introduction: Emotion Regulation plays a crucial role in human's daily lives. Extensive research has shown that people with different attachment orientations exhibit divergencies in how they perform emotion regulation strategies. Methods: 44 adults performed an experimental emotion regulation task in which they were instructed to attend, reappraise, or suppress their emotions while viewing negative and neutral images taken from the International Affective Picture System (IAPS). Afterward, participants rated valence, arousal, and emotional dominance elicited by the images. Additionally, attachment orientations were measured using the ECR-12 questionnaire. Results: Results showed a relationship between attachment avoidance and the level of arousal during the reappraisal condition; specifically, the higher attachment avoidance levels, the greater the emotional intensity during the implementation of cognitive reappraisal strategy. Such results suggest an association between failing in downregulate intense emotions using cognitive reappraisal when there are higher levels of attachment avoidance. Consistently, we also found that lower dominance during reappraisal was associated with more levels of avoidance. Conclusion: These results indicate that people with higher levels of attachment avoidance experience difficulties when using the cognitive reappraisal strategy to reduce the emotional impact produced by negative emotional stimuli. Our findings reinforce the idea that avoidant people experience high physiological activation when experience emotions.
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
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
Background: The Addenbrooke's Cognitive Examination III (ACE-III) is widely used for evaluation of dementia. Aim: To assess the psychometric properties of ACE-III, analyzing its factor structure, its reliability (from an Item Response Theory [TRI] model) and its diagnostic usefulness. Material and Methods: We studied 1101 older people without cognitive impairment and 63 currently having a diagnosis and receiving treatment for dementia. Results: The presence of two factors for the Attention subscale (Orientation and Attention, separately) was suggested. The factorial analysis showed adequate adjustment in all the subscales, except for the new Attention subscale. In the TRI analysis, the Attention subscale presented a greater number of items with lack of fit compared to the other subscales. Using a proposed threshold of 66 points or less to identify cognitive impairment related to dementia, a sensitivity of 0.97 and specificity of 0.81 was obtained. Conclusions: ACE-III is a valid, reliable, and useful measure for the clinical detection of dementia. The combined use of Orientation and Memory subscales is proposed as an alternative and time-saving ACE-III indicator.
ABSTRACT
BACKGROUND: The Addenbrooke's Cognitive Examination III (ACE-III) is widely used for evaluation of dementia. AIM: To assess the psychometric properties of ACE-III, analyzing its factor structure, its reliability (from an Item Response Theory [TRI] model) and its diagnostic usefulness. MATERIAL AND METHODS: We studied 1101 older people without cognitive impairment and 63 currently having a diagnosis and receiving treatment for dementia. RESULTS: The presence of two factors for the Attention subscale (Orientation and Attention, separately) was suggested. The factorial analysis showed adequate adjustment in all the subscales, except for the new Attention subscale. In the TRI analysis, the Attention subscale presented a greater number of items with lack of fit compared to the other subscales. Using a proposed threshold of 66 points or less to identify cognitive impairment related to dementia, a sensitivity of 0.97 and specificity of 0.81 was obtained. CONCLUSIONS: ACE-III is a valid, reliable, and useful measure for the clinical detection of dementia. The combined use of Orientation and Memory subscales is proposed as an alternative and time-saving ACE-III indicator.
Subject(s)
Cognitive Dysfunction , Dementia , Aged , Aged, 80 and over , Cognition , Cognitive Dysfunction/diagnosis , Dementia/diagnosis , Humans , Neuropsychological Tests , Psychometrics , Reproducibility of ResultsABSTRACT
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.
