OBJECTIVE: While considerable attention has focused on improving the detection of depression, assessment of severity is also important in guiding treatment decisions. Therefore, we examined the validity of a brief, new measure of depression severity.

https://onlinelibrary.wiley.com/doi/pdf/10.1046/j.1525-1497.2001.016009606.x

The PHQ-9: validity of a brief depression severity measure.

This article reports the development and validation of a scale to measure global life satisfaction, the Satisfaction With Life Scale (SWLS). Among the various components of subjective well-being, the SWLS is narrowly focused to assess global life satisfaction and does not tap related constructs such as positive affect or loneliness. The SWLS is shown to have favorable psychometric properties, including high internal consistency and high temporal reliability. Scores on the SWLS correlate moderately to highly with other measures of subjective well-being, and correlate predictably with specific personality characteristics. It is noted that the SWLS is suited for use with different age groups, and other potential uses of the scale are discussed.

The Satisfaction with Life Scale

世界経済・社会統計 = World development indicators

https://research.vu.nl/ws/files/2901670/267479.pdf

Quality criteria were proposed for measurement properties of health status questionnaires

The concept of cognitive impairment intervening between normal ageing and very early dementia has been in the literature for many years. Recently, the construct of mild cognitive impairment (MCI) has been proposed to designate an early, but abnormal, state of cognitive impairment. MCI has generated a great deal of research from both clinical and research perspectives. Numerous epidemiological studies have documented the accelerated rate of progression to dementia and Alzheimer's disease (AD) in MCI subjects and certain predictor variables appear valid. However, there has been controversy regarding the precise definition of the concept and its implementation in various clinical settings. Clinical subtypes of MCI have been proposed to broaden the concept and include prodromal forms of a variety of dementias. It is suggested that the diagnosis of MCI can be made in a fashion similar to the clinical diagnoses of dementia and AD. An algorithm is presented to assist the clinician in identifying subjects and subclassifying them into the various types of MCI. By refining the criteria for MCI, clinical trials can be designed with appropriate inclusion and exclusion restrictions to allow for the investigation of therapeutics tailored for specific targets and populations.

https://onlinelibrary.wiley.com/doi/epdf/10.1111/j.1365-2796.2004.01388.x

Mild cognitive impairment as a diagnostic entity

While neuropsychological tests have been identified for the early prediction of Alzheimer's disease, this has not been established for prediction of all-cause dementia. This would be helpful for clinicians concerned about the risk of progression to dementia in patients who may present with a variety of medical and neurological conditions. We wanted to determine whether neuropsychological tests could accurately predict incident dementia within 10 and five years of diagnosis in a community-based sample. The Canadian Study of Health and Aging was conducted in three waves over a 10-year period (1991-2002). We studied 1472 non-demented participants who completed neuropsychological testing in 1991 and received a diagnostic assessment for dementia in 2001 (n = 284). We also studied 1231 non-demented participants who completed neuropsychological testing in 1996 and received a diagnostic assessment in 2001 (n = 634). Diagnosticians were blinded to performance on the predictive tests. Age, education, and sex were included as covariates in all regression analysis. Ten-year prediction: 2 tests, Rey Auditory Verbal Learning Test (RAVLT) short delayed verbal recall and Wechsler Adult Intelligence Test Revised (WAIS-R) Digit Symbol, were significant predictors of dementia (sensitivity = 78%, specificity = 72%, positive likelihood ratio = 2.81). Five-year prediction: 4 tests, Wechsler Memory Scale Information, RAVLT short delayed verbal recall, animal fluency, and WAIS-R Digit Symbol, significantly predicted incident dementia (sensitivity = 75%, specificity = 74%, positive likelihood ratio = 2.90). Regression models were supported with bootstrapping estimates. Neuropsychological tests can accurately predict progression to all-cause dementia within 10 years of diagnosis in a large community-based sample of non-demented participants.

Prediction of all-cause dementia using neuropsychological tests within 10 and 5 years of diagnosis in a community-based sample.

Objectives: To compare the predictive accuracy of the Revised Trauma Score (RTS), the Glasgow Coma Scale (GCS), and their components in blunt trauma patients. Methods:This multicenter prospective cohort study was conducted in 20 communities as part of the Ontario Prehospital Advanced Life Support (OPALS) Study. It included adult trauma patients with Injury Severity Scores >12. The assessments made by trauma team leaders for the RTS, GCS, and their subscales were analyzed: 1) receiver operating characteristic (ROC) curve areas and Kendall's tau c correlation coefficient (Tc) for survival to hospital discharge, 2) Mann-Whitney U test and Tc correlations for intensive care unit admission, and 3) Spearman correlations with the disability measure Glasgow Outcome Scale. Results: The authors analyzed data from 795 blunt trauma patients with these characteristics: median age of 40 years, 70% male, and 18% mortality. The scores that best predicted survival were the RTS (ROC = 0.83, Tc = 0.39), the GCS (ROC = 0.82, Tc = 0.38), the motor component of the GCS (ROC = 0.81, Tc = 0.37), and the verbal component of the GCS (ROC = 0.81, Tc = 0.36). Only scores for the RTS (p = 0.03), the GCS (p = 0.02), and the motor component of the GCS (p = 0.03) showed a significant association with admission to the intensive care unit. The associations with disability were weak in all scores. Conclusions: The initial emergency department motor score showed the highest predictive validity among all of the other components. These results suggest its validity for blunt trauma triage when compared with the GCS or RTS.

Initial Emergency Department Trauma Scores from the OPALS Study: The Case for the Motor Score in Blunt Trauma

Aims: to estimate the age-specific prevalence of diabetes mellitus in elderly people in Canada, and to examine the effect of method of ascertainment on the estimation of prevalence. Method: three measures of diabetes were used in a secondary analysis of the Canadian Study of Health and Aging— a 1991 nation-wide cross-sectional study of the prevalence of dementia in a sample of 10 263 elderly subjects (aged 65-106 years). Results: of community-dwelling subjects, 10.3% reported diabetes. Supplementing this information with clinical reports and random plasma glucose measurements increased the prevalence to 12.0% in the community, 17.5% in institutions and 12.4% overall. Conclusion: diabetes is common in elderly people, although the prevalence falls in the very elderly. The method of ascertainment influences estimation of prevalence.

/pdf/prevalence-of-diabetes-mellitus-in-elderly-people-in-canada-jitjq3mqim.pdf

Prevalence of diabetes mellitus in elderly people in Canada: report from the Canadian Study of Health and Aging

The Canadian Study of Health and Aging (CSHA) is a national longitudinal study of the epidemiology of dementia in Canada. The CSHA also described patterns of disability, frailty and healthy aging. The study involved 10,263 people aged 65 or over, sampled representatively from the community and from long-term care institutions, and participants were interviewed and assessed clinically in 1991, 1996 and 2001. Over 200 papers have been published from the study; a brief summary of results is given. The current analyses provide descriptive statistics on patterns and correlates of early cognitive decline in the study cohort. Several salient findings emerged: almost half of this representative sample showed no cognitive decline over a 10-year period. Education showed a strong protective effect against decline, but not after age 80. There was little difference in crude rates of cognitive decline between men and women, but after adjustment for disability and cardiovascular risk factors, men showed a greater risk o...

Canadian Study of Health and Aging: Study Description and Patterns of Early Cognitive Decline

The Canadian Study of Health and Aging drew representative samples of people aged 65 or over from the community and institutions across Canada. The sample was designed to provide regional and national prevalence estimates for dementia by age and sex. Thirty-six sampling areas were used in a stratified cluster design with optimal allocation; sampling weights were developed to provide population estimates. The sample included 9,008 people aged 65 or over from the community, and 1,255 from institutions. This report describes the sampling procedures, the methods used to recruit people to the study and participation rates, the characteristics of the resulting sample, and the way in which sample weights should be used.

Ian McDowell

Papers

Prediction of all-cause dementia using neuropsychological tests within 10 and 5 years of diagnosis in a community-based sample.

Initial Emergency Department Trauma Scores from the OPALS Study: The Case for the Motor Score in Blunt Trauma

Prevalence of diabetes mellitus in elderly people in Canada: report from the Canadian Study of Health and Aging

Canadian Study of Health and Aging: Study Description and Patterns of Early Cognitive Decline

Study sampling in the Canadian Study of Health and Aging.