Impact of Mild Behavioral Impairment on Longitudinal Changes in Cognition.

Background: To examine cross-sectional differences and longitudinal changes in cognitive performance based on the presence of mild behavioral impairment (MBI) among older adults who are cognitively healthy or have mild cognitive impairment (MCI).

Methods: Secondary data analysis of participants (n = 17 291) who were cognitively healthy (n = 11 771) or diagnosed with MCI (n = 5 520) from the National Alzheimer's Coordinating Center database. Overall, 24.

Mild behavioral impairment as a predictor of cognitive functioning in older adults.

Objective: To assess the influence of mild behavioral impairment (MBI) on the cognitive performance of older adults who are cognitively healthy or have mild cognitive impairment (MCI).

Methods: Secondary data analysis of a sample (n = 497) of older adults from the Florida Alzheimer's Disease Research Center who were either cognitively healthy (n = 285) or diagnosed with MCI (n = 212). Over half of the sample (n = 255) met the operationalized diagnostic criteria for MBI.

Neuropsychiatric symptoms as a distinguishing factor between memory diagnoses.

Objectives: To determine whether neuropsychiatric symptoms (NPS) are able to differentiate those with mild cognitive impairment (MCI) and dementia from persons who are cognitively healthy.

Methods: Multinomial and binary logistic regressions were used to assess secondary data of a sample (n = 613) of older adults with NPS. Analyses evaluated the ability to differentiate between diagnoses, as well as the influence of these symptoms for individuals with amnestic MCI (MCI-A), non-amnestic MCI (MCI-NA), and dementia compared with those who are cognitively healthy.

Mortality and Cause of Death in Younger Homeless Veterans.

Objectives: Increased mortality has been documented in older homeless veterans. This retrospective study examined mortality and cause of death in a cohort of young and middle-aged homeless veterans.

Methods: We examined US Department of Veterans Affairs records on homelessness and health care for 2000-2003 and identified 23 898 homeless living veterans and 65 198 non-homeless living veterans aged 30-54.

Predictors of Mortality in Older Homeless Veterans.

Objectives: In this analysis of a cohort of older homeless veterans, we examined psychosocial, health, housing, and employment characteristics to identify predictors of mortality.

Method: Our sample of 3,620 older veterans entered Veteran Affairs homeless programs in years 2000-2003. Fifteen variables from a structured interview described this sample and served as predictors.

Increased Mortality Among Older Veterans Admitted to VA Homelessness Programs.

Objective: National Death Index data were examined to describe mortality patterns among older veterans who are homeless.

Methods: Homelessness and health care records from the U.S.

Health risk factors and differences in outcomes between younger and older veterans using VA transitional housing.

Objective: This study examined age-related differences in general medical and mental health risk factors for veterans participating in the U.S. Department of Veterans Affairs (VA) Grant Per Diem (GPD) transitional supportive housing program.

Verbal fluency patterns in mild cognitive impairment and Alzheimer's disease.

Background/aims: Verbal fluency patterns can assist in differential diagnosis during neuropsychological assessment and identify individuals at risk for developing Alzheimer's disease (AD). While evidence suggests that subjects with AD perform worse on category fluency than letter fluency tasks, the pattern in mild cognitive impairment (MCI) is less well known.

Methods: Performance on the Controlled Oral Word Association Test (COWAT) and Animal fluency was compared in control, amnestic MCI, non-amnestic MCI, and AD groups.

Perceptions of homelessness in older homeless veterans, VA homeless program staff liaisons, and housing intervention providers.

Purpose: To understand the needs and challenges encountered by older homeless veterans.

Methods: We conducted six focus groups of older veterans, two focus groups, and one semi-structured interview of VA staff liaisons, and two focus groups and one semi-structured interview of housing intervention providers.

Results: Major themes for older veterans: 1) negative homelessness experience; 2) benefits of the structured transitional housing program; 3) importance of peer outreach; and 4) need for age-tailored job placement programs.

Evaluating the impact of dental care on housing intervention program outcomes among homeless veterans.

Objectives: In this retrospective longitudinal cohort study, we examined the impact of dental care on outcomes among homeless veterans discharged from a Department of Veterans Affairs (VA) transitional housing intervention program.

Methods: Our sample consisted of 9870 veterans who were admitted into a VA homeless intervention program during 2008 and 2009, 4482 of whom received dental care during treatment and 5388 of whom did not. Primary outcomes of interest were program completion, employment or stable financial status on discharge, and transition to permanent housing.

Use of outpatient mental health services by homeless veterans after hurricanes.

Little is known about the impact of hurricanes on people who are homeless at the time a disaster occurs. Although researchers have extensively studied the psychosocial consequences of disaster produced homelessness on the general population, efforts focused on understanding how homeless people fare have been limited to a few media reports and the gray literature. In the event of a hurricane, homeless veterans may be at increased risk for negative outcomes because of their cumulative vulnerabilities.

Cognitive change checklist: psychometric characteristics in community-dwelling older adults.

Objective: To extend the psychometric study of the Cognitive Change Checklist (3CL) by examining the reliability, factor structure, and external correlates of 3CL informant and self-report ratings in community-dwelling adults. We also conducted receiver operating characteristic analyses examining rating scores from this normative sample with those of clinical samples.

Design: Scale reliability and validity study.

Further issues in determining the readability of self-report items: comment on McHugh and Behar (2009).

Objective: Issues regarding the readability of self-report assessment instruments, methods for establishing the reading ability level of respondents, and guidelines for development of scales designed for marginal readers have been inconsistently addressed in the literature. A recent study by McHugh and Behar (2009) provided new findings relevant to these issues. McHugh and Behar calculated indices of readability separately for the instructions and the item sets of 105 self-report measures of anxiety and depression.

An investigation of PreMCI: subtypes and longitudinal outcomes.

Background/aims: To investigate the clinical features and rates of progression of conditions that are not considered to be normal, but do not fulfill criteria for mild cognitive impairment (MCI).

Methods: We longitudinally evaluated 269 elderly subjects who did not meet formal criteria for MCI at baseline but had: (1) a clinical history suggesting MCI without neuropsychological deficits (PreMCI-Clinical); or (2) neuropsychological deficits on one or more memory measures in conjunction with a negative clinical examination (amnestic PreMCI-NP) or were normal on both neuropsychological and clinical examination.

Results: The rate of progression to MCI or dementia over an average of 2- to 3 years was 3.

Requiring sobriety at program entry: impact on outcomes in supported transitional housing for homeless veterans.

Objective: An important distinction in models of housing for the homeless is whether programs that require abstinence prior to program admission produce better outcomes than unrestricted programs. Data from a large transitional housing program were used to compare client characteristics of and outcomes from programs requiring abstinence at admission and programs not requiring abstinence.

Methods: The U.

Reasons for psychiatric medication prescription for new nursing home residents.

Objectives: This article focuses on justification of psychoactive medication prescription for NH residents during their first three months post-admission.

Method: We extracted data from 73 charts drawn from a convenience sample of individuals who were residents of seven nursing homes (NHs) for at least three months during 2009. Six focus groups with NH staff were conducted to explore rationales for psychoactive medication usage.

Assessment of cognition in early dementia.

Better tools for assessing cognitive impairment in the early stages of Alzheimer's disease (AD) are required to enable diagnosis of the disease before substantial neurodegeneration has taken place and to allow detection of subtle changes in the early stages of progression of the disease. The National Institute on Aging and the Alzheimer's Association convened a meeting to discuss state of the art methods for cognitive assessment, including computerized batteries, as well as new approaches in the pipeline. Speakers described research using novel tests of object recognition, spatial navigation, attentional control, semantic memory, semantic interference, prospective memory, false memory and executive function as among the tools that could provide earlier identification of individuals with AD.

Pre-MCI and MCI: neuropsychological, clinical, and imaging features and progression rates.

Objective: To compare clinical, imaging, and neuropsychological characteristics and longitudinal course of subjects with pre-mild cognitive impairment (pre-MCI), who exhibit features of MCI on clinical examination but lack impairment on neuropsychological examination, to subjects with no cognitive impairment (NCI), nonamnestic MCI (naMCI), amnestic MCI (aMCI), and mild dementia.

Methods: For 369 subjects, clinical dementia rating sum of boxes (CDR-SB), ApoE genotyping, cardiovascular risk factors, parkinsonism (UPDRS) scores, structural brain MRIs, and neuropsychological testing were obtained at baseline, whereas 275 of these subjects received an annual follow-up for 2-3 years.

Results: At baseline, pre-MCI subjects showed impairment on tests of executive function and language, higher apathy scores, and lower left hippocampal volumes (HPCV) in comparison to NCI subjects.

Defining mild cognitive impairment: impact of varying decision criteria on neuropsychological diagnostic frequencies and correlates.

Objective: To examine the impact of varying decision criteria on neuropsychological diagnostic frequencies and on their correlates.

Design: Descriptive and correlational study.

Setting: Florida Alzheimer's Disease Research Center.

Use of informants to identify mild cognitive impairment in older adults.

Extensive research supports the use of informant ratings in diagnosing dementia. In comparison, far fewer studies have examined the use of informant ratings in identifying mild cognitive impairment (MCI), a state that occurs as healthy older adults make the gradual transition to dementia. A review of available studies that have examined discrepancies between MCI patient and informant reports has for the most part demonstrated that informant ratings reveal greater loss of everyday functional ability and cognitive competency.

Reliability and validity of an algorithm for the diagnosis of normal cognition, mild cognitive impairment, and dementia: implications for multicenter research studies.

Background: The traditional consensus diagnosis (ConsDx) of normal cognition, mild cognitive impairment (MCI), and dementia relies on the reconciliation of an informant-based report of cognitive and functional impairment by a physician diagnosis (PhyDx), and a neuropsychological diagnosis (NPDx). As this procedure may be labor intensive and influenced by the philosophy and biases of a clinician, the diagnostic algorithm (AlgDx) was developed to identify individuals as cognitively normal, with MCI, or dementia.

Methods: The AlgDx combines the PhyDx with the NPDx, using a diagnostic algorithm that provides cognitive diagnoses, as defined by the National Alzheimer Coordinating Center/Uniform Data Set nomenclature.

Severity of medial temporal atrophy and amnestic mild cognitive impairment: selecting type and number of memory tests.

Objective: Medial temporal lobe atrophy (MTA) can be used as a biomarker of pathology that affects mechanisms of episodic memory. The authors compared the strength of this biomarker with performance on four memory measures and examined the influence of demographic factors including age, level of education, and primary language (English or Spanish).

Methods: The Hopkins Verbal Learning Test-revised, Fuld Object Memory Evaluation (FOME), delayed memory for a story passage, and delayed visual reproduction of the Wechsler Memory Scale-revised tests were administered to 281 subjects who were diagnosed as having no cognitive impairment, mild cognitive impairment (MCI), impaired non-MCI, or dementia.

Use of mental health services by nursing home residents after hurricanes.

Objective: A growing body of research supports the value of mental health intervention to treat people affected by disasters. This study used a mixed-methods approach to evaluate pre- and posthurricane mental health service use in Florida nursing homes.

Methods: A questionnaire was administered to 258 directors of nursing, administrators, and owners of nursing homes, representing two-thirds of Florida's counties, to identify residents' mental health needs and service use.