D. Szczesniak

Test Your Memory (TYM) as a screening instrument in clinical practice – the Polish validation study

Objectives: The Test Your Memory (TYM) test is a short, self-administered screening cognitive instrument designed for the detection of Alzheimers disease (AD). The study was aimed to examine the Polish version of TYM as a screening instrument in Polish clinical practice. Method: In this study 199 patients were assessed whereas 131 patients with AD and mild cognitive impairments (MCI) and 94 healthy control subjects took part in the final analysis. The sensitivity and specificity of the TYM test were evaluated among the AD group and healthy control group. The TYM test was compared to other neuropsychological tests, such as Mini-Mental State Examination (MMSE), Clock Drawing Test (CDT), DemTect and Verbal Fluency Test (FAS). Results: The average TYM score in healthy control group: 45.4, 40.9 in the MCI patients and 23.4 in AD patients. The Polish version of the TYM test showed good correlation with other neuropsychological instruments among AD patients. Participants aged ≥75 and those with primary education performed significantly worse in TYM. The TYM achieved the best differentiation between AD and the healthy control group for ≤39 cut-off with a sensitivity and specificity of 91% and 90%, respectively. Conclusion: The Polish version of the TYM test is a useful instrument and may be seen as an alternative to the MMSE screening test in clinical practice in patients with dementia. However, the normative data suggested that the age and the level of education of the respondents should be considered as important factors affecting the interpretation of the final score.

Whole-body Cryotherapy in Dementia

Current studies have not addressed the impact of extremely low temperatures on the cognitive functions of humans. Determining the etiopathogenesis of dementia is a crucial aspect of studies dealing with cognitive functions. There is a consensus among researchers that vascular lesions, oxidative stress, inflammatory processes and abnormal neurotransmission are associated with the development of dementia, including Alzheimers disease (Grammas 2011). An antioxidative activity of cryotherapy carried out on patients with multiple sclerosis has been shown in several studies. Clinical trials involving patients with secondary progressive multiple slcerosis showed them to have a statistically significant increase in the total antioxidant status (TAS) following 10 cryotherapy sessions (Miller 2010). Due to the anti-inflammatory (a modification of the concentration of proinflammatory cytokines) and antioxidatixe effect of low temperatures as well as the hormonal and lipid changes they cause, they may play an important role in preventing or inhibiting pathophysiological processes leading to dementia. Therefore, carrying out a study concerning the effect of systemic cryotherapy on the body in dementia will allow to assess its efficacy. Grammas P. Neurovascular dysfunction, inflammation and endothelial activation: implications for the pathogenesis of Alzheimer’s disease. J Neuroinflamm 2011;8:26. Miller E, Mrowicka M, Malinowska K, Mrowicki J, Saluk-Juszczak J, Kedziora J. The effects of wholebody cryotherapy on oxidative stress in multiple sclerosis patients, J Therm Biol, vol.35, 2010, s.406410.

The Utility of Slums as a Screening Tool Among Nursing Home Residents in Poland: First Results.

Introduction The aging of the world population implies challenges in the area of early diagnosis in geriatric psychiatry as well as in general medical practice. Researchers found that the screening tool developed by Saint Louis University detects early cognitive problems, specifically mild cognitive impairments (MCI), missed by other screening tools. Aims To compare the Polish version of SLUMS as a screening instrument with other screening tests mostly used in Poland such as: MMSE or STMS. Methods The cross-sectional descriptive study was conducted. The total sample included 58 nursing home residents with the mean age of 81.74 (± 8.6). According to CDR 32.8% (n=19) of participants fulfill the criteria of dementia, 27.6% (n=16) of MCI and 39.7% (n=23) were considered as healthy. Results The internal consistencies (Crohnbachs a) of the SLUMS test was 0.7031. The average of total SLUMS score were 23.3 in healthy participants, 19.3 in MCI and 13.1 in demented residents. The statistical analysis illustrated that SLUMS differentiate the dementia residents from those considered as MCI (p=0.01), as well as from healthy participant (p=0.0001). Furthermore, it is also useful in conducting the differential diagnosis between MCI and healthy participants (p=0.017), where MMSE does not offer such a possibility (MCI vs healthy, p=0.51) Conclusions It seems that the SLUMS is not just another screening tool that can complement the range of existing cognitive tests in Polish clinical practice. Preliminary statistical analysis demonstrated its superior capabilities in the screening diagnosis compared to most famous test in Poland, MMSE.

The Use of the Internalized Stigma Psychometric Tool Among Mentally Ill Patients: Preliminary Results.

Introduction Stigma is a phenomenon that has been evaluated according to endless numbers of attributes, health conditions and social groups. Research shows that mental illness is one of the most socially exclusive stigmata. Aukst Margetic underlines the importance of individual differences in personality as performing a key role in mediating between social and internalized stigma. Objectives To gain the existing state of the art on personality correlates and to verify the knowledge of the clinical variables on the phenomenon of internalized stigma among patients with severe mental illnesses. Aims To answer the question whether there are any differences in internalized stigmatization among patients with severe mental illnesses in relation to the personality traits and illness-related factors. Methods Two-stages, cross-sectional study design. Stage I, a pilot study to check the reliability of psychometric instrument measured the internalized stigma – Internalized Stigma of Mental Illness (ISMI) scale by Ritsher [Boyd]. Stage II,to examine the internalized stigma in relation to personality and clinical correlates. The study is conducted among people of both sexes between 18 and 65 years old with diagnosis of psychotic disorders (F20-29) and mood disorders (F30-39) according to ICD-10. Among used methods are: Personality Inventory NEO-FFI, Eysencks Personality Questionnaire (EPQ-R), a Polish version of questionnaire of Internalized Stigma of Mental Illness (ISMI). Results Data on relation between personality traits, clinical factors and internalized stigma. Conclusions In the future, the obtained results may contribute to the clinical and therapeutic fields, assuming that internalized stigma is strongly linked with the process of recovery.

The Value of Cognitive Screening Tests in Patients with Amnestic and Non-amnestic MCI.

Introduction Although the original diagnostic criteria for mild cognitive impairment (MCI) highlighted the importance of memory impairment, more recently the MCI classification was expanded to encompass other cognitive domains, allowing the diagnosis of amnestic or non-amnestic MCI. Objective The primary aim of this study was to identify cognitive tests and illustrate a neuropsychological profile of cognitive subtests of persons with amnestic MCI (aMCI) and non-amnestic MCI (naMCI). Material and Methods: The study used a cross-sectional design. The study group consisted of 35 aMCI and 16 naMCI subjects matched for age, sex and years of education. The groups did not differ according to CDR. All subjects underwent a wide range of psychological tests including MMSE, TYM, DemTect, FAS, CDT, IADL and GDS. The following tests were completed to measure episodic memory, working memory, executive functions, perception and language. The analysis of variance (ANOVA) was used to analyze the differences between group means. Results The statistical analysis illustrated that total scores of MMSE, TYM, DemTect and FAS to differentiate the aMCI from naMCI subjects. Compared to naMCI, aMCI subjects scored lower in MMSE (p=0.0104) and in DemTect (p=0.0002) while they had higher scores in TYM (p=0.0067) and FAS (p=0.0427). Conclusions This study shows that cognitive screening tests provide valuable information regarding the differential diagnosis of aMCI versus naMCI. MMSE and DemTect may be seen as superior screening tests in aMCI, while TYM and FAS in naMCI subjects.

Searching for Correlations Between Results of Psychological Tests and FDG-PET as Well as Spectroscopic Metabolites From Posterior Cingulate Gyrus in Patients with MCI.

Background The aim of the study was to search for correlations between the results of psychological tests and FDG-PET as well as spectroscopic metabolites from the posterior cingulate gyrus (PCG) in patients with amnestic (aMCI) and non-amnestic MCI (naMCI). Material and Methods The study group consisted of 35 aMCI, 16 naMCI and 20 control subjects matched for age, sex and years of education. All subjects underwent a wide range of psychological tests including MMSE, CDR, TYM, DEMTEC, CDR, FAS, IADL and GDS as well neuroimaging brain studies including FDG-PET with the evaluation of glucose metabolism and magnetic resonance spectroscopy (MRS) with the evaluation of several metabolites such as NAA (neuronal marker), choline (marker of myelin turnover) and myoinositol (marker of gliosis). The results of FDG-PET and the levels of MRS metabolites obtained from PCG were compared between the subject groups and then correlated with the scores of psychological tests using Pearson’s coefficient. Results Compared to CG, both aMCI and naMCI subjects showed significantly lower levels of glucose metabolism and NAA within PCG. In the aMCI subgroup the results of FDG-PET studies revealed significant negative correlations with the scores of TYM (p=0.17, r= -0.48) while in the naMCI subgroup lower levels of NAA correlated with lower scores in DEMTEC. Conclusions In both aMCI and naMCI metabolic changes within PCG such as glucose hipometabolism and decreased neuronal activity correlate with the results of single psychological test.

EPA-0363 - Unmet needs of the elderly from nursing homes- different perspectives.

Introduction The aging of the population and popularisation of the long-term care institutions in Poland confronts us with the challenge of improving the quality of these institutions and to evaluate the current state of its functioning. Objective The aim of the study was to evaluate and analyze needs of residents living in nursing homes using the Polish version of the Camberwell Assessment of Need for Elderly (CANE). Methods A sample of 300 residents from three urban cities was investigating using the Polish version of CANE. Data were collected from users, rater and staff involved. Subjects ranged in age from 74 to 102 with a mean age of 83,36±5,88. Results The most frequent unmet needs highlighted by users, rater as well as by staff were: psychological distress, company, intimate relationships, information, eyesight/hearing/communication and daytime activities. However, the comparison of total number of needs illustrated that overall users reported significantly fewer met needs compared with staff involved (Z=8,25; p Conclusion This study provides us with better understanding of an individual perspective of residents living in nursing houses in Poland perceived from different points of views. The results illustrated the differences in the unmet needs perception and pointed out that taking into account only staff perception may lead to under recognition of unmet needs.