Evelyn L. Teng

The Cognitive Abilities Screening Instrument (CASI): A Practical Test for Cross-Cultural Epidemiological Studies of Dementia

The Cognitive Abilities Screening Instrument (CASI) has a score range of 0 to 100 and provides quantitative assessment on attention, concentration, orientation, short-term memory, long-term memory, language abilities, visual construction, list-generating fluency, abstraction, and judgment. Scores of the Mini-Mental State Examination, the Modified Mini-Mental State Test, and the Hasegawa Dementia Screening Scale can also be estimated from subsets of the CASI items. Pilot testing conducted in Japan and in the United States has demonstrated its cross-cultural applicability and its usefulness in screening for dementia, in monitoring disease progression, and in providing profiles of cognitive impairment. Typical administration time is 15 to 20 minutes. Record form, manual, videotape of test administration, and quizzes to qualify potential users on the administration and scoring of the CASI are available upon request.

Clinical subtypes of dementia of the Alzheimer type

Clinical subtypes of dementia of the Alzheimer type were evaluated by comparing age at onset, aphasia, family history, and motor disorder in 146 individuals with progressive dementia. Early onset was significantly associated with more prevalent and more severe language disorder. Forty-five percent of all probands had familial history of dementia, but we could not differentiate relative familial risk based on age at onset or aphasia. Independent of duration of illness, myoclonus and noniatrogenic extrapyramidal disorder were associated with greater severity of dementia.

Transcallosal, interfornicial approaches for lesions affecting the third ventricle: surgical considerations and consequences

A group of 11 patients with a variety of lesions affecting the 3rd ventricle have been treated using a direct transcallosal interfornicial approach to the region. In 3 patients, no attendant hydrocephalus was present. In an effort to minimize potential cortical injury related to the approach, we studied the venous anatomy in the region of the coronal suture. Based on this study, appropriate flap placement and interhemispheric entry points were defined. Although no lasting, clinically apparent morbidity was observed in any of the 11 cases, we performed more sophisticated studies of the interhemispheric transfer of somesthetic and perceptual motor tasks, as well as psychometric testing related to parameters of intelligence and memory, 3 to 8 months postoperatively in 6 cases. The results and clinical material indicate that this surgical technique is a safe, feasible alternative in the management of a wide spectrum of pathological lesions within this region. A transcallosal, interfornicial approach offers excellent visualization of the entire 3rd ventricle without the dependence on hydrocephalus or an extensive extra-axial mass to enhance the exposure. With proper planning and technique, it may be accomplished with a minimum of physiological consequence.

The effects of age, education, and ethnicity on verbal fluency

A group of 317 healthy participants between 54 and 99 years of age performed a verbal fluency task. The participants included Chinese, Hispanic, and Vietnamese immigrants, as well as White and African American English speakers. They were given 1 min to name as many animals as possible in their native language. The results showed that more animal names were produced by younger people and those with more education. Language background was also an important factor: The Vietnamese produced the most animal names and the Spanish speakers produced the fewest. The exaggerated difference between these two groups is attributed to the fact that Vietnamese animal names are short (predominantly 1 syllable) while the Spanish animal names are longer than any other language in this study (2 and 3 syllables per word). Finally, although the ethnic groups named different animals, and appeared to vary in the variety of animal names they used, these factors did not affect overall verbal fluency performance.

Prevalence and Subtypes of Dementia in Taiwan: A community Survey of 5297 Individuals

OBJECTIVE: To study the prevalence rate of dementia in Taiwan, the relative frequencies of its subtypes, and its associations with age, education, gender, and residence location.

Depressive disorders among older residents in a Chinese rural community

BACKGROUND Two recent surveys of depression among Chinese elderly people sampled different populations, used different case ascertainment methods and resulted in a seven-fold difference in prevalence rates. The present study was conducted to compare prevalence rates obtained with two commonly used methods in the same population, and to examine the risk factors for depression. METHODS The target population included all residents aged 65 years and over in a rural Chinese community. Participants were interviewed for demographic and medical information, examined by a neurologist and administered Chinese versions of the Geriatric Depression Scale-Short Form (GDS-S), the Cognitive Abilities Screening Instrument (CASI) and an Activities of Daily Living (ADL) form. Individuals who screened positive on the GDS-S were also interviewed by a psychiatrist for diagnosis according to the DSM-III-R criteria. RESULTS Among the 1313 participants, 26% screened positive on the GDS-S and 13% were diagnosed as having a depressive disorder, including 6.1% with major depression. Individuals with depressive disorders were more likely to have poor ADL scores, lower CASI scores, and chronic physical illnesses. They were also more likely to be female, older, illiterate and without a spouse, but adding these variables did not increase the overall association with the GDS-S score. CONCLUSIONS Depression was quite common in this Chinese rural geriatric population. The prevalence rate was twice as high when judged by depression symptomatology rather than clinical diagnosis. The critical risk factors were functional impairments, poor cognitive abilities and the presence of chronic physical illnesses.

Dichotic ear difference is a poor index for the functional asymmetry between the cerebral hemispheres.

Abstract Dichotic ear difference reflects not only an “ability asymmetry” between the two hemispheres, but also an “input asymmetry” between the contralateral and the ipsilateral ear-to-hemisphere projection. Between-individual variations in ear differences may be attributable more to variations in input asymmetry than to those in hemispheric asymmetry. Within-individual fluctuations in ear difference scores are also too large for practical purposes.

Lateral preferences for hand, foot and eye, and their lack of association with scholastic achievement, in 4143 Chinese

Abstract A questionnaire survey was conducted among Chinese students divided between a grade-school sample and a university sample. Social pressure for right-handed writing and eating was effective, but showed limited transfer influence on other activities. Details of the handedness distribution varied with particular item combinations, but the general features of the distribution showed the same characteristics found in Caucasian samples. Distributions of lateral preferences in foot and eye uses, as well as the inter-correlations among hand, foot and eye preferences, were also comparable with Western results. No difference was obtained between the grade-school sample and the university sample, indicating a lack of association between lateral preferences and intelligence in the non-clinical population.

Subjective Memory Complaint in Relation to Cognitive Performance and Depression: A Longitudinal Study of a Rural Chinese Population

OBJECTIVES: To examine the associations of subjective memory complaint (SMC) in old age with (a) objective test performance, (b) past and subsequent cognitive decline, and (c) depression.

Patients’ versus caregivers’ report of poor memory in relation to dementia and tested abilities

Complaints of poor memory are common among older individuals, but their clinical significance remains unclear. We compared patients’ self-report of poor memory with their caregivers’ report, and to compare the two reports’ associations with the patients’ dementia status and tested cognitive performance. Participants included 709 patients at the Memory Clinic of the Taipei Veterans General Hospital and their primary caregivers. A total of 493 of the patients were diagnosed with dementia according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV),1 including 78% with probable AD, 15% with vascular dementia, and 7% with mixed or other types of dementia. The diagnosis of dementia and its subtypes was made by a neurologist based on interview, physical examination, cognitive test, and laboratory findings. Each patient and caregiver was asked separately by a neuropsychologist to describe the patient’s memory as being good/average or poor. They also answered questions for the …