M. Neri

The Validity of Informant Reports in Assessing the Severity of Dementia: Evidence from the CAMDEX Interview

The evaluation of a patient’s mental state, overall clinical profile and behavioural disturbance in the process of diagnosing dementia requires at least two sources of information: the patient and the informant. Since the severity of the dementia may interfere with the subjective perception of these disorders, it is important to evaluate the consistency between these two sources of information and the clinical and psychometric evaluation made by the physician. Accordingly, in this study five behavioural areas, derived from the semi-structured interview schedule provided by the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX, i.e., Sleep, Depressed Mood, Everyday Activity, Memory and Global Mental Functioning) have been tested on the patient and his/her informant. Eighty dementia patients (mean age = 74 years) and their informants participated in the study. The dementia group was subdivided into two levels of severity according to DSM-IIIR criteria: 41 with mild dementia and 39 with moderate dementia, respectively, matched for age and schooling. The rating of impairment was found to increase along with the severity of dementia in all the above-mentioned areas, except for sleep. However, the source of information per se significantly influenced the evaluation of memory functioning. Moreover, the significant interaction between the two factors considered indicates that memory functioning is evaluated quite differently by the patients and the informants, as only in the assessment made by the latter group did the impairment increase in parallel with severity of dementia. Finally, whereas none of the subjective measures recorded in the patients were significantly correlated with their test scores, the correlations between the informant memory appraisals and patient test results proved to be significant. The present findings confirm the validity of informant reports in assessing cognitive and memory disorders in early-stage dementia, as well as in distinguishing patients with mild from those with moderate dementia.

Transient global amnesia: Memory and metamemory

Twenty patients (mean age 64 years) with a previous episode of transient global amnesia (TGA) were examined to assess the functioning of objective memory (by using the Randt Memory Test), the metamemory capacities (Sehulster Memory Scale), the residual level of retrograde amnesia (Questionnaire of Remote Events), and the level of depression (Geriatric Depression Scale). Patients with residual retrograde amnesia scored significantly lower than non- amnesic ones on indices of both short- term and long- term memory, and for one of three main metamemory components, namely self- rating of memory functioning through comparison with memory functioning of peers (Set3). Age, time interval from TGA attack and TGA duration did not prove to influence memory and metamemory scores. Retrograde amnesia and depression were rather substantially associated (1/5), and this association was found to negatively influence nearly all memory and metamemory scores. Depression level showed a positive correlation with short- term memory functioning in non- amnesics. The different pattern and strength of the relationships between metamemory components and objective memory dimensions observed in amnesics and non- amnesics indicate that metamemory evaluations are more closely related to memory functioning in amnesics than in non- amnesics.

Validation Study of the Italian Version of the Cambridge Mental Disorders of the Elderly Examination: Preliminary Findings

A validation study was planned to assess, by comparing the performance of a group of suspected demented (i.e. scoring less than 27 in the Mini Mental State Examination, MMSE) and a control group of no

Validation of the Full and Short Forms of the CAMDEX Interview for Diagnosing Dementia

The present study compares the sensitivity and specificity of the short and full forms of the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX) interview in diagnosing dementia. We tested 73 subjects meeting DSM-IIIR criteria for dementia and 61 matched controls. The short version was applied 3 months after the full one to guarantee a relative stability of the tested functions. Referred to an independent clinical rating made at the beginning of the study, the levels of sensitivity and specificity were not significantly different in the two forms and fully comparable with those of the original full English version. Moreover, the scores on analogous sections of the two versions were highly correlated in the demented and control groups. These findings support the hypothesis that the short form of the CAMDEX maintains the psychometric properties of the full one, and consequently can be used in diagnostic routines for a variety of clinical and research purposes.

The validity of informant report for grading the severity of Alzheimer's dementia.

The validity of informant- based techniques has been established for the detection of dementia cases by non-pathological individuals, but is still controversial for the assessment of the severity of dementia. This study aimed at ascertaining whether informant- based evaluation (the so-called informant report) of the cognitive and behavioral impairment of a patient is valid for grading the severity of dementia, and consistent with objective assessment of the patient’s cognitive and behavioral functioning. We enrolled 96 community-dwelling outpatients and 56 controls assessed at the Geriatric Evaluation Unit of the University of Modena, Italy. All patients scored lower than 27 on the MMSE, and met DSM-IV inclusion criteria for Alzheimer’s dementia. Patients and controls were administered the CAMDEX interview, containing a section which collects participant (patient or control) and informant evaluations on dementiarelated cognitive and behavioral deficits. The informant report resulted effective at MANOVA for grading the severity of dementia in 4 of its 5 measures (namely, memory, everyday activities, general mental functioning and depressed mood), and was correlated with the scores of several scales of the CAMDEX cognitive section (i.e., CAMCOG). Instead, the participant’s (patient or control) report showed a lower capacity for grading dementia, and was poorly correlated with the psychometric outcomes of cognitive functioning. On the whole, the results corroborated the validity of the informant report in the diagnostic work-up for grading dementia, given its sensitivity to the severity of dementia, and its consistency with cognitive psychometric outcomes.

Validation of the Full and Short Forms of the CAMDEX Interview for Diagnosing Dementia: Evidence from a One-Year Follow-Up Study

The sensitivity and specificity of the two forms of the CAMDEX interview for dementia diagnosis were assessed in a 1-year follow-up study. At the beginning of the study, 60 patients (22 males and 38 females) who met DSM-IV criteria for dementia and 60 matched controls (15 males and 45 females), were administered the short form of the CAMDEX (short CAMDEX) 3 months after the full one (full CAMDEX). At the follow-up, all patients were administered both the full and short CAMDEX (again with a 3-month interval), whereas controls were administered either CAMDEX form (in any case, at a 12-month interval from initial testing). Upon initial testing, the sensitivity of the full CAMCOG proved to be significantly higher than that of the short CAMCOG, while the opposite trend was observed for specificity, that is the sensitivity of the full Organicity was lower than that of the short Organicity, with specificity remaining equal in the two forms. Upon follow-up, the specificity and sensitivity levels of the two forms did not significantly differ for the CAMCOG and Organicity indices. Moreover, in detecting mildly demented patients, the full CAMCOG proved to be more accurate than the short one, while the opposite trend was observed for Organicity. Among the dementia subjects, significant correlations were found between the homologous indices of the two forms for both test sessions. On the whole, the short CAMDEX appears to maintain most of the psychometric properties of the full version and therefore the two CAMDEX forms can be considered to be interchangeable.

Grammatical ambiguity resolution in right hemisphere-damaged patients: Evidence from an insertion task

Abstract We examined the issue of right cerebral hemisphere (RH) participation in sentential syntax processing. A modified version of the Insertion Task of Schneiderman and Saddy 88) was administered to eight right hemisphere brain-damaged (RHD), eight left hemisphere brain-damage (LHD) and 28 right-handed control (CTR) subjects: 28 word/syntagm insertions required role reassignment of a lexical item in the stimulus sentence (Shift); 25 insertions implied only semantic reinterpretation of the sentence (Nonshift). Age, formal education, cognitive proficiency, mood and verbal intelligence were introduced as covariates in the analysis of the outcomes to partial out their influence on performance. The LHD group outperformed the RHD patients on the Shift items, though both scored similarly on other language tasks. The RHD group performed significantly worse only on the Shift items. However, there were no differences between the RHD and CTR Nonshift scores, or between the LHD and CTR Shift scores. Again, the RH...

Tempo e giustizia nella conciliazione vita-lavoro

Work-life balance is one of the current issues within the academic, political, and managerial debate. An article discussed in a TAO Research Programs seminar held in June 2015 at the University of Modena and Reggio Emilia, suggests a critical interpretation of the mainstream literature and its related controversial results in terms of work-life reconciliation practices. The article also provides an alternative analytical framework based on Bruno Maggi’s organization theory, Norbert Elias’ theory of time, and Amartya Sen’s theory of justice. Scholars from different universities and disciplines contribute with comments on the notions of time, justice, organization and the proposed interpretative framework as well.

Dibattito su Storie di imprese

Storie di imprese (TAO Digital Library, 2010), dedicated to the organizational transformations of five enterprises (Fiat Auto, Finmeccanica, Ciba Specialty chemicals, Zurich, Poste Italiane) during the 2000-2010 decade, stimulated a wide debate. This publication, which collects the commentaries and discussions of three seminar that took place in different Universities with the participation of scholars from different disciplines, continues the reflection about the crucial question: How do enterprises change?