Remigiusz Sokołowski

Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis.

OBJECTIVES Screening tests play a crucial role in dementia diagnostics, thus they should be very sensitive for mild cognitive impairment (MCI) assessment. Nowadays, the MiniMental State Examination (MMSE) is the most commonly used scale in cognitive function evaluation, albeit it is claimed to be imprecise for MCI detection. The Montreal Cognitive Assessment (MoCA), was created as an alternative method for MMSE. Aim. MoCA vs. MMSE credibility assessment in detecting MCI, while taking into consideration the sensitivity and specificity by cut-off points. METHODS A systematic literature search was carried out by the authors using EBSCO host Web, Wiley Online Library, Springer Link, Science Direct and Medline databases. The following medical subject headings were used in the search: mild cognitive impairment, mini-mental state examination, Montreal cognitive assessment, diagnostics value. Papers which met inclusion and exclusion criteria were chosen to be included in this review. At the end, for the evaluation of MoCA 20, and MMSE 13 studies were qualified. Research credibility was established by computing weighted arithmetic mean, where weight is defined as population for which the result of sensitivity and specificity for the cut-off point was achieved. The cut-offs are shown as ROC curve and accuracy of diagnosis for MoCA and MMSE was calculated as the area under the curve (AUC). RESULTS ROC curve analysis for MoCA demonstrated that MCI best detection can be achieved with a cut-off point of 24/25 (n = 9350, the sensitivity of 80.48% and specificity of 81.19%). AUC was 0.846 (95% CI 0.823-0.868). For MMSE, it turned out that more important cut-off was of 27/28 (n = 882, 66.34% sensitivity and specificity of 72.94%). AUC was 0.736 (95% CI 0.718-0.767). CONCLUSIONS MoCA test better meets the criteria for screening tests for the detection of MCI among patients over 60 years of age than MMSE.

Sleep quality disorders among the people of old and presenile age

Podhorecka Marta, Cytarska Magdalena, Gebka Dominika, Perkowski Radoslaw, Jaroch Alina, Siedlecka–Glowczewska Emilia, Sokolowski Remigiusz, Radzinska Michalina, Zukow Walery, Kedziora-Kornatowska Kornelia. Sleep quality disorders among the people of old and presenile age. Journal of Education, Health and Sport. 2017;7(12):322-338. eISSN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.1133977 http://ojs.ukw.edu.pl/index.php/johs/article/view/5181 The journal has had 7 points in Ministry of Science and Higher Education parametric evaluation. Part B item 1223 (26.01.2017). 1223 Journal of Education, Health and Sport eISSN 2391-8306 7 © The Authors 2017; This article is published with open access at Licensee Open Journal Systems of Kazimierz Wielki University in Bydgoszcz, Poland Open Access. This article is distributed under the terms of the Creative Commons Attribution Noncommercial License which permits any noncommercial use, distribution, and reproduction in any medium, provided the original author(s) and source are credited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. This is an open access article licensed under the terms of the Creative Commons Attribution Non Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial use, distribution and reproduction in any medium, provided the work is properly cited. The authors declare that there is no conflict of interests regarding the publication of this paper. Received: 01.12.2017. Revised: 15.12.2017. Accepted: 28.12.2017. Sleep quality disorders among the people of old and presenile age Zaburzenia jakości snu wśrod osob w wieku starczym i przedstarczym Marta Podhorecka1, Magdalena Cytarska1, Dominika Gebka1, Radoslaw Perkowski1, Alina Jaroch2, Emilia Siedlecka–Glowczewska1, Remigiusz Sokolowski1, Michalina Radzinska1, Walery Zukow3, Kornelia Kedziora-Kornatowska1 Faculty of Health Sciences, Department and Clinic of Geriatrics, Nicolaus Copernicus University, Torun, Poland, M. Sklodowskiej-Curie 9, 85-094 Bydgoszcz, Poland Faculty of Health Sciences, Department and Institute of Nutrition and Dietetics, Nicolaus Copernicus University in Torun, Ludwik Rydygier Collegium Medicum in Bydgoszcz, Poland Department of Spatial Management and Tourism, Faculty of Earth Sciences, Nicolaus Copernicus University in Torun, Torun, Poland Streszczenie: Wedlug najnowszych badan na zaburzenia snu cierpi ponad polowa osob w populacji geriatrycznej. Obnizona jakośc snu wplywa negatywnie na biopsychspoleczne funkcjonowanie jednostki. Celem badan bylo określenie wielości problemu wystepowania zaburzen jakości snu u osob starszych. Badania do pracy zostaly przeprowadzano za pomocą anonimowej ankiety, ktora skladala sie z dwoch kwestionariuszy: Kwestionariusza Jakości Snu Pittsburgh (PSQI) oraz ankiety wlasnej konstrukcji. W badaniach wzielo udzial 100 osob a ankieta byla skierowana do osob po 50 roku zycia.. Badania pokazaly, ze ponad jedna piąta badanych ocenia swoj sen na raczej zly oraz wykazano istotne korelacje miedzy wydluzeniem czasu potrzebnego do zaśniecia a budzeniem sie w nocy lub nad ranem czy brakiem energii. Slowa kluczowe: sen, osoby starsze, geriatria Summary: According to the newest research over the half of geriatric population suffers from sleep disorders. Lowered quality of sleep has got a negative influence on biopsychosocial functioning of an individual. The aim of the study was to define the magnitude of the problem of sleep quality disorders occurrence in the elderly. The research for the study was carried out by means of anonymous survey which consists of two questionnaires: The Pittsburgh Sleep Quality Index (PSQI) and a survey constructed for the sake of the study. 100 people took part in the study and the survey was aimed at people over the age of 50. The research showed that over one fifth of the subjects assess their sleep as rather bad and significant correlations between lengthening the time needed to fall asleep and waking up at night or before dawn and the lack of energy. Key words: sleep, the elderly, geriatrics

Falls in the elderly – risk assessment and procedding

The aging of society was an incentive to the development of many fields of medicine including geriatric physiotherapy. Rehabilitation in geriatrics involves a range of issues connected with the involutional and/or disease related changes in the organism of an elderly person. To highlight the most important ones, so called ‘great geriatric problems’ were distinguished. One of them are falls. The risk of falls rises significantly after the age of 65. Among people older than 65 the chances of falls are 40% higher than among younger people. The article aims at showing the issues connected with the role of physiotherapy in falls prophylaxis in the elderly. The problem of falls in the elderly is mainly connected with the consequences of falls. Falls may lead to injuries, disability and even death. Falls prophylaxis should start with complex geriatric assessment. To assess the risk of falls a physiotherapist may use special scales: the stand up and go and the Tinetti test. After thorough analysis of the state of health of the elderly person appropriate prophylaxis measures may be chosen: removal of the environmental threats, appropriate selection of shoes as well as the assisting equipment, acute and chronic diseases treatment, pharmacotherapy modification, physiotherapy. Anti-fall rehabilitation usually focuses on balance training, expanding the range of motion, gait re-education and analgesic measures. In some medical centres special anti-fall programs are being developed, where physical activities and appropriate assisting equipment play the most important role. Modern physiotherapy methods enable individual anti-fall prophylaxis adjustment to the elderly person’s needs. The use of rehabilitation to diminish the risk of falls in the elderly is more and more common.