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An Interpretive Report for the Dementia Rating Scale–2™ (DRS-2™) is now available on PARiConnect. The DRS-2 measures mental status in adults with cognitive impairment and assesses an individual’s overall level of cognitive functioning.

The DRS-2 Interpretive Report provides:

  • Age-corrected subscale scores, an age- and education-corrected DRS-2 Total Score, and percentile subscale scores.
  • Interpretive text that describes the client’s overall performance and subtest performance.
  • A graphic profile of the client’s performance.

Save money and valuable clinical time by letting PARiConnect handle scoring and interpretation of your DRS-2 administrations without the investment of purchasing the entire software program.

Don’t have a PARiConnect account? It’s easy to sign up—plus you get three free administrations and three free reports! Learn more.

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More than 50 million people are living with Alzheimer’s disease and other dementias. Alzheimer’s disease is currently the only leading cause of death in the U.S. that cannot be prevented, cured, or slowed.  

 

What you should know about Alzheimer’s and other dementias 

  • Someone in the U.S. develops Alzheimer’s disease every 66 seconds. Estimates indicate this will increase to one every 33 seconds by 2050. 

  • Alzheimer’s is the most common cause of dementia among older adults. Most individuals with Alzheimer’s disease start exhibiting signs in their mid-60s. 

  • Just this month, the Food and Drug Administration approved the use of the drug aducanumab for Alzheimer’s patients, the first novel therapy to be approved since 2003. 

 

Ways you can show your support 

Raise awareness on social media. The Alzheimer’s Association makes it simple to update your Facebook profile with a frame in support of Alzheimer’s awareness. 

Share your story. Use hashtags #ENDALZ and #EndAlzheimers to share your story about how Alzheimer’s has touched your life and read more about how Alzheimer’s and other dementias have impacted people throughout the world.  

Wear purple. Show your support by wearing purple! You may even want to show your support by tying purple ribbons on your home or car to show your support. 

Raise funds through the Solstice Challenge. The longest day of the year—June 20—is a day dedicated to fighting against the darkness of Alzheimer’s. The Alzheimer’s Association offers suggestions on how you can participate, whether through games, parties, sports, or the arts! 

 

PAR offers a range of products designed to assess and monitor dementia. Learn more

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February 14-21 is Alzheimer’s and Dementia Staff Education Week. This week brings awareness to the importance of properly training individuals from a variety of fields. Whether you are a health care provider, 911 operator, first responder, clergy member, elder care attorney, or have another role working with the elderly, this week focuses on the importance of comprehensive dementia education. 

Beyond educating individuals beyond those in mental and physical health care about the importance of dementia education, the week also shines a spotlight on caregivers supporting individuals with these diagnoses. 

 

Some resources for Alzheimer’s disease and dementia care 

The National Institute on Aging is the primary government agency conducting research on Alzheimer’s disease. 

The Alzheimer’s Association is the leading voluntary health organization in Alzheimer’s care, support, and research. The association’s website offers resources for caregivers as well as those living with Alzheimer’s. 

The National Council of Certified Dementia Practitioners (NCCDP) provides resources, including seminars and training. NCCDP members may download a free Alzheimer’s and Dementia Staff Education Week toolkit from their website. 

 

Need help assessing for neurocognitive impairment? 

Patients with neurocognitive impairment such as dementia are often unreliable reporters of their symptoms. An observer—such as a family member, friend, or home health care nurse—can often provide valuable insight into an individual’s functioning. The Older Adult Cognitive Screener™ (OACS™) is a quick informant rating scale that helps provide information on a patient’s mental status and determine if there is a need for more in-depth testing. Learn more about the OACS

The Dementia Rating Scale–2™ (DRS-2™) measures mental status in individuals with cognitive impairment. It assesses an individual’s mental status over time. 

 

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Dementia is one of the most devastating diagnoses a patient and family can receive. It is a major cause of disability and dependency among older people worldwide, and nearly 10 million new cases are diagnosed globally each year. Early screening of dementia symptoms in older adults is critical to ensure timely treatment and intervention—and to minimize the impact on the patient and family.

PAR’s new neuropsychological assessment instrument, the Older Adult Cognitive Screener (OACS), will help you serve your older patients and their families with quicker answers. An all-digital informant rating scale, the OACS is designed for early screening of dementia symptoms for patients ages 55–90 years and will assist with follow-up determinations, including initiating or referring your clients for comprehensive diagnostic testing. Results are based on the observations and knowledge of a reliable caregiver, family member, or friend (e.g., spouse or home health care worker).

How does the OACS help you screen for neurocognitive impairments? 

1. Administration and scoring are rapid and reliable.

Raters can complete the items in only 5–10 minutes online, and scoring is instant via PARiConnect. Change Reports are available to help you track change over time.

2. The OACS is entirely digital, ideal for telehealth and social distancing.

Another significant advantage of the OACS is its digital format, which aligns well with today’s telehealth models and enables you to continue testing even when social distancing is required. Plus, because the OACS is administered through PARiConnect, data are easily exported into an electronic medical record (EMR) system.

Related article: SPEAKING MORE THAN ONE LANGUAGE MAY DELAY ONSET OF DEMENTIA

3. Items map onto DSM-5 domains.

The OACS is the only neurocognitive screener with items that map directly onto the six principal domains of neurocognitive function identified in the DSM-5®: executive function, complex attention, language, perceptual–motor, social cognition, and learning and memory. An additional item addresses activities of daily living (ADLs) to help you determine how the patient performs common physical tasks.

Why should I use the OACS?

Designed to be used in medical settings by primary care and specialty physicians, the OACS can also be administered and scored appropriately by nursing staff and properly trained clerical staff. It is also useful for clinical psychologists, neuropsychologists, and others who treat older adults on a clinical basis in a variety of mental health settings, including nursing homes and community mental health centers.

It was developed by trusted authors Cecil R. Reynolds, PhD, and Erin D. Bigler, PhD, to provide a rapid, cost-effective, and valid means of screening older adults for cognitive dysfunction.

To learn more or to order, visit parinc.com/OACS or call PAR Customer Support at 1.800.331.8378.

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This fall, PAR will add a new neuropsychological assessment instrument to our lineup: the Older Adult Cognitive Screener (OACS), an all-digital informant rating scale that enables you to make quick decisions about your older clients’ (ages 55 to 90 years) mental status. The OACS is designed for early screening of dementia symptoms and will assist with follow-up determinations, including initiating or referring your clients for comprehensive diagnostic testing. Administration and scoring take only 10 minutes.

Working with authors Cecil R. Reynolds, PhD, and Erin D. Bigler, PhD, our goal as we’ve developed the OACS was to provide a rapid, cost-effective, and valid means of screening older adults for cognitive dysfunction based on the observations and knowledge of a reliable caregiver, family member, or friend (e.g., spouse or home health care worker).

Unlike on similar measures, OACS items map directly onto the six principal domains of neurocognitive function identified in the DSM-5®: executive function, complex attention, language, perceptual–motor, social cognition, and learning and memory. Activities of daily living (ADLs) are also assessed.

Related article: TICS: ASSESS FOR COGNITIVE IMPAIRMENT REMOTELY

Another significant advantage of the OACS is its digital format, which aligns well with today’s telehealth models and enables you to continue testing even when social distancing is required. Plus, because the OACS is administered through PARiConnect, data are easily exported into an electronic medical record (EMR) system.

The OACS is designed to be used in medical settings by primary care and specialty physicians and can be administered and scored appropriately by nursing staff and properly trained clerical staff. It is also useful for clinical psychologists, neuropsychologists, and others who treat older adults on a clinical basis in a variety of mental health settings, including nursing homes and community mental health centers.

The OACS will be released this fall. For more information, or to preorder, visit parinc.com/OACS.

A recent study of 648 older adults in India suggests that those who were bilingual developed dementia more than four years later, on average, than those who spoke only one language—regardless of educational level.

Published recently in Neurology, the medical journal of the American Academy of Neurology (AAN), the study found that speaking two languages seems to have a protective effect against three types of dementia: Alzheimer’s disease, frontotemporal dementia, and vascular dementia.

“Speaking more than one language is thought to lead to better development of the areas of the brain that handle executive functions and attention tasks, which may help protect from the onset of dementia,” said study author Suvarna Alladi, DM, with Nizam’s Institute of Medical Sciences in Hyderabad, India, in a press release from the AAN.

The study subjects, all of whom were diagnosed with dementia, had an average age of 66. Approximately half spoke two or more languages; 14 percent were illiterate.

“These results offer strong evidence for the protective effect of bilingualism against dementia in a population very different from those studied so far in terms of its ethnicity, culture and patterns of language use,” Alladi said.

To learn more or to read the full article online, visit the Neurology Web site.
A remarkable transformation is taking place in nursing homes around the country as elderly patients are reconnecting with life through music. The brainchild of social worker Dan Cohen, a program called Music & Memory has created personalized iPod playlists for residents of elder care facilities, many of whom have Alzheimer's type dementia. The results have been truly life changing for patients as they are “reawakened” by the music of their youth.

Cohen is now working with renowned neuropsychologist Oliver Sacks (author of Musicophilia: Tales of Music and the Brain) on a documentary about Cohen’s program and the elderly patients who are responding so positively. In a clip from this documentary, a man reacts to hearing music from his past:

 

http://www.youtube.com/watch?v=fyZQf0p73QM

 

“Our approach is simple, elegant and effective,” says Cohen on his Music & Memory Web site. “We train elder care professionals how to set up personalized music playlists, delivered on iPods and other digital devices, for those in their care. These musical favorites tap deep memories not lost to dementia and can bring residents and clients back to life, enabling them to feel like themselves again, to converse, socialize and stay present.”

What do you think? Has music helped your clients with dementia to access memories and engage more positively in daily life? PAR wants to hear from you, so leave a comment and join the conversation!
One of the world’s most popular and trusted assessments of cognitive impairment is now available as a convenient app for smartphones and tablets. Like the paper-and-pencil version, the app can be used to screen for cognitive impairment, to select patients for clinical trials research in dementia treatment, or to track patients’ progress over time.

The MMSE/MMSE-2 app includes a brief instructional video that walks users through the features of the app. In addition to the original MMSE, both standard and brief versions of the MMSE-2 are available, enabling health care providers to choose the version that will suit each client. Scoring is done automatically, and patient records can be uploaded directly to an electronic medical records (EMR) system or e-mailed to appropriate personnel. Equivalent, alternate forms of the MMSE-2 decrease the possibility of practice effects that can occur over serial examinations. The app also includes norms for the MMSE and the MMSE-2, by age and education level.

The MMSE/MMSE-2 app is available to qualified health care professionals from the Apple® App StoreSM (for the iPhone® or iPad®) and from Google Play (for Android™ devices). The app is free—users pay only for administrations, which start at $1.25 each.

 
Broader Definition of the Disease Could Help Doctors with Early Diagnosis and Intervention

In April of this year, the National Institutes of Health and the Alzheimer’s Association announced significant changes in the clinical diagnostic criteria for Alzheimer’s disease dementia. These revisions—the first in 27 years—are intended to help diagnose patients in the very early stages of the disease, allowing doctors to prescribe medication when it is most effective; that is, before a patient’s memory becomes compromised.

The new guidelines recognize two early stages of the disease: preclinical Alzheimer's, in which biochemical and physiological changes caused by the disease have begun; and mild cognitive impairment, a stage marked by memory problems severe enough to be noticed and measured, but not severe enough to compromise a person’s independence. The new guidelines also reflect the increased knowledge scientists have about Alzheimer’s, including a better understanding of the biological changes that occur and the development of new tools that allow early diagnosis.

William H. Thies, chief scientific and medical officer of the Alzheimer’s Association, explains, “If we start 10 years earlier and could push off the appearance of dementia by, say, five years … that could cut the number of demented people in the U.S. by half” (Los Angeles Times, April 25, 2011).

For more information about the updated guidelines, as well as a list of journal articles and answers to frequently asked questions for clinicians, visit the National Institute on Aging Web site at http://www.nia.nih.gov/Alzheimers/Resources/diagnosticguidelines.htm.

What made you decide initially to develop the Mini-Mental® State Examination (MMSE)?


We developed the MMSE to solve a clinical problem on a geriatric psychiatric inpatient service. The diagnoses of patients on our unit included depression, dementia, delirium, and occasional late-life schizophrenia. We needed a practical quantitative cognitive exam in order to aide clinicians in determining the severity of cognitive impairment ranging from mild to severe and to document improvement or decline.

At the time, Susan was a psychiatry resident rotating on the geriatric psychiatric unit where I (Marshal) was a junior attending. Always a perfectionist, she was not happy when I repeatedly asked for cognitive information that she had not asked about. So she asked me to write down all the items that I wanted her to include.

What made you decide to update it and create the Mini-Mental® State Examination, Second Edition™ (MMSE®-2™)?


Over the years, students and other users made many suggestions about how to improve the MMSE. There was a need to clarify the instructions so that certain tasks were administered; there was a need for phrases that were more easily translated into other languages; and users requested multiple forms in order to minimize practice effects with serial administration. In addition, we had long wanted to develop a shorter version that could be given very quickly in busy clinical settings, and also a longer version that would eliminate ceiling effects. We wanted this longer version to be more sensitive than the original MMSE to disorders of executive function and to the kinds of memory impairment found in mild cognitive impairment.

What would you like to tell people about the MMSE-2 that they may not know?


The MMSE-2 Standard Version scores are equivalent to the original MMSE scores. We took care that subjects tested during development scored the same, regardless of whether they were given the original MMSE or the MMSE-2 Standard Version. Longitudinal studies currently underway can switch to the new version without any adjustment to scores. The original, unrevised MMSE is still available if users do not want to change to the revised versions.

How do you spend your free time?


Marshal takes flute lessons and is trying to improve his photography. Susan enjoys gardening and reading spy novels, biographies, Jane Austen, and Patrick O’Brian. She has a new job at the University of Miami School of Medicine with a joint appointment in psychiatry and in the Hussman Institute for Human Genomics. We both like to write and watch old movies.

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