Biomedical subjects

Graham Ratcliff

Publications and source records attributed to Graham Ratcliff.

3 recordsLinked to original sources

PubMed2005

Long-term survival following traumatic brain injury.

PURPOSE: The study used a retrospective cohort design to establish long-term mortality rates and predictors of mortality for persons after moderate to severe traumatic brain injury (TBI). METHOD: Consecutive records of persons with moderate to severe TBI who were discharged from a large rehabilitation hospital in Pittsburgh, Pennsylvania in the years 1974-1984, 1988 and 1989 were reviewed. RESULTS: Six hundred and forty-two eligible individuals were identified and mortality was ascertained up to 24 years post injury. One hundred and twenty-eight of these individuals were found to be deceased. Poisson regression analyses revealed at least a 2-fold increased risk for mortality compared to the general population. Pre-injury characteristics and levels of disability at discharge from in-patient rehabilitation were among the strongest predictors of mortality. CONCLUSIONS: These data constitute evidence for premature death in the post-acute TBI population following a moderate to severe head injury and are discussed in relation to other research in the area.

Adolescent↗

PubMed2003

Tracking cognitive functioning over time: ten-year longitudinal data from a community-based study.

Over 10 years, a community-based sample age 65> or = years, with a starting cohort size of 1,206, was assessed biennially with the Mini-Mental State Exam; the Consortium to Establish a Registry for Alzheimer's Disease battery; Immediate and Delayed Recall of a Story; Verbal Fluency for P and S, Fruits and Animals; Clock Drawing; Temporal Orientation; and Trail Making tests. We report distributions of scores over time, at each wave, in (a) all individuals who were assessed at that wave, whether or not they participated in all waves, and (b) the Survivor subgroup of 425 participants who completed all tests at all 5 waves. Scores and factor structures remained remarkably stable over the study period. The most marked decline over time was seen on the Trail Making tests. As the survivors are de facto a largely healthy and motivated group, their data can be considered population-based healthy norms and may serve as a reference for other studies conducting repeated evaluations using the same tests.

Aged↗

PubMed2002

Sensitivity and specificity of cognitive and functional screening instruments for dementia: the Indo-U.S. Dementia Epidemiology Study.

There is a shortage of adequate screening instruments for dementia in poorly educated populations and non-English-speaking groups. An epidemiological survey was conducted in a population-based, largely illiterate, sample of 5,126 individuals aged 55 and older in 28 villages in the rural community of Ballabgarh in northern India. All participants were administered a general mental status test, the Hindi Mental State Examination (HMSE), and a brief battery of neuropsychological tests. Their informants answered a questionnaire assessing functional ability, the Everyday Abilities Scale for India (EASI). Six hundred thirty-two participants underwent clinical diagnostic evaluation for dementia. We investigated whether the sensitivity, specificity, and predictive value for dementia of the mental status test could be improved by the addition of the brief neuropsychological test battery or the functional questionnaire, comparing the instruments alone and in combination. In participants who could be tested cognitively, the HMSE, the neuropsychological battery, and EASI had sensitivities of 81.3%, 81.3%, and 62.5%, respectively, with specificities of 60.2%, 74.5%, and 89.7%, respectively. The combination of all three was 93.8% sensitive and 41.8% specific. The sensitivity of the HMSE alone was nonsignificantly improved by the addition of either the EASI or the neuropsychological battery, whereas its specificity was significantly decreased by either addition. An advantage of the EASI was that it could also be administered to informants of subjects who were cognitively untestable. In this largely illiterate community, with a low prevalence of dementia, the combination of cognitive tests and a functional ability questionnaire had substantial value for population screening.

Aged↗