Biomedical subjects

L W Duke

Publications and source records attributed to L W Duke.

6 recordsLinked to original sources

PubMed1997

Development and validation of a Structured Telephone Interview for Dementia Assessment (STIDA): the NIMH Genetics Initiative.

As part of the NIMH Genetics Initiative Alzheimer's Disease (AD) Study Group, a brief structured telephone interview to distinguish individuals with normal cognitive functioning from those with changes in cognition and daily functioning suggestive of early AD was developed. The Structured Telephone Interview for Dementia Assessment (STIDA), yields a dementia score between 0 and 81 (higher scores indicating greater impairment). Subscales corresponding to the subscales of the Clinical Dementia Rating Scale (CDR) can be derived. The STIDA performed well as a screening instrument for mildly demented individuals. When a score of 10 or more (based on informant interview and subject testing) was used to identify mildly impaired individuals, the STIDA had a sensitivity of .93 and a specificity of .92 for a clinician-derived CDR of 0.5 or more. The STIDA was also capable of accurately assessing the level of dementia. STIDA-derived CDR ratings agreed with clinician-derived CDR scores in 23 of 28 cases, corresponding to an unweighted kappa of.71 and a weighted kappa of.81. A much-abbreviated short STIDA that could be administered directly to the subject was able to detect possible impairment with a sensitivity of .93 and a specificity of.77. These results suggest that the short STIDA provides a sensitive and fairly specific telephone screen for dementia, and that the full STIDA, consisting of an interview with a knowledgeable informant and subject testing, approximates the success of a face-to-face clinical interview, and provides reliable and valid screening and staging of dementia over the telephone.

Aged↗

PubMed1997

Subscale validity of the Mattis Dementia Rating Scale.

The Mattis Dementia Rating Scale (DRS), a widely used dementia screening instrument, generates five subscale scores in the areas of Attention (ATT), Initiation-Perseveration (IP), Construction (CN), Conceptualization (CON), and Memory (MEM). The present study sought to determine the criterion validity of the DRS subscales in a sample of 50 patients with Alzheimer's disease (25 with mild and 25 with moderate dementia). Subject performance on the five DRS subscales was correlated with performance on five well-validated neuropsychological criterion measures using Pearson r and stepwise regression. On a univariate level, each DRS subscale correlated most strongly with its assigned neuropsychological criterion measure. On a multivariate level, each DRS subscale emerged as the Step 1 predictor of its assigned criterion measure, with the exception of DRS CN, which was the Step 2 predictor. The results suggested that overall the DRS subscales are valid measures of their respective constructs and have value for both clinical and research purposes in mild and moderate dementia.

Journal Article↗

PubMed1996

Effects of age and Alzheimer's disease on recognition of gated spoken words.

This study investigated the effects of normal aging and Alzheimer's disease on listeners' ability to recognize gated spoken words. Groups of healthy young adults, healthy older adults, and adults with Alzheimer's disease were presented isolated gated spoken words. Theoretical predictions of the Cohort model of spoken word recognition (Marslen-Wilson, 1984) were tested, employing both between-group and within-group comparisons. The findings for the young adults supported the Cohort model's predictions. The findings for the older adult groups revealed different effects for age and disease. These results are interpreted in relation to the theoretical predictions, the findings of previous gating studies, and differentiating age from disease-related changes in spoken word recognition.

Adolescent↗

PubMed1994

An analysis of home-based oral rehydration therapy in the Kingdom of Lesotho.

Mothers in developing countries are being successfully taught to give an oral rehydration solution (ORS) at home. The quantity of oral rehydration fluid that mothers administer to their child remains a critical question. Inadequate quantities render oral rehydration therapy (ORT) ineffective. The primary focus of our investigation was direct measurement of the quantity of fluid unsupervised mothers gave their children at home. This study validates a methodology that provides precise information on ORS administration in the home, information essential for evaluating the effectiveness of home-based therapy and for planning programmes to influence unsupervised mothers to correctly administer ORS to their sick children. This study, conducted in the Kingdom of Lesotho, assessed the impact on home care of the national control of diarrhoeal disease (CDD) programme. Direct observations in the home established each child's status and the quantity of fluid used 24 hr after children left the ORT unit where mothers were instructed to give ORS at home. Data were gathered on natural consequences that might discourage use of ORS, such as vomiting, increased frequency of watery stools and distaste for the solution. The health status of most of the 197 children followed improved. The average volume of ORS administered was 544 ml. A full liter was given by 21% of the mothers. Only 3% of the mothers gave no ORS. The average dose was 65 ml/kg. Younger children got about the same volume as older children; thus, they received a higher ml/kg dose. Mothers gave more ORS to children who had more symptoms of diarrhoeal disease at the time they were brought to the clinic.(ABSTRACT TRUNCATED AT 250 WORDS)

Child, Preschool↗

PubMedDate not supplied

Generation effect and frequency judgment in young and elderly adults.

In Experiment 1, young and old adults both generated and read the same words either two, five, or eight times (with frequencies combined orthogonally) and then judged the frequency of either the generated or read words. In Experiment 2, young and old adults generated and read different words either one, two, or three times and judged the frequency of both the generated and read words. In both experiments, generation, compared to reading, increased the slope of frequency judgments comparably for the two age groups. In Experiment 1, neither age group could discriminate read from generated frequency. In Experiment 2, a 24-h retention interval reduced the slope of frequency judgments, but did not interact with either age or generation efforts. These results seem most consistent with a semantic activation explanation of the generation effect and a familiarity-based judgment about frequency of occurrence.

Adult↗

PubMedDate not supplied

The clinical validity of the Mattis Dementia Rating Scale in staging Alzheimer's dementia.

Considerable heterogeneity exists in the criteria used for the establishment of stages of impairment for patients with dementia. The valid distinction of stages is important both for clinical interpretation and the study of dementia. This study reports on the use of the Mattis Dementia Rating Scale (DRS) in staging dementia. Using a sample of 42 patients diagnosed with Alzheimer-type dementia, DRS performance and a rating of Instrumental Activities of Daily Living (IADL) were compared with clinical ratings of dementia severity. Total DRS score provides a clinically valid measure of stage of impairment and appeared to provide a better distinction among stages than IADL score. However, use of the IADL score in conjunction with total DRS may improve correspondence with clinical staging over use of the total DRS score alone. Normative data for the DRS are also provided.

Activities of Daily Living↗