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O'Caoimh R.,St Finbarrs Hospital | Gao Y.,St Finbarrs Hospital | McGlade C.,St Finbarrs Hospital | Healy L.,St Finbarrs Hospital | And 3 more authors.
Age and Ageing | Year: 2012

Introduction: differentiating mild cognitive impairment (MCI) from normal cognition (NC) is difficult. The AB Cognitive Screen (ABCS) 135, sensitive in differentiating MCI from dementia, was modified to improve sensitivity and specificity, producing the quick mild cognitive impairment (Qmci) screen.Objective: this study compared the sensitivity and specificity of the Qmci with the Standardised MMSE and ABCS 135, to differentiate NC, MCI and dementia.Methods: weightings and subtests of the ABCS 135 were changed and a new section 'logical memory' added, creating the Qmci. From four memory clinics in Ontario, Canada, 335 subjects (154 with MCI, 181 with dementia) were recruited and underwent comprehensive assessment. Caregivers, attending with the subjects, without cognitive symptoms, were recruited as controls (n = 630).Results: the Qmci was more sensitive than the SMMSE and ABCS 135, in differentiating MCI from NC, with an area under the curve (AUC) of 0.86 compared with 0.67 and 0.83, respectively, and in differentiating MCI from mild dementia, AUC of 0.92 versus 0.91 and 0.91. The ability of the Qmci to identify MCI was better for those over 75 years.Conclusion: the Qmci is more sensitive than the SMMSE in differentiating MCI and NC, making it a useful test, for MCI in clinical practice, especially for older adults. © The Author 2012. Published by Oxford University Press on behalf of the British Geriatrics Society. Source


Ryan J.,Alimentary Pharmabiotic Center | Murphy C.,Alimentary Health Ltd. | Twomey C.,St Finbarrs Hospital | Paul Ross R.,National University of Ireland | And 5 more authors.
Irish Journal of Medical Science | Year: 2010

Introduction: Clostridium difficile is an increasing cause of nosocomial diarrhoea and colitis. The aim of this study was to identify the prevalence and characteristics of asymptomatic C. difficile carriage in a continuing care institution for the elderly. Methods: Stool samples were collected from 100 asymptomatic patients, whose median age was 83 years. Samples were tested for C. difficile using traditional culturing methods, 16s rDNA and 16s-23s intergenic spacer (IGS) rDNA sequencing, and analysed for toxin production and toxin genes. Results: The prevalence of C. difficile carriage was 10/100 (10%) following culture and 16s and IGS sequencing. An additional seven isolates, initially identified as C. difficile, were subsequently identified by IGS rDNA sequencing as C. sordellii of the 10% that tested positive for C. difficile, seven tested positive for toxin A and B. A significant number of C. difficile carriers had recent antibiotic exposure compared with non-carriers, P = 0.046. Conclusion: The prevalence of asymptomatic C. difficile carriage in this institution was 10%, 7% of which were toxin positive. This study underscores the importance of increased vigilance for C. difficile using microbial and molecular methodology and identifies patients at increased risk following antibiotic administration. © 2009 Royal Academy of Medicine in Ireland. Source


O'Caoimh R.,St Finbarrs Hospital | Svendrovski A.,McMaster University | Johnston B.C.,McMaster University | Gao Y.,St Finbarrs Hospital | And 5 more authors.
Journal of Clinical Epidemiology | Year: 2014

Objectives The Alzheimer's Disease Assessment Scale-cognitive section and its standardized version (SADAS-cog) are the current standard for assessing cognitive outcomes in clinical trials of dementia. This study compares a shorter cognitive instrument, the Quick Mild Cognitive Impairment (Qmci) screen, with the SADAS-cog as outcome measures in clinical trials. Study Design and Setting The SADAS-cog, Qmci, Clinical Dementia Rating (CDR) scale, and the Lawton-Brady activities of daily living (ADL) scale were assessed at multiple time points, over 1 year in a multicenter randomized clinical trial of 406 patients with mild to moderate Alzheimer's dementia. Correlations were estimated using regression at each time point, all time points, and mean values across time. Responsiveness was assessed using the standardized response mean (SRM). Results Regression for pooled time points showed strong and significant correlation between the SADAS-cog and Qmci (r = -0.75, P < 0.001). Correlations remained strong for mean values across time and at each time point. The SADAS-cog and Qmci also correlated with CDR and ADL scores. There was no difference in SRMs between the SADAS-cog and Qmci [t(357) = -0.32, P = 0.75]. Conclusion The Qmci correlated strongly with the SADAS-cog and both were equally responsive to deterioration. We suggest that clinicians and investigators can substitute the shorter Qmci for the SADAS-cog. © 2014 Elsevier Inc. All rights reserved. Source

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