Browsing by Author "Crowe, Michael"

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    Performance of the NINDS-CSN 5-Minute Protocol in a National Population-Based Sample
    (Cambridge University Press, 2014-09) Kennedy, Richard E.; Wadley, Virginia G.; McClure, Leslie A.; Letter, Abraham J.; Unverzagt, Frederick W.; Crowe, Michael; Nyenhius, David; Kelley, Brendan J.; Kana, Bhumika; Marceaux, Janice; Tamura, Manjula Kurella; Howard, Virginia; Howard, George; Department of Psychiatry, IU School of Medicine
    Background In 2006, the National Institute of Neurological Disorders and Stroke-Canadian Stroke Network (NINDS-CSN) Vascular Cognitive Impairment Harmonization Standards recommended a 5-Minute Protocol as a brief screening instrument for vascular cognitive impairment (VCI). We report demographically adjusted norms for the 5-Minute Protocol and its relation to other measures of cognitive function and cerebrovascular risk factors. Methods Cross-sectional analysis of 7,199 stroke-free adults in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study on the NINDS-CSN 5-Minute Protocol score. Results Total scores on the 5-Minute Protocol were inversely correlated with age and positively correlated with years of education, and performance on the Six-Item Screener, Word List Learning, and Animal Fluency (all p-values<0.001). Higher cerebrovascular risk on the Framingham Stroke Risk Profile (FSRP) was associated with lower total 5-Minute Protocol scores (p<0.001). The 5-Minute Protocol also differentiated between participants with and without confirmed stroke and with and without stroke symptom histories (p<0.001). Conclusions The NINDS-CSN 5-Minute Protocol is a brief, easily administered screening measure that is sensitive to cerebrovascular risk and offers a valid method of screening for cognitive impairment in populations at risk for VCI.
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    The relationship of cognitive change over time to the self-reported Ascertain Dementia 8-item Questionnaire in a general population
    (Oxford University Press, 2021) Passler, Jesse S.; Kennedy, Richard E.; Crowe, Michael; Clay, Olivio J.; Howard, Virginia J.; Cushman, Mary; Unverzagt, Frederick W.; Wadley, Virginia G.; Psychiatry, School of Medicine
    Objective: The aim of the study was to examine the relationship between longitudinally assessed cognitive functioning and self-reported dementia status using the Ascertain Dementia 8-item questionnaire (AD8) in a national population-based sample. Methods: The analysis included 14,453 participants from the REasons for Geographic and Racial Differences in Stroke study. A validated cutoff of ≥2 symptoms endorsed on the AD8 (administered 10 years after enrollment) represented positive AD8 status. Incident cognitive impairment was defined as change from intact to impaired status in the Six-Item Screener score, and cognitive decline was defined by trajectories of Letter "F" Fluency from the Montreal Cognitive Assessment, and Animal Fluency, Word List Learning, and Word List Delayed recall, all from the Consortium to Establish a Registry for Alzheimer's Disease battery. Logistic regression models controlled for demographics, health variables, and depressive symptoms. Results: Sensitivity and specificity of the AD8 to detect incident cognitive impairment were 45.2% and 78.4%, respectively. Incident cognitive impairment and a one-word decline in WLL increased the odds of self-reported positive AD8 by 96% (95% CI: 1.68-2.28) and 27% (95% CI: 1.17-1.37), respectively. There was a strong association between high depression risk and self-reported positive AD8 in sensitivity analyses. Conclusions: Incident cognitive impairment and high depression risk were the strongest predictors of self-reported positive AD8 in this population-based sample. Our results inform the utility of the AD8 as a self-report measure in a large, national sample that avoids selection biases inherent in clinic-based studies. The AD8 is screening measure and should not be used to diagnose dementia clinically.
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    Verbal Fluency in a National Sample: Telephone Administration Methods
    (Wiley, 2019-01-18) Marceaux, Janice C.; Prosje, Michelle A.; McClure, Leslie A.; Kana, Bhumika; Crowe, Michael; Kissela, Brett; Manly, Jennifer; Howard, George; Tam, Joyce W.; Unverzagt, Frederick W.; Wadley, Virginia G.; Psychiatry, School of Medicine
    Objectives: Describe novel methods for ascertaining verbal fluency in a large national sample of adults, examine demographic factors influencing performance, and compare scores to studies using in-person assessment. Methods/Design: Participants were from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study, a national, population-based, longitudinal study of stroke in adults aged 45 years an older. Letter and semantic fluency were gathered, using Letter “F” and Animal Naming, via a telephone-based assessment with computer-assisted scoring of digital recordings. Results: Initial letter and semantic fluency scores were obtained on 18,505 and 18,072 participants, respectively. For both fluency tests, scores were normally distributed. Younger age and more years of education were associated with better performances (p<0.0001). The mean and standard deviation for matched subgroups, based on age, gender, and education, were quite comparable to scores reported out of samples using an in-person administration format. Telephone-based assessment also allowed for a level of quality control not available via in-person measurement. Conclusions: Telephone-based assessment of verbal fluency and computer-assisted scoring programs designed for this study facilitated large scale data acquisition, storage, and scoring of protocols. The resulting scores have similar characteristics to those obtained by traditional methods. These findings extend validation of cognitive assessment methods, using survey research staff and computer-assisted technology for test administration.