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Cognitive Impairment in the Non-elderly: Validation of a New Tool to Assess Intellectual Disability in Community and Clinical Populations

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Abstract

In the absence of dementia or delirium, cognitive impairment in non-elderly adults is most often associated with intellectual or developmental disability. There is limited information about the prevalence of intellectual disability or its impact on mental disorders and health services use derived from epidemiological studies. Existing assessment measures of intelligence are not easily administered in large, population samples. This study investigates cognitive impairment in the non-elderly utilizing data from the NIMH Epidemiologic Catchment Area Program (ECA). The study also examines the validity and psychometric properties of a newly-developed, brief, and easily administered instrument to assess cognitive impairment in non-elderly adults in community and clinical populations. Utilizing items of the ECA Standardized Psychiatric Examination encompassing three domains—proverb interpretation, fund of knowledge, and interpretation of similarities and differences—a scale (PROFOKS) was developed and validated against various measures and indicators of cognitive impairment in both the community and clinical samples.

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References

  • American Association on Mental Retardation (1992). Mental retardation: Definition, classification, and systems of supports (9th edn.), Washington, DC.

  • Anthony, J. C., Folstein, M., Romanoski, A., Von Korff, M., Nestadt, G., Chahal, R., et al. (1985). Comparison of the lay Diagnostic Interview Schedule and a standardized psychiatric diagnosis: Experience in eastern Baltimore. Archives of General Psychiatry, 42, 667–675.

    PubMed  Google Scholar 

  • Axelrod, B. N., & Naugle, R. I. (1998). Evaluation of two brief and reliable estimates of the WAIS-R. The International Journal of Neuroscience, 94(1–2), 85–91.

    PubMed  Google Scholar 

  • Bowers, T. L., & Pantle, M. L. (1998). Shipley Institute for Living Scale and the Kaufman Brief Intelligence Test as screening instruments for intelligence. Assessment, 5(2), 187–195.

    Article  PubMed  Google Scholar 

  • Bruce, M. L., & McNamara, R. (1992). Psychiatric status among the homebound elderly: An epidemiologic perspective. Journal of the American Geriatrics Society, 40(6), 561–566.

    PubMed  Google Scholar 

  • Cooper-Patrick, L., Crum, R. M., Pratt, L. A., Eaton, W. W., & Ford, D. E. (1999). The psychiatric profile of patients with chronic diseases who do not receive regular medical care. International Journal of Psychiatry in Medicine, 29(2), 165–180.

    Article  PubMed  Google Scholar 

  • Cowley, A., Newton, J., Sturmey, P., Bouras, N., & Holt, G. (2005). Psychiatric inpatient admission of adults with intellectual disabilities: Predictive factors. American Journal on Mental Retardation, 110(3), 216–225.

    Article  PubMed  Google Scholar 

  • Eaton, W. W., Regier, D. A., Locke, B. Z., & Taube, C. A. (1981). The epidemiologic catchment area program of the National Institute of Mental Health. Public Health Reports, 96, 319–325.

    PubMed  Google Scholar 

  • Edinger, J. D., Shipley, R. H., Watkins, C. E., Jr., & Hammett, E. B. (1985). Validity of the Wonderlic Personnel Test as brief IQ measure in psychiatric patients. Journal of Consulting and Clinical Psychology, 53(6), 937–939.

    Article  PubMed  Google Scholar 

  • Fichter, M. M., Bruce, M. L., Schroppel, H., Meller, I., & Merikangas, K. (1995). Cognitive impairment and depression in the oldest old in a German and in US communities. European Archives of Psychiatry and Clinical Neuroscience, 245(6), 319–325.

    Article  PubMed  Google Scholar 

  • Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). Mini-Mental State: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.

    Article  PubMed  Google Scholar 

  • Folstein, M. F., Romanoski, A. J., Nestadt, G., Chahal, R., Merchant, A., Shapiro, S., et al. (1985). Brief report of the clinical reappraisal of the Diagnostic Interview Schedule carried out at the Johns Hopkins site of the Epidemiological Catchment Area Program of the NIMH. Psychological Medicine, 15, 809–814.

    Article  PubMed  Google Scholar 

  • Fryers, T. (1987). Epidemiological issues in mental retardation. Journal of Mental Deficiency Research, 31(Pt 4), 365–384.

    PubMed  Google Scholar 

  • Gallo, J. J., Rabins, P. V., & Anthony, J. C. (1999). Sadness in older persons: 13-year follow-up of a community sample in Baltimore, Maryland. Psychological Medicine, 29(2), 341–350.

    Article  PubMed  Google Scholar 

  • Gustafsson, C. (1997). The prevalence of people with intellectual disability admitted to general hospital psychiatric units: Level of handicap, psychiatric diagnoses and care utilization. Journal of Intellectual Disability Research, 41(Pt 6), 519–526.

    Article  PubMed  Google Scholar 

  • Hafner, J. L., Corotto, L. V., & Curnutt, R. H. (1978). The development of a WAIS short form for clinical populations. Journal of Clinical Psychology, 34(4), 935–937.

    Article  PubMed  Google Scholar 

  • Hall, W. (1996). What have population surveys revealed about substance use disorders and their co-morbidity with other mental disorders? Drug and Alcohol Review, 15(2), 157–170.

    Article  PubMed  Google Scholar 

  • Hand, J. E. (1994). Report of a national survey of older people with lifelong intellectual handicap in New Zealand. Journal of Intellectual Disability Research, 38(Pt 3), 275–287.

    PubMed  Google Scholar 

  • Heikura, U., Linna, S. L., Olsen, P., Hartikainen, A. L., Taanila, A., & Jarvelin, M. R. (2005). Etiological survey on intellectual disability in the Northern Finland birth cohort 1986. American Journal on Mental Retardation, 110(3), 171–180.

    Article  PubMed  Google Scholar 

  • Hybels, C. F., Blazer, D. G., & Kaplan, B. H. (2000). Social and personal resources and the prevalence of phobic disorder in a community population. Psychological Medicine, 30(3), 705–716.

    Article  PubMed  Google Scholar 

  • Janicki, M. P., Davidson, P. W., Henderson, C. M., McCallion, P., Taets, J. D., Force, L. T., et al. (2002). Health characteristics and health services utilization in older adults with intellectual disability living in community residences. Journal of Intellectual Disability Research, 46(Pt 4), 287–298.

    Article  PubMed  Google Scholar 

  • Klimczak, N. C., Bradford, K. A., Burright, R. G., & Donovick, P. J. (2000). K-FAST and WRAT-3: Are they really different? The Clinical Neuropsychologist, 14(1), 135–138.

    PubMed  Google Scholar 

  • Kramer, M., German, P. S., Anthony, J. C., Von Korff, M., & Skinner, E. A. (1985). Patterns of mental disorders among the elderly residents of eastern Baltimore. Journal of the American Geriatrics Society, 33(4), 236–245.

    PubMed  Google Scholar 

  • Kvaal, S. A., Wygonik, E., Spanos, A., & Landsberger, S. (2001). A revalidation of the Thurstone Test of Mental Alertness as a brief measure of intelligence through comparison with the Wechsler Adult Intelligence Scale-III. Psychological Reports, 88(2), 581–586.

    Article  PubMed  Google Scholar 

  • La Malfa, G., Lassi, S., Bertelli, M., Salvini, R., & Placidi, G. F. (2004). Autism and intellectual disability: A study of prevalence on a sample of the Italian population. Journal of Intellectual Disability Research, 48(Pt 3), 262–267.

    Article  PubMed  Google Scholar 

  • Lyketsos, C. G., Chen, L. S., Anthony, J. C. (1999). Cognitive decline in adulthood: An 11.5 year follow-up of the Baltimore epidemiologic catchment area study. The American Journal of Psychiatry, 156, 58–65.

    PubMed  Google Scholar 

  • Mansell, J., Ashman, B., Macdonald, S., & Beadle-Brown, J. (2002). Residential care in the community for adults with intellectual disability: Needs, characteristics and services. Journal of Intellectual Disability Research, 46(Pt 8), 625–633.

    Article  PubMed  Google Scholar 

  • Mason, J., & Murphy, G. (2002). People with an intellectual disability in the criminal justice system: Developing an assessment tool for measuring prevalence. The British Journal of Clinical Psychology, 41(Pt 3), 315–320.

    Article  PubMed  Google Scholar 

  • Myers, B. A. (1987). The Mini-Mental State in those with developmental disabilities. The Journal of Nervous and Mental Disease, 175(2), 85–89.

    Article  PubMed  Google Scholar 

  • Narrow, W. E., Regier, D. A., Norquist, G., Rae, D. S., Kennedy, C., & Arons, B. (2000). Mental health service used by Americans with severe mental illnesses. Social Psychiatry and Psychiatric Epidemiology, 35(4), 147–155.

    Article  PubMed  Google Scholar 

  • Pfeiffer, E. (1975). A short Portable Mental Status Questionnaire for the assessment of organic brain deficit in elderly patients. Journal of the American Geriatrics Society, 23(10), 433–441.

    PubMed  Google Scholar 

  • Purser, J. L., Fillenbaum, G. G., Pieper, C. F., & Wallace, R. B. (2005). Mild cognitive impairment and 10-year trajectories of disability in the Iowa established populations for epidemiologic studies of the elderly cohart. Journal of the American Geriatrics Society, 53(11), 1966–1972.

    Article  PubMed  Google Scholar 

  • Rabins, P. V., Black, B., German, P., Roca, R., McGuire, M., Brant, L., et al. (1996). The prevalence of psychiatric disorders in elderly residents of public housing. Journals of Gerontology. Series A, Biological sciences and Medical Sciences, 51(6), M319–M324.

    Google Scholar 

  • Rice, D. P., & Miller, L. S. (1998). Health economics and cost implications of anxiety and other mental disorders in the United States. The British Journal of Psychiatry, 173(Suppl. 34), 4–9.

    Google Scholar 

  • Robbins, L. N., Helzer, H. E., Croughan, J., Williams, J. B. W., & Spitzer, R. L. (1981). NIMH diagnostic interview schedule, version III. Rockville, MD: National Institute of Mental Health.

    Google Scholar 

  • Shuttleworth-Edwards, A. B., Kemp, R. D., Rust, A. L., Muirhead, J. G., Hartman, N. P., & Radloff, S. E. (2004). Cross-cultural effects on IQ test performance: A review and preliminary normative indications on WAIS-III test performance. Journal of Clinical and Experimental Neuropsychology, 26(7), 903–920.

    Article  PubMed  Google Scholar 

  • Silver, J. M., Kramer, R., Greenwald, S., & Weissman, M. (2001). The Association between head injuries and psychiatric disorders: Findings from the New Haven NIMH Epidemiologic Catchment Area Study. Brain Injury, 15(11), 935–945.

    Article  PubMed  Google Scholar 

  • Swanson, J., Estroff, S., Swartz, M., Borum, R., Lachicotte, W., Zimmer, C., et al. (1997). Violence and severe mental disorder in clinical and community populations: The effect of psychotic symptoms, comorbity and lack of treatment. Psychiatry, 60(1), 1–22.

    PubMed  Google Scholar 

  • Swofford, C. D., Scheller-Gilkey, G., Miller, A. H., Woolwine, B., & Mance, R. (2000). Double jeopardy: Schizophrenia and substance use. The American Journal of Drug and Alcohol Abuse, 26(3), 343–353.

    Article  PubMed  Google Scholar 

  • Van Schrojenstein Lantman-de Valk, H. M., Metsemakers, J. F., Soomers-Turlings, M. J., Haveman, M. J., & Crebolder, H. F. (2000). Health problems in people with intellectual disability in general practice: A comparative study. Family Practice, 17(5), 405–407.

    Article  PubMed  Google Scholar 

  • Verney, S. P., Granholm, E., Marshall, S. P., Malcarne, V. L., & Saccuzzo, D. P. (2005). Culture-fair cognitive ability assessment: Information processing and psychophysiological approached. Assessment, 12(3), 303–319.

    Article  PubMed  Google Scholar 

  • Welch, D. C., & West, R. L. (1999). The Short Portable Mental Status Questionnaire: Assessing cognitive ability in nursing home residents. Nursing Research, 48(6), 329–332.

    Article  PubMed  Google Scholar 

  • Yen, Y. C., Yang, M. J., Shih, C. H., & Lung, F. W. (2004). Cognitive impairment and associated risk factors among aged community members. International Journal of Geriatric Psychiatry, 19(6), 564–569.

    Article  PubMed  Google Scholar 

  • Zweig, M. H., & Campbell, G. (1993). Receiver-operating characteristics (ROC) plots: A fundamental evaluation tool in clinical medicine. Clinical Chemistry, 39(4), 561–577.

    PubMed  Google Scholar 

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Correspondence to Gerard Galluccci.

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Table 4 PROFOKS instrument

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Galluccci, G., Hackerman, F., Nestadt, G. et al. Cognitive Impairment in the Non-elderly: Validation of a New Tool to Assess Intellectual Disability in Community and Clinical Populations. J Dev Phys Disabil 19, 519–530 (2007). https://doi.org/10.1007/s10882-007-9068-2

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