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ACOS

Richard Uwakwe* Ifeoma Modebe Ifeoma Njelita Nkiru Ezeama Toochukwu Mbachi. *Faculty of Medicine College of Health Sciences Nnamdi Azikiwe University Awka NIGERIA. ACOS. ACOS.

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ACOS

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  1. Richard Uwakwe* Ifeoma Modebe Ifeoma Njelita Nkiru Ezeama Toochukwu Mbachi *Faculty of Medicine College of Health Sciences Nnamdi Azikiwe University Awka NIGERIA. ACOS NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  2. ACOS Screening for memory impairment in community dwelling older adults in rural Nigeria: use of the Short Blessed memory test. NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  3. background1 Controversies about screening for dementia in non patient community dwelling older adults. NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  4. background2 Some research and consensus reports: Risk dates much earlier May no longer be modifiable once disease has begun Not clearly recommended. NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  5. background3 Other findings and reports: Potential to delay progression when detected early Leads to evaluation Determines further clinical approach NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  6. background4 Aim: What is the utility of the Short Blessed memory test in community dwelling older adults in rural Nigeria. NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  7. background5 First phase in a planned whole Local Government Area cognitive study in Anambra State, South East, Nigeria. NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  8. methods1 The six item short Blessed Memory test administered to 50 participants. Site: Dunukofia Social Centre, near Abagana, Njikoka NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  9. setting1 NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  10. setting2 NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  11. methods2 BOCM tests: Year month time counting 20 to 1 backwards months of the year in reverse order memory phrase to recall. NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  12. methods3 Within less than 5 minutes In this study, the memory phrase was changed to a local language name and address. NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  13. methods4 Scoring of Blessed: Weighted Total score range=0-29 No error=0 Cut score consistent with dementia=≥ 10 NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  14. results1 NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  15. results2 NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  16. results3 NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  17. results4 NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  18. results5 NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  19. results Score on Blessed Range=12-21 Mean=17 ± 3.6 NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  20. results NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  21. results6 NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  22. results7 NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  23. results8 Time now Wrong=100% NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  24. results9 NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  25. results10 NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  26. results11 NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  27. comments1 Main considerations in choosing a screening test : Practicality Applicability in settings in which the older adults receive their care. NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  28. comments2 To be considered: • Sensitivity • Specificity • Validity • Testing cost • Ceiling/flooring NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  29. comments3 The financial effects of the test i.e.: Benefits of a true-positive finding Costs of a false-positive finding Epidemiology of dementia . NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  30. comments4 With a score range of 12- 21 , mean of 17±3.6, on the Blessed test and a recommended cut score of ≥ 10, 100% of the participants would be +ve for dementia. Spurious ! NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  31. comments5 Great confounds of cognitive tests Age Gender Education Race Ethnicity Culture NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  32. comments6 The sense of time in rural Nigeria seems to be entirely different from what it is in developed countries : Morning, afternoon, evening . No participant was able to state the exact time within one hour error margin. NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  33. comments7 Worst performances : Months of the year backwards ( 1 person=2%) correct Present year ( 3 persons=6% ) correct NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  34. comments8 Surprisingly only 8% correctly recalled a local name and exact address five minutes after its first presentation. NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  35. comments9 ? Villages / rural communities have no street numbers NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  36. Comments 10 The best performance was in counting 20 backwards. The unmodified six item Blessed short memory tests can not be used to screen for cognitive impairment in community older adults in Nigeria. NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  37. comments11 The currently available tests appear too long for screening in the rural Nigerian setting. NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  38. comments12 Enormous cultural adaptation needed for a very short and quick screener ? A one stage assessment / diagnosis may be a trade off (depending on use). NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

  39. limitations GMS result- not presented NNAMDI AZIKIWE UNIVERISTY AWKA NIGERIA

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