The population of China is ageing. Accompanying this aging population, dementia and frailty have a growing importance. However there is little consensus on the association between dementia and frailty, in terms of how the criteria that are part of this two syndromes overlap, as both disorders are age-related and increase the risk for falls, further leading to loss of independence. To meet the above needs, the thesis describes research into different frailty diagnostic criteria, as well as its association with dementia symptoms. We examined cognitive measures that can be used for assessment of Mild Cognitive Impairment (MCI) and dementia screening (the Hopkins Verbal Learning Test, HVLT) and compared its discriminant ability with the commonly used cognitive screening tool, the Mini-Mental State Examination (MMSE) in distinguishing Cognitive Impairment (including MCI and dementia) from No Cognitive Impairment (NCI, normal controls) in two community-dwelling elderly Chinese populations and in one institutionalised elderly population in Shanghai, China. Subsequently we investigated whether physical and cognitive symptoms clustered together to form frailty phenotypes. We employed indicators that have been widely used to diagnose frailty, including physical measures (grip strength, Time-Up and Go test, 15 feet gait speed test and Berg balance test), and psychological measures (the HVLT and the MMSE) to predict cognitive impairment (CI) and frailty. Additionally, we described demographics (age, gender, education) and other potential modifiers when detecting cognitive impairment and functional disability. We then built up a model for possible frailty phenotype using various indicators. Lastly, we examined whether demographic (age, gender, education and profession), and lifestyle (smoking/alcohol history, exercise frequency, and dietary habit) could be used to predict future cognitive impairment. It was found that advanced age, lower education (no or primary level), and being vegetarian were significant risk factors for cognitive impairment. Furthermore, whereas high consumption of green vegetables is a protector against cognitive impairment, high intake of tofu was negatively related to cognitive performance among community-dwelling elderly in China. To meet the above needs, the thesis describes research into different frailty diagnostic criteria, as well as its association with dementia symptoms. We examined cognitive measures that can be used for assessment of Mild Cognitive Impairment (MCI) and dementia screening (the Hopkins Verbal Learning Test, HVLT) and compared its discriminant ability with the commonly used cognitive screening tool, the Mini-Mental State Examination (MMSE) in distinguishing Cognitive Impairment (including MCI and dementia) from No Cognitive Impairment (NCI, normal controls) in two community-dwelling elderly Chinese populations and in one institutionalised elderly population in Shanghai, China. Subsequently we employed these two cognitive measures to investigate whether they were part of the frailty syndrome among elderly from the community-based studies. We investigated whether physical and cognitive symptoms clustered together to form frailty phenotypes. We employed indicators that have been widely used to diagnose frailty, including physical measures (grip strength, Time-Up and Go test, 15 feet gait speed test and Berg balance test), and psychological measures (the HVLT and the MMSE) to predict cognitive impairment (CI). We found four distinct subtypes of elderly characterised by increasing care needs: 1. Persona elderly as defined by age >78, year of education<6 years, grip strength <11.8 KG, and a MMSE total score <25; 2. Persona Physical frailty (fitness), defined by a total score on the Timed-Up and Go (TUG) test >12.7 seconds and 15 feet gait speed >4.4 seconds; 3. Persona Cognitive impairment, defined by a MMSE total score <25, a HVLT Immediate Recall (IR) score <15, and a HVLT Delayed Recall (DR) <5; 4. Persona Physical frailty (balance,) defined by a Berg Balance test score of <53. Additionally, we described demographics (age, gender, education) and other potential modifiers when detecting cognitive impairment and functional disability. We then built up a model for possible frailty phenotype using various indicators, Frailty here was defined as: 1. Low BMI as measured by this algorithm: BMI= Weight (kg)/Height (m)2 2. Weakness (upper and lower body): grip strength in the lowest quintile, adjusted for gender; and TUG get up with assistance or unable to get up 3. Slowness (lower body): TUG score in the lowest quintile, adjusted for gender; and 15 feet gait speed in the lowest quintile, adjusted for gender; 4. Poor balance: Berg Balance test score in the lowest quintile, adjusted for gender; 5. Low physical activity: engaging in exercise less than once per week. An individual with 4 or more present frailty components out of a total of 7 was considered to be frail , whereas equal or less than 3 characteristics were hypothesized to be pre-frail . Those with no present frailty components were considered as robust. Lastly, we examined whether demographic (age, gender, education and profession), and lifestyle (smoking/alcohol history, exercise frequency, and dietary habit) could be used to predict future cognitive impairment (as defined by a HVLT IR score of ≤19). The results of our studies show that compared to the MMSE, the HVLT is superior in differentiating MCI and dementia from NCI, and is also less affected by demographic factors in detecting frailty. Furthermore, in the current study, physical, psychological, demographic and other modifiable risk factors cluster together into different phenotypes of cognitive impairment and functional disability in these cohorts. A phenotype of frailty is built up using BMI, grip strength, TUG, 15 feet gait speed, balance and exercise frequency as indicators. The most common was the elderly phenotype followed by the cognitively impaired. A novel finding of the current study is that only 4.8% (8 out 168) of the whole sample fulfilled all three categories in the current study (cognitive impairment, functional disability and frailty). Finally, advanced age, lower education (no or primary level), and being vegetarian were significant risk factors for cognitive impairment. Furthermore, whereas high consumption of green vegetables is a protector against cognitive impairment, high intake of tofu was negatively related to cognitive performance among community-dwelling elderly in China.

Accurate, early diagnosis of Alzheimer's Disease is becoming increasingly important in light of its growing prevalence among the expanding older-aged adult population. Due to its ability to assess multiple domains of cognitive functioning and provide a profile of impairment rather than a simple global score, the Neurobehavioral Cognitive Status Examination (NCSE) is suggested to better assess such patterns of cognitive deficit for the purpose of diagnosis. The performance of the NCSE was compared with that of the Mini-Mental State Examination (MMSE) for diagnostic sensitivity in a sample of patients diagnosed as having probable Alzheimer's Disease. The strength of correlation between severity of cognitive impairment on these tests and report of behavior problems on the Memory and Behavior Problems Checklist (MBPC) was also explored, as was performance on the NCSE and report of behavior problems using the MBPC in predicting Single Photon Emission Computed Tomography (SPECT) scan results. The NCSE was found to exhibit greater sensitivity to physician diagnosis of probable Alzheimer's Disease relative to two versions (Serial 7's or WORLD) of the MMSE (.90, .77 and .68, respectively). While both measures were found to correlate significantly with the report of behavior problems, only a moderate proportion (NCSE = .22 and MMSE = .33) of the explained variance was accounted for by either test. Severity of cognitive impairment on the NCSE was found to be significant, though small in estimate of its effect size, for predicting the absence/presence of pathognomic findings on SPECT scans. In contrast, the report of behavior problems on the MBPC did not significantly predict SPECT scan outcomes. The NCSE would appear to be a sensitive tool for the identification of the extent and severity of cognitive impairment found among demented individuals; however, it may be "over"-sensitive to such diagnosis. Although relationships between cognitive impairment and behavior problems and/or neuroradiological findings are observed, their meaningfulness remains with the need for further, more detailed, study using standardized criteria for comparison purposes.

Cold exposure activates the sympathetic nervous system and increases the concentration of beta-endorphin and noradrenaline in the blood, thus contributing to overall well-being. The aim of this thesis is to collect data of a selected sample of the population about their well-being and at the same time-frequency of hardening and find out the possible connection. 39 students from the Pedagogical Faculty of the University of South Bohemia participated in the study of hardening in the age range 19 - 25 years. The probands were divided into experimental and control groups. For about 3 months, 26 probands were hardened by cold showers. Data on the structure of the mental status of probands were obtained using the SUPOS questionnaire before and after the hardening period. Based on this analysis, it was found, that the experimental group showed a higher degree of well-being, with a simultaneous decline in impulsiveness, psychological unrest and anxiety expectations and fears, but statistically inconclusive. The positive influence of hardening of the organism on human well-being cannot be confirmed by the conclusion of this thesis.

No description available.

xiv, 149 p. A print copy of this thesis is available through the UO Libraries. Search the library catalog for the location and call number. / Three types of literate words, including abstract nouns (freedom, challenge), mental state verbs (assume, explain), and derivatives (relationship, respectful), were examined in narrative and expository writing in typically developing children and adolescents. It was predicted that older students would use literate words more frequently than younger students, and that literate words would occur more frequently in expository writing than in narrative writing. One hundred and twenty typically developing children and adolescents including forty 5th graders, forty 8th graders, and forty 11th graders wrote one narrative and one expository essay at school. The results showed that genre had a substantial impact on the use of literate words in the writing of school-age children and adolescents. except metalinguistic verbs. Moreover, literate words were used significantly more often in expository than in narrative text, except derived adjectives. Additionally, metalinguistic verbs occurred more often in narrative writing than expository writing; however, the difference was not statistically significant. Age-related increases occurred in the use of abstract nouns, derived nominals, early/late developing metacognitive verbs and late developing metalinguistic verbs in narrative writing. Age-related increases also occurred in the use of derived adjectives, and late developing metacognitive and metalinguistic verbs in expository writing. The present study adds to the knowledge base concerning the development of literate word use in narrative and expository writing in typically developing children and adolescents. / Adviser: Marilyn Nippold

This study has the objective of investigating the performance of adults and seniors in terms of working memory skills and at the Mini-Exam of Mental State, verifying how these skills relate to each other, to the age and to the scholarship level. The sample was composed by 34 people, with ages among 37 and 83 years-old, Brazilians, Portuguese speakers, literate and without any evident and referred neurological and/or cognitive alterations and it was shared into four groups according to the age group. The adults and seniors performance at the working memory assessments was checked through the repetition of non-words task to assess specifically the phonological memory and the repetition of a sequence of digits to assess the central executive and the phonological memory, according to Baddeley and Hitch s proposal (1974 apud GATHERCOLE & BADDELEY, 1993). The Mini-Mental State Examination, Folstein and McHugh s proposal (1975), was used to assess the orientation, immediate memory, attention, calculation, mandate, language, reading and constructive praxis. In order to analyze the co-relation among the evaluations it was used the non parametric test, the Sperarman s Correlation Coefficient, from which it was identified: 1) the younger people had a better performance at the three tasks applied when compared with the older ones; 2) there was a significant correlation between the repetition of non-words and repetition of a sequence of digits tasks; 3) the Mini-Mental State Examination has a small correlation with the memory working tasks; 4) it was observed significant correlation of age and scholarship with the tasks of repetition of non-word, repetition of a sequence of digit and Mini-Mental State Examination. Comparing the four groups, it was verified that the rightness average at the three assessmests diminished as much as the age group increased. It was observed that the rightness averages at the working memory and Mini- Mental State Examination tasks increased according to the scholarship level. It concluded that older people with low scholarship level, considered as a group not individually, present smaller performance at the working memory and Mini-Mental State Examination tasks than younger people and with higher scholarship level / Este estudo teve por objetivo investigar o desempenho de adultos e idosos em habilidades de memória de trabalho e no Mini-Exame do Estado Mental, verificando como estas habilidades relacionam-se entre si, com a faixa etária e com o nível de escolaridade. A amostra foi formada por 34 sujeitos, com idades entre 37 e 83 anos, brasileiros, falantes do português, alfabetizados e sem alterações neurológicas e/ou cognitivas evidentes e referidas, e foi dividida em quatro grupos conforme a faixa etária. O desempenho dos adultos e idosos nas avaliações de memória de trabalho foi verificado através da tarefa de repetição de não-palavras para avaliar especificamente a memória fonológica, e da tarefa de repetição de seqüência de dígitos para avaliar o executivo central e a memória fonológica, segundo a proposta de Baddeley & Hitch (1974 apud GATHERCOLE & BADDELEY, 1993). O Mini-Exame do Estado Mental, proposto por Folstein & McHugh (1975), foi utilizado para avaliar orientação, memória imediata, atenção, cálculo, evocação, linguagem, leitura e praxia construtiva. Para analisar a correlação entre as medidas foi utilizado o teste não-paramétrico Coeficiente de Correlação de Spearman, através dos quais verificou-se que: 1) os sujeitos mais jovens desempenharam melhor as três tarefas aplicadas quando comparados com os sujeitos mais velhos; 2) houve correlação significativa entre as tarefas de repetição de não-palavras e repetição de seqüência de dígitos; 3) o Mini-Exame do Estado Mental apresentou fraca correlação com as tarefas de memória de trabalho; 4) houve correlação significativa entre idade e escolaridade com as tarefas de repetição de nãopalavras, repetição de seqüência de dígitos e com o Mini-Exame do Estado Mental. Na comparação entre os quatro grupos, verificou-se que as médias de acertos nas três avaliações aplicadas diminuíram conforme a faixa etária aumentou. Comparando-se as médias de acertos nas tarefas de memória de trabalho e no Mini-Exame do Estado Mental de acordo com o grau de escolaridade, observou-se que as médias nas tarefas analisadas aumentaram em função do grau de escolaridade. Concluiu-se que sujeitos mais velhos e com baixa escolaridade, quando considerados como um grupo e não individualmente, apresentam desempenho inferior nas tarefas de memória de trabalho e no Mini-Exame do Estado Mental do que os sujeitos mais jovens e com níveis mais altos de escolaridade

Föräldrar pratar olika med sina barn och ett sätt att prata på är med mental-state-talk vilket har visats främja barns utveckling på olika sätt. Föreliggande studie syftade till att beskriva föräldrars mental-state-talk och analysera sambandet med barns språkutveckling samt mängden tid ägnad åt läsning för barnet i hemmet. För att undersöka detta transkriberades inspelade filmer där föräldrar (N=78) narrativt berättade en saga från en bilderbok för sina barn i tvåårsåldern. Utifrån transkriptionerna räknades totalt antal ord och föräldrarnas mental-state-talk kodades och analyserades. Det korrelerades sedan med barnens språkutveckling utifrån ordförråd, pragmatik och grammatik mätt med The Swedish Early Communicative Development Inventory - Words and Sentences (SECDI-w&amp;s). Resultatet visade att föräldrarna pratade mest om kognitiva mentala tillstånd och riktade flest ord om mentala tillstånd till karaktärer i boken. Inga signifikanta skillnader hittades mellan mammor och pappor. Resultaten visade positiva signifikanta samband mellan föräldrarnas mental-state-talk och barnens ordförråd och grammatik, men ingen signifikant korrelation med barnens pragmatik. Föräldrarnas totala mängd ord hade endast ett positivt samband med barnens grammatik. Föräldrarnas mental-state-talk korrelerade inte signifikant med mängden tid som ägnades åt läsning för barnet i hemmet. Resultaten tyder på att det är sättet som föräldrar pratar på, om de pratar mycket om mentala tillstånd, snarare än hur mycket de pratarsom har samband med barns språkutveckling.

This thesis deals with the neuropsychological diagnosis of Alzheimer's disease. The aim is to evaluate the psychometric characteristics ofthe new Czech translation of the Montreal Cognitive Assessment (MoCA) by comparison with the Mini-Mental State Examination (MMSE), a method widely used by doctors inscreening diagnostics of Alzheimer's disease. The theoretical part deals with the diagnostics of Alzheimer's disease and mild cognitive impairment. We describe international diagnostic criteria of cognitive disorders and provide an overview of the screening neuropsychological methods most commonly used by Czech specialists. We summarize the current psychometric and psychodiagnostic findings on these methods and focuse on description of MMSE and MoCA. In the empirical part we compare Czech version of MMSE and MoCA-CZ (the new Czech translation of the test). We examined 38 patients with Alzheimer's disease and 70 cognitively healthy seniors. The results show that MoCA-CZ is sufficiently valid and reliable screening method that accurately distinguishbetween healthy subjects and patiens with Alzheimer's disease. We believe that it can enrich screening tools that are available to Czech experts. Key words: Montreal Cognitive Assessment, Mini-Mental State Examination, Alzheimer's disease, psychodiagnostics,...

The present study investigated the criterion-based validity of the Mini-Mental State Examination (MMSE), the Cognitive Capacity Screening Examination (CCSE), and the Neurobehavioral Cognitive Status Examination (NCSE) in a sample of older adults with suspected cognitive impairment. As cognitive screening tests, the MMSE, CCSE, and NCSE should predict performance relative to a more thorough testing procedure. In the present study, performance on the Halstead-Reitan Neuropsychological Test Battery (HRNTB) was employed as the criterion measure. Scores on the General Neuropsychological Deficit Scale (G-NDS), a global performance measure computed from the HRNTB, served as the standard by which to judge the presence of cognitive impairment. The sensitivity, specificity, and predictive value of each screening test, as well as how well each screening test correlated with the G-NDS, were investigated. Results of this investigation found that, although the MMSE, CCSE, and NCSE were all significantly correlated with the G-NDS, only the NCSE demonstrated an appropriate balance between high sensitivity and specificity. When a rigorous neuropsychological evaluation was employed as the criterion standard, the NCSE accurately detected the presence of cognitive impairment: in 82% of the cases. The MMSE and CCSE, however, failed to detect cognitive deficits in approximately 80% of the cases. These findings strongly suggest that the MMSE and CCSE may have limited utility in the identification of cognitive impairment in older adults. The heightened sensitivity of the NCSE appears to be the result of several unigue features of the instrument, including a multidimensional scoring system and a graded series of increasingly difficult items within each ability area. Future studies need to examine the utility of the NCSE in other geriatric settings, as well as with more diverse populations suffering from a variety of organic mental syndromes.

1) INTRODUCTION: Obesity is a global problem and its the prevalence is constantly rising. Overweight and obesity are key risk factors for many diseases. Obese patients are a greater economic burden for the state, they often rely on the help of others. The goal of obesity treatment is to reduce weight and then keep it within the recommended range. In an obese patient, it is not always just about the actual weight loss, but also about treating the associated diseases caused by obesity. Bariatric surgery allows patients to lose weight in a relatively short period of time and has a very positive effect on associated diseases. 2) OBJECTIVE: The aim of this diploma thesis was to evaluate the physical and mental condition before and after gastric bypass and to determine whether this surgery has a positive or negative effect on the physical and mental condition of the patient. The objective was further divided into sub-goals and hypotheses. 3) METHODOLOGY: The research was carried out using a quantitative method. This is an observational study, in which the mental and physical condition and advancement of patients who were about to undergo bariatric surgery - gastric bypass - were monitored for 6 months. Mental status was monitored using four standardized questionnaires: MAF, HADS, iADL, SF-36 in four time...