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  • 1.
    Petrazzuoli, Ferdinando
    et al.
    SNAMID Natl Soc Med Educ Gen Practice, Italy;Lund University, Sweden.
    Palmqvist, Sebastian
    Lund University, Sweden.
    Thulesius, Hans
    Lund University, Sweden.
    Buono, Nicola
    SNAMID Natl Soc Med Educ Gen Practice, Italy.
    Pirrotta, Enzo
    SNAMID Natl Soc Med Educ Gen Practice, Italy.
    Cuffari, Alfredo
    SNAMID Natl Soc Med Educ Gen Practice, Italy.
    Cambielli, Marco
    SNAMID Natl Soc Med Educ Gen Practice, Italy.
    D'Urso, Maurizio
    SNAMID Natl Soc Med Educ Gen Practice, Italy.
    Farinaro, Carmine
    SNAMID Natl Soc Med Educ Gen Practice, Italy.
    Chiumeo, Francesco
    SNAMID Natl Soc Med Educ Gen Practice, Italy.
    Marsala, Valerio
    SNAMID Natl Soc Med Educ Gen Practice, Italy.
    Wiig, Elisabeth H.
    Boston Univ, USA.
    A Quick Test of Cognitive Speed: norm-referenced criteria for 121 Italian adults aged 45 to 90 years2014In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 26, no 9, p. 1493-1500Article in journal (Refereed)
    Abstract [en]

    Background: A Quick Test of Cognitive Speed (AQT) is a brief test that can identify cognitive impairment. AQT has been validated in Arabic, English, Greek, Japanese, Norwegian, Spanish, and Swedish. The aim of this study was to develop Italian criterion-referenced norms for AQT. Methods: AQT consists of three test plates where the patient shall rapidly name (1) the color of 40 blue, red, yellow, or black squares (AQT color), (2) the form of 40 black figures (circles, squares, triangles, or rectangles; AQT form), (3) the color and form of 40 figures (consisting of previous colors and forms; AQT color-form). The AQT test was administered to 121 Italian cognitively healthy primary care patients (age range: 45-90 years). Their mean Mini-Mental State Examination (MMSE) score was 28.8 +/- 0.9 points (range 26-30 points). AQT naming times in seconds were used for developing preliminary criterion cut-off times for different age groups. Results: Age was found to have a significant moderate positive correlation with AQT naming times color (r = 0.65, p < 0.001), form (r = 0.53, p < 0.001), color-form (r = 0.63, p < 0.001) and a moderate negative correlation with MMSE score (r = -0.44, p < 0.001) and AQT naming times differed significantly between younger (45-55 years old), older (56-70 years old), and the oldest (71-90 years old) participants. Years of education correlated positively but weakly with MMSE score (r = 0.27, p = 0.003) and negatively but weakly with AQT color (r = -0.16, p = ns), form (r = -0.24, p = 0.007), and color-form (r = -0.19, p = 0.005). We established preliminary cut-off times for the AQT test based on +1 and +2 standard deviations according to the approach in other languages and settings. Conclusions: This is the first Italian normative AQT study. Future studies of AQT - a test useful for dementia screening in primary care - will eventually refine cut-off times for normality balancing sensitivity and specificity in cognitive diagnostics.

  • 2.
    Petrazzuoli, Ferdinando
    et al.
    Lund University, Sweden..
    Vinker, Shlomo
    Tel Aviv Univ, Israel.
    Koskela, Tuomas H.
    Univ Tampere, Finland.
    Frese, Thomas
    Martin Luther Univ Halle Wittenberg, Germany.
    Buono, Nicola
    SNAMID Natl Soc Med Educ Gen Practice, Italy.
    Soler, Jean Karl
    Mediterranean Inst Primary Care, Malta.
    Ahrensberg, Jette
    Univ Aarhus, Res Unit Gen Practice, Denmark.
    Asenova, Radost
    Med Univ Plovdiv, Bulgaria.
    Boreu, Quinti Foguet
    Univ Autonoma Barcelona, Spain.
    Peker, Gulsen Ceyhun
    Ankara Univ, Turkey.
    Collins, Claire
    Irish Coll Gen Practitioners, Ireland.
    Hanzevacki, Miro
    Hlth Care Ctr Zagreb, Croatia.
    Hoffmann, Kathryn
    Med Univ Vienna, Austria.
    Iftode, Claudia
    Timis Soc Family Med, Romania.
    Kurpas, Donata
    Wroclaw Med Univ, Poland.
    Le Reste, Jean Yves
    Univ Bretagne Occidentale, France.
    Lichtwarck, Bjorn
    Innlandet Hosp Trust, Norway.
    Petek, Davorina
    Univ Ljubljana, Slovenia.
    Pinto, Daniel
    NOVA Med Sch, Portugal.
    Schrans, Diego
    Univ Ghent, Belgium.
    Streit, Sven
    Univ Bern, Switzerland.
    Tang, Eugene Yee Hing
    Newcastle Univ, UK.
    Tatsioni, Athina
    Univ Ioannina, Greece.
    Torzsa, Peter
    Semmelweis Univ, Hungary.
    Unalan, Pemra C.
    Marmara Univ, Turkey.
    van Marwijk, Harm
    Univ Manchester, UK.
    Thulesius, Hans
    Lund University, Sweden.
    Exploring dementia management attitudes in primary care: a key informant survey to primary care physicians in 25 European countries2017In: International psychogeriatrics, ISSN 1041-6102, E-ISSN 1741-203X, Vol. 29, no 9, p. 1413-1423Article in journal (Refereed)
    Abstract [en]

    Background: Strategies for the involvement of primary care in the management of patients with presumed or diagnosed dementia are heterogeneous across Europe. We wanted to explore attitudes of primary care physicians (PCPs) when managing dementia: (i) the most popular cognitive tests, (ii) who had the right to initiate or continue cholinesterase inhibitor or memantine treatment, and (iii) the relationship between the permissiveness of these rules/guidelines and PCP's approach in the dementia investigations and assessment. Methods: Key informant survey. Setting: Primary care practices across 25 European countries. Subjects: Four hundred forty-five PCPs responded to a self-administered questionnaire. Two-step cluster analysis was performed using characteristics of the informants and the responses to the survey. Main outcome measures: Two by two contingency tables with odds ratios and 95% confidence intervals were used to assess the association between categorical variables. A multinomial logistic regression model was used to assess the association of multiple variables (age class, gender, and perceived prescription rules) with the PCPs' attitude of trying to establish a diagnosis of dementia on their own. Results: Discrepancies between rules/guidelines and attitudes to dementia management was found in many countries. There was a strong association between the authorization to prescribe dementia drugs and pursuing dementia diagnostic work-up (odds ratio, 3.45; 95% CI 2.28-5.23). Conclusions: Differing regulations about who does what in dementia management seemed to affect PCP's engagement in dementia investigations and assessment. PCPs who were allowed to prescribe dementia drugs also claimed higher engagement in dementia work-up than PCPs who were not allowed to prescribe.

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