Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-22T05:47:00.408Z Has data issue: false hasContentIssue false
  • English
  • Français

Associations between the Brief Memory and Executive Test (BMET), Activities of Daily Living, and Quality of Life in Patients with Cerebral Small Vessel Disease

Published online by Cambridge University Press:  06 April 2016

Matthew J. Hollocks ,
Rebecca Brookes ,
Robin G. Morris  and
Hugh S. Markus
Matthew J. Hollocks
Affiliation:
University of Cambridge, Department of Clinical Neurosciences, R3, Box 183, Addenbrookes Biomedical Campus, Cambridge, CB2 0QQ, United Kingdom
Rebecca Brookes
Affiliation:
University of Cambridge, Department of Clinical Neurosciences, R3, Box 183, Addenbrookes Biomedical Campus, Cambridge, CB2 0QQ, United Kingdom
Robin G. Morris
Affiliation:
King’s College London, Institute of Psychiatry, Neurosciences and Psychology, Department of Psychology, PO Box 078, De Crespigny Park, London, SE5 8AF, United Kingdom
Hugh S. Markus*
Affiliation:
University of Cambridge, Department of Clinical Neurosciences, R3, Box 183, Addenbrookes Biomedical Campus, Cambridge, CB2 0QQ, United Kingdom
*
Correspondence and reprint requests to: Hugh S. Markus, University of Cambridge, Department of Clinical Neurosciences, R3, Box 183, Addenbrookes Biomedical Campus, Cambridge, CB2 0QQ, United Kingdom. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives: In addition to neuropsychological difficulties, patients with cerebral small vessel disease (SVD) can have reduced activities of daily living and a poorer quality of life compared to healthy adults. The Brief Memory and Executive Test (BMET), is a cognitive screening tool designed to be sensitive to the neuropsychological profile of patients with SVD. While the BMET is sensitive to the cognitive consequences of SVD, it is unclear how well scores on this measure relate to functional outcomes. The aims of this study are to investigate the relationship between scores on the BMET and functional outcomes (activities of daily living and quality of life) in SVD, and to compare this with other commonly used cognitive screening tools. Methods: This study included 184 participants with SVD (mean age=63.2; SD=9.9) and 299 healthy controls (mean age=62.4; SD=13.8) who were tested using the BMET, Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Stroke Specific - Quality of Life Scale (SS-QoL), Geriatric Depression Scale (GDS), and measures of both instrumental activities of daily living (IADL) and basic activities of daily living (BADL). Results: After controlling for covariates the scores on the BMET, but not the MoCA or MMSE, were significantly related to poorer IADL and quality of life in the SVD group. In addition to the BMET scores, symptoms of depression were found to be significant associated with functional outcome. Conclusion: These results support the clinical utility of using of the BMET, in combination with a standardized depression questionnaire, during the early assessment of patients with SVD. (JINS, 2016, 22, 1–9)

Keywords

AdultsDementiaCerebrovascular diseaseCognitiveNeuropsychological testsStroke
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 22 , Issue 5 , May 2016 , pp. 561 - 569
Copyright
Copyright © The International Neuropsychological Society 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Arboix, A., Font, A., Garro, C., García-Eroles, L., Comes, E., & Massons, J. (2007). Recurrent lacunar infarction following a previous lacunar stroke: A clinical study of 122 patients. Journal of Neurology, Neurosurgery, and Psychiatry, 78, 1392–1394. doi:10.1136/jnnp.2007.119776 CrossRefGoogle ScholarPubMed
Banerjee, S., Smith, S.C., Lamping, D.L., Harwood, R.H., Foley, B., Smith, P., & Knapp, M. (2006). Quality of life in dementia: More than just cognition. An analysis of associations with quality of life in dementia. Journal of Neurology, Neurosurgery, and Psychiatry, 77(2), 146–148. doi:10.1136/jnnp.2005.072983 CrossRefGoogle ScholarPubMed
Barberger-Gateau, P., Commenges, D., Gagnon, M., Letenneur, L., Sauvel, C., & Dartigues, J.F. (1992). Instrumental activities of daily living as a screening tool for cognitive impairment and dementia in elderly community dwellers. Journal of the American Geriatrics Society, 40, 1129–1134.CrossRefGoogle ScholarPubMed
Brookes, R.L., Hannesdottir, K., Lawrence, R., Morris, R.G., & Markus, H.S. (2012). Brief Memory and Executive Test: Evaluation of a new screening test for cognitive impairment due to small vessel disease. Age and Ageing, 41(2), 212–218. doi:10.1093/ageing/afr172 CrossRefGoogle ScholarPubMed
Brookes, R.L., Herbert, V., Lawrence, A.J., Morris, R.G., & Markus, H.S. (2014). Depression in small-vessel disease relates to white matter ultrastructural damage, not disability. Neurology, 83(16), 1417–1423. doi:10.1212/WNL.0000000000000882 CrossRefGoogle Scholar
Brookes, R.L., Herbert, V., Paul, S., Hannesdottir, K., Markus, H.S., & Morris, R.G. (2014). Executive dysfunction, awareness deficits and quality of life in patients with cerebral small vessel disease: A structural equation model. Neuropsychology, 28, 247–253. doi:10.1037/neu0000015 CrossRefGoogle ScholarPubMed
Brookes, R.L., Hollocks, M.J., Khan, U., Morris, R.G., & Markus, H.S. (2015). The Brief Memory and Executive Test (BMET) for detecting vascular cognitive impairment in small vessel disease: A validation study. BMC Medicine, 13(1), 290. doi:10.1186/s12916-015-0290-y CrossRefGoogle ScholarPubMed
Brookes, R.L., Willis, T.A., Patel, B., Morris, R.G., & Markus, H.S. (2013). Depressive symptoms as a predictor of quality of life in cerebral small vessel disease, acting independently of disability; a study in both sporadic small vessel disease and CADASIL. International Journal of Stroke, 8(7), 510–517. doi:10.1111/j.1747-4949.2011.00763.x CrossRefGoogle ScholarPubMed
Broomfield, N.M., Laidlaw, K., Hickabottom, E., Murray, M.F., Pendrey, R., Whittick, J.E., & Gillespie, D.C. (2011). Post-stroke depression: The case for augmented, individually tailored cognitive behavioural therapy. Clinical Psychology and Psychotherapy, 18, 202–217. doi:10.1002/cpp.711 CrossRefGoogle ScholarPubMed
Cahn-Weiner, D.A., Boyle, P.A., & Malloy, P.F. (2002). Tests of executive function predict instrumental activities of daily living in community-dwelling older individuals. Applied Neuropsychology, 9, 187–191. doi:10.1207/S15324826AN0903_8 Google Scholar
Cahn-Weiner, D.A., Farias, S.T., Julian, L., Harvey, D.J., Kramer, J.H., Reed, B.R., & Chui, H. (2007). Cognitive and neuroimaging predictors of instrumental activities of daily living. Journal of the International Neuropsychological Society, 13, 747–757. doi:10.1017/S1355617707070853 Google Scholar
Fazekas, F., Chawluk, J.B., Zimmerma, A., & June, M. (1987). MR signal abnormalities at 1.5 T in Alzheimer’s dementia and normal aging. AJR American Journal of Roentgenology, 149, 351–356.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. doi:10.1016/0022-3956(75)90026-6 CrossRefGoogle ScholarPubMed
Hachinski, V., Iadecola, C., Petersen, R.C., Breteler, M.M., Nyenhuis, D.L., Black, S.E., & Leblanc, G.G. (2006). National Institute of Neurological Disorders and Stroke-Canadian Stroke Network vascular cognitive impairment harmonization standards. Stroke, 37, 2220–2241. doi:10.1161/01.STR.0000237236.88823.47 Google Scholar
Hollocks, M.J., Lawrence, A.J., Brookes, R.L., Barrick, T.R., Morris, R.G., Husain, M., & Markus, H.S. (2015). Differential relationships between apathy and depression with white matter microstructural changes and functional outcomes. Brain, 138, 3803–3815. doi:10.1093/brain/awv304 CrossRefGoogle ScholarPubMed
Jongbloed, L.Y.N. (1986). Prediction of function after stroke. Stroke, 17(4), 765–776.CrossRefGoogle ScholarPubMed
Karlawish, J.H.T., Casarett, D., Klocinski, J., & Clark, C.M. (2001). The relationship between caregivers’ global ratings of Alzheimer’s disease patients’ quality of life, disease severity, and the caregiving experience. Journal of the American Geriatric Society, 49, 1066–1070.CrossRefGoogle ScholarPubMed
Lawrence, A.J., Patel, B., Morris, R.G., MacKinnon, A.D., Rich, P.M., Barrick, T.R., & Markus, H.S. (2013). Mechanisms of cognitive impairment in cerebral small vessel disease: Multimodal MRI results from the St George’s cognition and neuroimaging in stroke (SCANS) study. PloS One, 8(4), e61014. doi:10.1371/journal.pone.0061014 CrossRefGoogle Scholar
Lawton, M.P., & Brody, E.M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. The Gerontologist, 9(3), 179–186. doi:10.1093/geront/9.3_Part_1.179 CrossRefGoogle ScholarPubMed
Levine, B., Robertson, I.H., Clare, L., Carter, G., Hong, J., Wilson, B.A., & Stuss, D.T. (2000). Rehabilitation of executive functioning: An experimental-clinical validation of goal management training. Journal of the International Neuropsychological Society, 6, 299–312. doi:10.1017/S1355617700633052 CrossRefGoogle ScholarPubMed
Makin, S.D.J., Turpin, S., Dennis, M.S., & Wardlaw, J.M. (2013). Cognitive impairment after lacunar stroke: Systematic review and meta-analysis of incidence, prevalence and comparison with other stroke subtypes. Journal of Neurology, Neurosurgery, and Psychiatry, 84, 893–900. doi:10.1136/jnnp-2012-303645 CrossRefGoogle ScholarPubMed
Martyr, A., & Clare, L. (2012). Executive function and activities of daily living in Alzheimer’s disease: A correlational meta-analysis. Dementia and Geriatric Cognitive Disorders, 33, 189–203. doi:10.1159/000338233 CrossRefGoogle ScholarPubMed
Martyr, A., Nelis, S.M., & Clare, L. (2014). Predictors of perceived functional ability in early-stage dementia: Self-ratings, informant ratings and discrepancy scores. International Journal of Geriatric Psychiatry, 29(8), 852–862. doi:10.1002/gps.4071 Google Scholar
Mercier, L., Audet, T., Hébert, R., Rochette, A., & Dubois, M.F. (2001). Impact of motor, cognitive, and perceptual disorders on ability to perform activities of daily living after stroke. Stroke, 32, 2602–2608. doi:10.1161/hs1101.098154 Google Scholar
Mograbi, D.C., & Morris, R.G. (2014). On the relation among mood, apathy, and anosognosia in Alzheimer’s disease. Journal of the International Neuropsychological Society, 20, 2–7. doi:10.1017/S1355617713001276 CrossRefGoogle ScholarPubMed
Mok, V.C.T. (2004). Cognitive impairment and functional outcome after stroke associated with small vessel disease. Journal of Neurology, Neurosurgery, & Psychiatry, 75, 560–566. doi:10.1136/jnnp.2003.015107 Google Scholar
Monaci, L., & Morris, R.G. (2012). Neuropsychological screening performance and the association with activities of daily living and instrumental activities of daily living in dementia: Baseline and 18- to 24-month follow-up. International Journal of Geriatric Psychiatry, 27(2), 197–204. doi:10.1002/gps.2709 Google Scholar
Nasreddine, Z.S., Phillips, N.A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I., & Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53, 695–699. doi:10.1111/j.1532-5415.2005.53221.x CrossRefGoogle Scholar
Nelson, H.E., & Willison, J.R. (1991). The Revised National Adult eading Test-Test manual. Windsor, UK: NFER-Nelson.Google Scholar
Robinson, R.G., Schultz, S.K., Castillo, C., Kopel, T., Kosier, J.T., Newman, R.M., & Starkstein, S.E. (2000). Nortriptyline versus fluoxetine in the treatment of depression and in short-term recovery after stroke: A placebo-controlled, double-blind study. American Journal of Psychiatry, 157, 351–359. doi:10.1176/appi.ajp.157.3.351 Google Scholar
Sackley, C.M. (1990). The relationships between weight-bearing asymmetry after stroke, motor function and activities of daily living. Physiotherapy Theory and Practice, 6, 179–185. doi:10.3109/09593989009048293 Google Scholar
Schmitter-Edgecombe, M., Parsey, C., & Cook, D.J. (2011). Cognitive correlates of functional performance in older adults: Comparison of self-report, direct observation, and performance-based measures. Journal of the International Neuropsychological Society, 17, 853–864. doi:10.1017/S1355617711000865 CrossRefGoogle ScholarPubMed
Shin, I.-S., Carter, M., Masterman, D., Fairbanks, L., & Cummings, J.L. (2005). Neuropsychiatric symptoms and quality of life in Alzheimer disease. The American Journal of Geriatric Psychiatry, 13(6), 469–474. doi:10.1176/appi.ajgp.13.6.469 CrossRefGoogle ScholarPubMed
Spikman, J.M., Boelen, D.H.E., Lamberts, K.F., Brouwer, W.H., & Fasotti, L. (2010). Effects of a multifaceted treatment program for executive dysfunction after acquired brain injury on indications of executive functioning in daily life. Journal of the International Neuropsychological Society, 16, 118–129. doi:10.1017/S1355617709991020 CrossRefGoogle ScholarPubMed
van de Port, I.G., Kwakkel, G., Schepers, V.P., Heinemans, C.T., & Lindeman, E. (2007). Is fatigue an independent factor associated with activities of daily living, instrumental activities of daily living and health-related quality of life in chronic stroke? Cerebrovascular Diseases, 23, 40–45. doi:10.1159/000095757 CrossRefGoogle ScholarPubMed
Wade, D.T., & Collin, C. (1988). The Barthel ADL Index: A standard measure of physical disability? International Disability Studies, 10, 64–67. doi:10.3109/09638288809164105 CrossRefGoogle ScholarPubMed
Williams, L. S., Weinberger, M., Harris, L. E., Clark, D. O., & Biller, J. (1999). Development of a stroke-specific quality of life scale. Stroke, 30(7), 1362--1369.CrossRefGoogle Scholar
Yesavage, J.A., Brink, T.L., Rose, T.L., Lum, O., Huang, V., Adey, M., & Leirer, V.O. (1982). Development and validation of a geriatric depression screening scale: A preliminary report. Journal of Psychiatric Research, 17, 37–49. doi:10.1016/0022-3956(82)90033-4 Google Scholar