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SOYSAL, PINAR

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Author: Isik, AT × Author: Kaya, D × End date: 2019 × Start date: 2011 × Rights: info:eu-repo/semantics/openAccess ×

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    PublicationOpen Access
    Triple Test Plus Rapid Cognitive Screening Test: A Combination of Clinical Signs and A Tool for Cognitive Assessment in Older Adults.
    (2019-08-15) Isik, AT; Koc, Okudur; Dokuzlar, O; Kaya, D; SOYSAL, PINAR
    Less time-consuming, easy-to-apply and more reliable cognitive screening tests are essential for use in primary care. The aim of this study was to investigate the diagnostic value of the Turkish version of the Rapid Cognitive Screen (RCS-T) and Triple Test individually and the combination of RCS-T with each sign and Triple Test to screen elderly patients for cognitive impairment (CI). A total of 357 outpatients aged 60 or older, who underwent comprehensive geriatric assessment, were included in the study. Presence or absence of attended alone sign (AAS), head-turning sign, and applause sign was investigated. The mean age of the patients was 74.29 ± 7.46. Of those, 61 patients (28 men, 33 women) had Alzheimer's disease (AD), 59 patients had mild cognitive impairment (MCI) (29 men, 30 women), and 237 (80 men, 157 women) were cognitively robust. The sensitivity of the combination of RCS-T and negative for AAS for CI, AD and MCI is 0.79, 0.86 and 0.61, respectively; the specificity was 0.92, 0.93 and 0.92, respectively; and the positive and negative predictive values revealed good diagnostic accuracy. The combination of RCS-T and negative for AAS is a simple, effective and rapid way to identify possible CI in older adults.
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    PublicationOpen Access
    The Outcomes Of Serial Cerebrospinal Fluid Removal In Elderly Patients With Idiopathic Normal Pressure Hydrocephalus.
    (2019-11-19) Soysal, PINAR; Kaya, D; Ates, Bulut; Isik, AT; Dokuzlar, O; SOYSAL, PINAR
    Purpose: Elderly patients with iNPH (idiopathic normal pressure hydrocephalus) might be potentially high-risk surgical patients. Our purpose was to investigate the outcome of serial removal of cerebrospinal fluid (CSF) in the patients with iNPH who refused to have the ventriculoperitoneal or lumboperitoneal shunt surgery or had contraindications to them. Patients and methods: There were 42 patients, with a median age of 78 years. Recurrent CSF removal was performed when the patients had deteriorated gait which was defined as >10% pre-removal change on the average of two walking trials during timed up and go (TUG). All the patients underwent mini-mental status examination (MMSE), frontal assessment battery (FAB), Stroop test, Tinetti Performance Oriented Mobility Assessment (POMA), TUG and nine-hole peg test (NHPT) with the dominant hand, before and after CSF removal. Results: Thirty-five patients had two CSF removal procedures with a mean interim period of 7.4 months ranging from 1.5 to 35 months. Thirteen patients had three CSF removal procedures. The mean TUG scores were decreased after the first, second and third procedures (p<0.001; p<0.001; p=0.007; respectively). The POMA scores including both gait and balance components improved after the first and second procedures (p<0.05; for each). After the third procedure, the increase in POMA-balance score was statistically significant (p<0.05). After the first procedure, the FAB scores and NHPT scores were significantly improved (p<0.02). The median follow-up duration of the patients was 34.5 months. Conclusion: The deterioration of gait disturbance may be improved, and cognitive decline may be stabilized, at least postponed, by applying recurrent CSF removal in those unshunted patients with iNPH.