The 'attended alone' and 'attended with' signs in the assessment of cognitive impairment: a revalidation

Postgraduate Medicine
A J Larner

Abstract

Objectives: To examine the diagnostic utility of the 'attended alone' (AA) and 'attended with' (AW) signs for the diagnosis of major and minor neurocognitive disorder.Methods: Consecutive unselected new outpatient referrals (N = 1209) to a dedicated cognitive disorders clinic over a 5-year period (2015-2019 inclusive) were observed for the AA and AW signs. Criterion diagnoses were by usual clinic assessment using standard (DSM-5) diagnostic criteria.Results: AW proved to be very sensitive for the identification of major and minor neurocognitive disorder but with generally low positive predictive values. In the subgroup of patients attending with more than one informant, the AW2+ sign, positive predictive value was higher and likewise with increasing patient age where the prevalence of AW was higher. Diagnostic utility of AW and AA was independent of patient gender.Conclusion: AW and AA are easily observed and categorized signs. AW has a high sensitivity for cognitive impairment while AA has a high positive predictive value for its absence.

References

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Mar 29, 2011·European Journal of Epidemiology·Alex J Mitchell
Oct 30, 2012·Alzheimer Disease and Associated Disorders·Andrew J Larner
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Nov 13, 2015·Postgraduate Medicine·M Bonello, A J Larner
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Sep 22, 2018·International Journal of Clinical Practice·Andrew J Larner
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Nov 20, 2018·Neurodegenerative Disease Management·Viraj Bharambe, Andrew J Larner
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Dec 7, 2019·The Journal of the Royal College of Physicians of Edinburgh·Mona Ghadiri-Sani, Andrew J Larner

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Citations

Jul 22, 2021·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Iago Rego-GarcíaCristóbal Carnero-Pardo

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