Article: Cognitive Abilities Screening Instrument, Chinese Version 2.0 (CASI C-2.0): Administration and Clinical Application.[show abstract] [hide abstract]
ABSTRACT: Abstract- The Cognitive Abilities Screening Instrument (CASI) has been commonly used in dementia research and clinical practice to evaluate a subject's cognitive abilities and to follow-up possible progression of dementia. It has a detailed manual for test administration and scoring in order to minimize testing errors. The Chinese version of CASI (CASI C-2.0) has been used in many clinical and epidemiological studies in Taiwan. Since cognitive abilities are influenced by education, and there are high rates of illiterate or loweducation individuals among the elderly in Taiwan, the normative data of CASI, including its total score and its cognitive domain scores, should be divided into different education ranges. In clinical practice, the cut-off scores in differentiating between dementia and normal are suggested to be: 49/50 for Education year = 0; 67/68 for Education years = 1-5; and 79/80 for Education years more than 6.Acta neurologica Taiwanica 12/2012; 21(4):180-189.
Article: APOE ε4 increases the risk of progression from amnestic mild cognitive impairment to Alzheimer's disease among ethnic Chinese in Taiwan.[show abstract] [hide abstract]
ABSTRACT: To evaluate the effect of the apolipoprotein E (APOE) ε4 in the progression from mild cognitive impairment (MCI) to Alzheimer's disease (AD) in ethnic Chinese people in Taiwan. Subjects older than 60 years with normal cognition, MCI or AD were enrolled from the memory clinic from 2000 to 2008. Normal ageing and MCI subjects were evaluated with clinical and neuropsychological examinations annually, and their APOE genotypes were determined. A total of 326 normal ageing subjects, 304 amnestic MCI and 537 AD patients were recruited at baseline. The frequencies of APOE ε4 were 22.1% in normal ageing, 26.6% in MCI and 40.8% in AD patients. During the follow-up period (42.5±18.5 months), there were 227 MCI patients, and 248 normal ageing subjects received one or more annual follow-up evaluation. The ε4+carriers had a higher annual conversion rate than did the ε4-negative subjects either in the MCI (15.9% vs 9.0%) or in the normal ageing subjects (2.2% vs 0.7%). The mean survival time before progression to AD was 57.0 months for the MCI ε4+carriers, 85.9 months for MCI ε4-negative patients, 86.2 months for normal ageing e4+carriers and 120.8 months for normal ageing ε4-negative subjects. The adjusted hazard ratio of APOE ε4 for developing AD was 2.0 (95% CI 1.2 to 3.2) in MCI and 5.3 (95% CI 1.2 to 24.1) in normal ageing. APOE ε4 increased the risk of developing AD both in amnestic MCI and in normal ageing in a clinic-recruited ethnic Chinese population.Journal of neurology, neurosurgery, and psychiatry 02/2011; 82(2):165-9. · 4.87 Impact Factor
Article: On tree types of competitive learning algorithms with their comparisons and applications to MRI segmentation.Int. J. Intell. Syst. 01/2010; 25:1081-1102.
Article: Accelerated hippocampal atrophy rates in stable and progressive amnestic mild cognitive impairment.[show abstract] [hide abstract]
ABSTRACT: Studies suggest that smaller hippocampal volume predicts Alzheimer's disease (AD) in mild cognitive impairment (MCI). However, few studies have demonstrated decline rates in cognition and hippocampal volume in MCI subjects with stable clinical presentation. Furthermore, the effects of apolipoprotein E (ApoE) on the change rates of medial temporal structures and cognition in MCI are rarely investigated. Fifty-eight subjects with amnestic MCI and 20 normal aging elderly controls received annual neuropsychological and magnetic resonance imaging (MRI) assessments. Annual decline rates in neuropsychological test scores, hippocampal and amygdalar volumes were calculated. ApoE genotypes were examined. Nineteen (32.7%) MCI subjects converted to AD during an average 22.5-month follow-up period. The annual hippocampal atrophy rate was correlated with a decline in memory test scores. The presence of the ApoE varepsilon4 allele did not affect the change rates in neuropsychological test scores and medial temporal structures volume. Compared to subjects with stable MCI (MCI-S) and normal aging, progressive MCI (MCI-P) had the highest annual decline rates in cognition and hippocampal volume. Logistic regression analysis showed that higher annual decline rates in hippocampal volume and global cognitive test scores were associated with conversion to AD. Furthermore, although MCI-S subjects had little cognitive decline, their hippocampal atrophy rates were higher than those of normal aging controls. Therefore, accelerated hippocampal atrophy rates may be an early and important presentation in MCI subjects.Psychiatry Research 03/2009; 171(3):221-31. · 2.52 Impact Factor
Article: Evaluating the uses of the total score and the domain scores in the Cognitive Abilities Screening Instrument, Chinese version (CASI C-2.0): results of confirmatory factor analysis.[show abstract] [hide abstract]
ABSTRACT: The Cognitive Abilities Screening Instrument (CASI) consists of items which are designed to measure the nine domains of cognitive ability. Its total score is used clinically to represent the overall underlying cognitive ability of the patient. This study aimed to evaluate the justification of the uses of the all-domain-total-score as an overall cognitive measure and the domain scores as measures of designated individual cognitive ability. To justify the use of total score of all the items as an overall measure of cognitive ability, a second-order confirmatory factor analysis was performed to examine whether the items in CASI contributed significantly to a common underlying construct. The uses of domain scores were also examined by inspecting the loadings of the items on their designated domains. The CASI data from 608 patients, 68 normal and 540 with Alzheimer's disease, were analyzed. The goodness-of-fit indices for the second-order factor model were as follows: CFI was 0.912 for WLSMV and 0.977 for WLSM; TLI and RMSEA values were 0.975 and 0.090 respectively. The loadings of the items on the common underlying construct are all salient (>0.3). The loadings of all but the long-term memory items on their respective subdomains were also salient. The items of the CASI C-2.0 were useful not only in profiling the correlated cognitive domain scores, but also in forming an overall measure of the underlying cognitive ability of the patients.International Psychogeriatrics 12/2007; 19(6):1051-63. · 2.24 Impact Factor