Background: The Mini-Mental State Examination-Second Edition (MMSE-2) consists of three visions: a brief version (MMSE-2:BV), a standard version (MMSE-2:SV), and an expanded version (MMSE-2: EV). Each version was equipped with alternate forms (blue and red). There was a lack of evidence on the practice effect and test-retest reliability of the three versions of the MMSE-2, limiting its utility in both clinical and research settings. The purpose of this study was to examine the practice effect and test-retest reliability of the MMSE-2 in people with dementia.Methods: One hundred and twenty participants were enrolled, of which 60 were administered with the blue form twice (i.e., the same-form group, [SF group]) and 60 were administered with the blue form first and then the red form (alternate-form group, [AF group]). The practice effect was evaluated using a pairedt-test and Cohen’sd. The test-retest reliability was examined using the intraclass correlation coefficient (ICC).Results: For the practice effects, in the SF group, no statistically significant differences were found for the MMSE-2:BV and MMSE-2: EV total scores and eight subtests (p = 0.061–1.000), except for the MMSE-2:SV total score (p = 0.029). In the AF group, no statistically significant differences were found for all three versions of the total scores and subtests (p = 0.106–1.000), except for the visual-constructional ability subtest (p = 0.010). Cohen’sdof all three versions’ total scores and subtests were 0.00–0.20 and 0.00–0.26 for SF group and AF group, respectively. For the test-retest reliability, ICC values for all three versions and eight subtests in SF and AF groups were 0.60–0.93 and 0.56–0.93, respectively.Conclusion: Our results demonstrated that the practice effect could be minimized when alternate forms of the MMSE-2 were used. The MMSE-2 had good to excellent test-retest reliability, except for three subtests (i.e., visual-constructional ability, registration, and recall). Caution should be taken when interpreting the results of visual-constructional ability, registration, and recall subtests of the MMSE-2.

Background: Administering activities of daily living (ADL) and recovery of ADL functions are the main treatment goals in rehabilitation for patients with stroke. Reablement is one form of rehabilitative intervention, which aims to restore ADL functions performed in the community. The purpose of this study was to investigate the effects of home-based reablement from 3 concepts of ADL (ie, actual performance, ability, and self-perceived difficulty) for patients with stroke. Methods: This was a single-blind pilot randomized clinical trial. Twenty-six patients were randomly assigned into 2 groups: home-based reablement group (n = 12) and control group (n = 14). The home-based reablement group received ADL training in the home environment for 6 weeks. The control group received conventional rehabilitation in the hospital. Outcome measures contained the Canadian Occupational Performance Measure (COPM) and the Barthel Index-based Supplementary Scales (BI-SS). The COPM was applied to identify patients’ level of performance and satisfaction with ADL training. The BI-SS included 3 ADL scales: actual performance, ability, and self-perceived difficulty. Results: The patients in the home-based reablement group showed statistically significant improvements in the ability scale and total score of the BI-SS than the control group (P < .05) and demonstrated moderate effect size (success rate difference = 0.34–0.42). No significant differences were noticed in the COPM and the other 2 scales of the BI-SS (actual performance and self-perceived difficulty), but small effect sizes were found (success rate difference = 0.17–0.22). Conclusions: For patients with stroke, the 6-week home-based reablement program had similar effects with the control group on patients’ perceived performance, satisfaction, and difficulty in ADL, but it displayed potential for enhancing their ability in executing ADL tasks.

Background: The Cognitive Abilities Screening Instrument (CASI) is increasingly used to assess general cognitive function in people with dementia. The Mini-Mental State Examination (MMSE) score can be converted from the CASI (i.e., the estimated MMSE). Recognizing that measurement equivalence is critical to meaningfully representing one with the other, we aimed to determine whether the estimated MMSE score obtained from the CASI was equivalent to the original MMSE in people with dementia. Methods: We obtained 110 data points for the MMSE and CASI scores in people with dementia. The intraclass correlation coefficient (ICC), Pearson’s r, percent of standard error of measurement (SEM%), paired t-test, and effect size (Cohen’s d) were used to investigate the equivalence. Results: To examine the equivalence between the original and estimated MMSE score, the ICC and Pearson’s r of the total score and six domains were 0.62–0.95 and 0.62–0.96, respectively. The SEM% of the total score and six domains were 0.6–8.9%. The paired t-test results showed a significant difference (p < 0.05) between the total score and the three domains. The Cohen’s d of the total score and six domains were 0.06–0.27. Conclusions: The estimated MMSE score was found to have moderate to excellent equivalence to the original MMSE score. The three domains (i.e., registration, attention and calculation, and visual-constructional ability) with moderate equivalence should be used cautiously to interchange with the original MMSE in people with dementia.

Malnutrition is one of commonly issues in patients with stroke. The Mini Nutritional Assessment (MNA) is a widely used measure for assessing nutritional status in patients with stroke. A nutritional measure with acceptable test-retest reliability allows clinicians to consistently assess patients’ nutritional status. Knowledge of the relationship between nutritional status and quality of life (QOL) could guide clinicians to improve QOL in patients with stroke more effectively. This study aimed to examine test-retest reliability of the MNA and its relationship with QOL in patients with stroke. Fifty-nine patients participated in the test-retest reliability study and the correlation between the MNA and WHO Quality of Life-BREF (WHOQOL-BREF) study. A repeated-assessments design (1 week apart) was used to examine the test-retest reliability of the MNA. The intraclass correlation coefficient for the MNA was 0.91. The minimal detectable change and percentage of minimal detectable change for the MNA were 2.1 and 8.2%, respectively. The MNA was positively associated with the QOL (r = 0.32; p = 0.013). The result of linear regression analysis shows that after controlling for age, sex and activities of daily living functions, only the MNA was significantly associated with the WHOQOL-BREF (r² = 0.104; p = 0.008). The MNA has satisfactory test-retest reliability that is useful for repeatedly assessing the nutritional status of patients with stroke. The MDC of the MNA has acceptable random measurement error which is useful for determining whether the change score of a patient is outside the range of random measurement error. Future studies that recruit stroke patients in the acute stage is needed to further examine the relationship between the nutritional status and QOL.

BACKGROUND: Nutritional status could affect functional capacity and reduce quality of life in patients with stroke. Although the associations between nutritional status, basic activities of daily living (BADL)/Instrumental ADL, and quality of life (QOL) in older people have been identified, the relationships have not yet been examined in patients with stroke, using the full Mini Nutritional Assessment (MNA) or MNA-short form (MNA-SF). OBJECTIVE: This study aimed to examine the relationship between nutritional status (using full MNA and MNA-SF), comprehensive ADL function, and QOL in patients with stroke. METHODS: Eighty-two patients with ischemic stroke participated in this cross-sectional design study. Each participant was assessed with the full MNA, MNA-SF, comprehensive ADL function (including Barthel Index and Frenchay Activities Index), and WHO Quality of Life Questionnaire (WHOQOL-BREF) once. RESULTS: The MNA-SF was only significantly correlated with the comprehensive ADL function (rho = 0.27, p = 0.013), whereas, the full MNA was found to be significantly correlated with the comprehensive ADL function and WHOQOL-BREF (rho = 0.24, p = 0.029 and rho = 0.30, p = 0.005, respectively). The MNA-SF was a significant predictor of comprehensive ADL function, accounting for 44% of the variance. The full MNA was the only significant predictor of the WHOQOL-BREF, explaining 17% of the variance. CONCLUSIONS: This study has revealed a relationship between nutritional status, comprehensive ADL function, and QOL among patients with stroke. Patients with stroke with better nutritional status had higher ADL function as well as better QOL. The MNA-SF was useful in predicting comprehensive ADL, whereas, the full MNA could be used to predict QOL. Knowledge and evidence of the association and predictive power of the MNA-SF and full MNA could guide clinicians to choose tools for assessing the nutritional status of patients with stroke more effectively.

Background: Reablement is 1 approach to conduct rehabilitation in the community (ie, home environment), which aims to enhance an individual's functional ability to perform everyday activities that individuals perceive as important. We investigated the effects of a home-reablement program on different rehabilitation outcomes in people with stroke. Methods: A single-blind randomized clinical trial was conducted. Twenty-six people with stroke were randomly assigned to the home-reablement group or control group. For 6 weeks, participants in the home-reablement group received training for activities of daily living (ADL) that they perceived as important but difficult to perform. Participants in the control group received conventional rehabilitation in the hospital. Outcome measures included the Fugl–Meyer Assessment for the upper-extremity (FMA-UE) and the Stroke Impact Scale 3.0 (SIS 3.0) subscales. Results: No statistically significant differences between the 2 groups were noticed in the FMA-UE and the SIS 3.0 subscales (P = .226–1.000). Small effect size (success rate difference = 0.12–0.25) were noticed in the FMA-UE and the 5 SIS 3.0 subscales. The home-reablement group exhibited a greater proportion of participants with scores greater than the minimal detectable change in the FMA-UE and the 6 SIS 3.0 subscales (ie, strength, ADL/instrumental ADL, mobility, emotion, memory, and participation). Conclusions: People with stroke that underwent the 6-week home-reablement program showed potential for improving their motor function, ADL/instrumental ADL, emotion, memory, and activity participation.