Detection of dementia of the Alzheimer type in a population-based sample: Neuropsychological test performance

1995 ◽  
Vol 1 (3) ◽  
pp. 252-260 ◽  
Author(s):  
Deborah A. Cahn ◽  
David P. Salmon ◽  
Nelson Butters ◽  
Wigbert C. Wiederholt ◽  
Jody Corey-Bloom ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
At Risk ◽  
Test Performance ◽  
Logistic Model ◽  
Neuropsychological Test ◽  
Population Based ◽  
Community Dwelling ◽  
Elderly Subjects ◽  
Alzheimer Type

AbstractThe ability to detect dementia of the Alzheimer type (DAT) in a community-dwelling sample of elderly individuals on the basis of neuropsychological test performance was examined. Three hundred sixty community-dwelling individuals were identified by neurological examination as having probable or possible Alzheimer’s disease, being at risk for Alzheimer’s disease, or having no cognitive impairment. A logistic model comprised of tests of verbal and nonverbal memory, mental flexibility, and confrontation naming correctly classified 82% of DAT subjects and 98% of normal elderly subjects. The logistic model classified 77% of subjects who were diagnosed as at risk for Alzheimer's disease as being cognitively normal. A cross-validation with a clinically based sample of subjects correctly classified 89% of DAT patients and 100% of normal control subjects. The results suggest that psychometric discrimination of dementia may be less accurate in community-dwelling populations than in clinically based samples. (JINS, 1995, I, 252–260.)

A population-based analysis of qualitative features of the neuropsychological test performance of individuals with dementia of the Alzheimer type: Implications for individuals with questionable dementia.

1997 ◽  
Vol 3 (4) ◽  
pp. 387-393 ◽  
Author(s):  
DEBORAH A. CAHN ◽  
DAVID P. SALMON ◽  
MARK W. BONDI ◽  
NELSON BUTTERS ◽  
SHANNON A. JOHNSON ◽  
...  
Keyword(s):  
Test Performance ◽  
Logistic Model ◽  
Neuropsychological Test ◽  
Population Based ◽  
Alzheimer Type ◽  
Confrontation Naming ◽  
Perseverative Errors ◽  
Diagnostic Usefulness ◽  
Questionable Dementia ◽  
Specific Error

Qualitative features of the neuropsychological test performance of individuals with dementia of the Alzheimer type (DAT) were examined in a population-based study. Qualitative error scores were derived from measures of verbal and figural memory, verbal fluency and confrontation naming for 38 patients with clinically diagnosed DAT, 236 normal elderly (NE) individuals, and 72 others who were questionably demented and at risk (AR) for DAT. Persons with DAT made a greater proportion of intrusion and perseverative errors, and more lexical and semantic naming errors, than the NE participants. These measures provided fair specificity but poor sensitivity for the diagnosis of DAT, and a logistic model based on these measures correctly classified 98% of the NE participants, but only 29% of the DAT participants. The AR participants demonstrated a pattern of errors that was highly similar to that of the DAT patients, and when their scores were subjected to the logistic model, 90% were classified as NE and 10% as DAT. These results indicate that specific error types that have been associated with DAT in self-referred or clinic-based samples also occur in the general population to a greater degree in individuals with DAT or questionable dementia than in NE individuals. Furthermore, these qualitative features may have some diagnostic usefulness in that their presence provides reasonable specificity for DAT or questionable dementia. (JINS, 1997, 3, 387–393.)

Sex Differences in Neuropsychological Test Performance in Alzheimer’s Disease and the Influence of the ApoE Genotype

2018 ◽  
Vol 32 (2) ◽  
pp. 145-149 ◽  
Author(s):  
Maria Tensil ◽  
Johannes B. Hessler ◽  
Maria Gutsmiedl ◽  
Lina Riedl ◽  
Timo Grimmer ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Sex Differences ◽  
Test Performance ◽  
Neuropsychological Test ◽  
Apoe Genotype

Determinants and Detection of Low Body Mass Index in Community-Dwelling Adults With Alzheimer's Disease

2000 ◽  
Vol 12 (1) ◽  
pp. 87-98 ◽  
Author(s):  
Michel Bédard ◽  
D. William Molloy ◽  
Rhonda Bell ◽  
Judy A. Lever
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Body Mass Index ◽  
At Risk ◽  
Body Mass ◽  
Community Dwelling ◽  
Assessment Protocol ◽  
Geriatric Clinic ◽  
Low Body Mass Index ◽  
Low Bmi

Objective: To determine the proportion of older adults with Alzheimer's disease presenting to a geriatric clinic with low body mass index (BMI), the proportion of these individuals recognized by clinicians as malnourished, and what patients' characteristics and caregivers' and clinicians' impressions are associated with low BMI. Design: Cross-sectional study. Setting: An outpatient geriatric clinic located in a university-affiliated teaching hospital. Participants: 340 patients with Alzheimer's disease, average age 75 years. Measurements: Individuals with a BMI below 21 were considered at risk of malnutrition. Physical examination and medical information were obtained from patients and caregivers by clinicians using a standardized assessment protocol. Clinicians' impression regarding evidence of malnutrition was obtained. Results: Forty-six patients (16%) had a BMI below 21. Clinicians reported evidence of potential malnutrition in 11 patients, 8 of whom had a BMI below 21. Using logistic regression, we found that women were five times more likely to have a BMI below 21 than men, and that individuals with low cognition were twice as likely to have a BMI below 21 than individuals with higher cognition. Conclusion: The proportion of patients with Alzheimer's disease with a BMI below 21 is similar to that encountered in the general population aged 65+. However, clinicians have difficulty identifying persons at risk of malnutrition according to BMI status. Women with low cognition were at increased risk of having a low BMI. Improvement in the detection of malnutrition is desirable. Further exploration of causal links between cognition and malnutrition is required.

Predicting functional performance by patients with Alzheimer's disease using the Problems in Everyday Living (PEDL) Test: A preliminary study

2002 ◽  
Vol 8 (1) ◽  
pp. 48-57 ◽  
Author(s):  
GEORGE S. LECKEY ◽  
WILLIAM W. BEATTY
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Mental State ◽  
Test Performance ◽  
Functional Performance ◽  
Population Based ◽  
Preliminary Study ◽  
Adl Performance ◽  
Population Based Survey ◽  
Everyday Living

Findings from a recent population-based survey indicate that about 33% of patients with dementia reside alone. Because many of these patients may not have a caregiver who visits them regularly, the need for a neuropsychological (NP) test to predict patients' functional competence to live alone safely is evident. In this study, we compared the accuracy of predicting Instrumental and Basic Activities (IADLs and ADLs) of 22 patients with Alzheimer's disease using several standard NP tests and the newly developed Problems in Everyday Living (PEDL) test. Performance of IADLs and ADLs as rated by caregivers was significantly correlated with performance on the PEDL, the Mini-Mental State Exam (MMSE), and with the Shipley Institute of Living Test of Verbal Abstraction (SILS-A), but not with vocabulary or naming. The PEDL was the best predictor of IADL scores (r = 0.71), compared to the MMSE (r = 0.52) and the SILS-A (r = 0.57), while the MMSE was the best predictor of ADL performance (r = 0.69), compared to the PEDL (r = 0.58) and the SILS-A (r = 0.50). (JINS, 2002, 8, 48–57.)

Estimation of the risk of conversion of mild cognitive impairment of Alzheimer type to Alzheimer's disease in a south Brazilian population-based elderly cohort: the PALA study

2011 ◽  
Vol 24 (4) ◽  
pp. 674-681 ◽  
Author(s):  
Cláudia Godinho ◽  
Ana Luiza Camozzato ◽  
Diego Onyszko ◽  
Márcia Lorena Chaves
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Population Based ◽  
Alzheimer Type ◽  
Risk Of Progression ◽  
Elderly Cohort ◽  
The Impact ◽  
Cognitively Intact

ABSTRACTBackground: Higher mild cognitive impairment (MCI) prognostic variability has been related to sample characteristics (community-based or specialized clinic) and to diverse operationalization criteria. The aim of the study was to evaluate the trajectory of MCI of Alzheimer type in a population-based elderly cohort in Southern Brazil. We also estimated the risk for the development of probable Alzheimer's disease (AD) in comparison with healthy subjects.Methods: Data were derived from a population-based cohort (the PALA study). MCI outcomes were sub-classified into three categories: conversion, stabilization, and reconversion. The risk of progression to dementia was compared between MCI and normal participants. The analysis was based on 21 MCI subjects and 220 cognitively intact participants (N = 241).Results: Of the 21 MCI subjects, 38% developed dementia, 24% remained stable and 38% improved. The MCI annual conversion rate to AD was 8.5%. MCI was associated with significantly higher risk of conversion to AD (HR = 49.83, p = 0.004), after adjustment for age, education, sex and Mini-Mental State Examination score.Conclusions: Independent of the heterogeneity of the outcomes, MCI of the Alzheimer type participants showed significantly higher risk of developing probable AD, demonstrating the impact of the use of these MCI criteria that emphasize long-term episodic memory impairment.

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