scholarly journals A-02 A Novel Tool for the Differential Diagnosis of Clinical Alzheimer’s Disease, Mild Cognitive Impairment, and Normal Cognition: Development and Validation

2020 ◽  
Vol 35 (6) ◽  
pp. 775-775
Author(s):  
A Parker ◽  
L Hynan ◽  
C Munro ◽  
W Goette ◽  
L Lacritz ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Demographic Data ◽  
Roc Curves ◽  
Weighted Sum ◽  
Validation Sample ◽  
Sum Scores ◽  
Sensitivity Specificity ◽  
Normal Cognition

Abstract Objective To create a clinician-friendly diagnostic tool based on neuropsychological and demographic data to assist classification of Alzheimer’s Disease (AD), Mild Cognitive Impairment (MCI), and normal cognition (NC). Methods Neuropsychological and demographic data from 652 (256 NC,122 MCI,274 AD) subjects were selected from a regional Alzheimer’s Disease Research Center. Utilizing half the sample, two binary logistic regressions compared NC to (MCI + AD) and AD to (NC + MCI) groups. Initial models were reduced in a step-wise manner to determine significant predictors. Raw scores for these variables were multiplied by weights derived from the final regression models and combined to create weighted-sum scores. Cut-points between diagnoses were established using ROC curves based on weighted-sum scores. The tool was validated in the remaining subjects through ROC analyses and sensitivity/specificity calculations for each diagnosis. Results Age, education, sex, Trails A&B, Logical Memory, Animals, and CVLT were all diagnostic predictors. ROC curves comparing weighted sum scores and consensus diagnoses in the validation set showed good discriminability (NC vs MCI + AD: AUC = .95; AD vs NC + MCI: AUC = .98). Scores of 305.75 predicted AD, MCI, and NC respectively, with good sensitivity/specificity in the validation sample (NC = .857/.913, MCI = .711/.883, AD = .914/.951), with 83% of all subjects correctly classified. Conclusions We created a user-friendly diagnostic tool based on demographic and neuropsychological test scores which distinguished between AD, MCI, and NC in an initial validation sample with relatively good accuracy. Results merit replication in other samples, but suggest that this approach may be useful to aid clinical diagnosis, particularly when biomarker data are not available in clinical settings.

scholarly journals Ecological assessment of executive functions in mild cognitive impairment and mild Alzheimer’s disease

2009 ◽  
Vol 15 (5) ◽  
pp. 751-757 ◽  
Author(s):  
ANA ESPINOSA ◽  
MONTSERRAT ALEGRET ◽  
MERCÈ BOADA ◽  
GEORGINA VINYES ◽  
SERGI VALERO ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Behavioral Assessment ◽  
Elderly Subjects ◽  
Action Program ◽  
Dysexecutive Syndrome ◽  
Six Elements ◽  
Normal Cognition

AbstractAlthough memory deficits are typically the earliest and most profound symptoms of Alzheimer’s disease (AD) and mild cognitive impairment (MCI), there is increasing recognition of subtle executive dysfunctions in these patients. The purpose of the present study was to determine the sensitivity of the Behavioral Assessment of the Dysexecutive Syndrome (BADS), and to detect early specific signs of the dysexecutive syndrome in the transition from normal cognition to dementia. The BADS was administered to 50 MCI subjects, 50 mild AD patients, and 50 normal controls. Statistically significant differences were found among the three groups with the AD patients performing most poorly, and the MCI subjects performing between controls and AD patients. The Rule Shift Cards and the Action Program subtests were the most highly discriminative between MCI and controls; the Zoo Map and Modified Six Elements between MCI and AD; and the Action Program, Zoo Map, and Modified Six Elements between AD and controls. These results demonstrate that the BADS is clinically useful in discriminating between normal cognition and progressive neurodegenerative conditions. Furthermore, these data confirm the presence of a dysexecutive syndrome even in mildly impaired elderly subjects. (JINS, 2009, 15, 751–757.)

Memory impairment in Alzheimer's disease: replication and extension of the delayed word recall (DWR) test

1996 ◽  
Vol 13 (2) ◽  
pp. 55-58 ◽  
Author(s):  
Robert F Coen ◽  
Gregory RJ Swanwick ◽  
Conor Maguire ◽  
Michael Kirby ◽  
Brian A Lawlor ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Free Recall ◽  
Recognition Performance ◽  
Word Recall ◽  
Control Subjects ◽  
Clinical Interest ◽  
Delayed Recognition ◽  
Sensitivity Specificity

AbstractObjective: The original DWR test, which measured delayed free recall, was reported to have high predictiveaccuracy in discriminating Alzheimer's disease (AD) patients from control subjects (overall accuracy of 95%).Comparison of differential performance in free recall and recognition of the same material may be of clinical interest. In the present study a delayed recognition component was added to the DWR test and the utility of both measures in discriminating AD patients from control subjects was evaluated.Procedure: This extended version of the DWR test was administered to 66 patients meeting NINCDS/ADRDA criteria for probable AD and 42 control subjects.Results: In a comparison between 42 of these patients (MMSE range 18–29), and 42 age matched healthy controls, both the delayed free recall and recognition measures were highly accurate in distinguishing patients from controls. The free recall measure achieved 98% sensitivity, specificity and overall accuracy, while the recognition measure yielded 98% sensitivity, 95% specificity, and 96% overall accuracy. The recognition performance of all 66 patients, ranging in severity from very mild to severe (MMSE range 11–29), was also evaluated to determine its relationship, if any, to measures of global cognitive impairment. While therecognition measure correlated poorly with MMSE and CAMCOG there was a modest but significant correlation with the CAMCOG memory subscale.Conclusions: In this study of highly selected AD patients both the free recall and recognition measures were sensitive and specific indicators of AD compared to control subjects. Recognition performance appears to be more closely related to degree of amnesia than to degree of global cognitive impairment.

scholarly journals DTI studies in patients with Alzheimer's disease, mild cognitive impairment, or normal cognition with evaluation of the intrinsic background gradients

2011 ◽  
Vol 53 (10) ◽  
pp. 749-762 ◽  
Author(s):  
Geon-Ho Jahng ◽  
Songfan Xu ◽  
Micheal W. Weiner ◽  
Dieter J. Meyerhoff ◽  
Seungjoon Park ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Normal Cognition ◽  
Intrinsic Background

scholarly journals Plasma β-amyloid in mild behavioural impairment – neuropsychiatric symptoms on the Alzheimer’s continuum

2021 ◽  
Author(s):  
Ruxin Miao ◽  
Hung-Yu Chen ◽  
Sascha Gill ◽  
James Naude ◽  
Eric E. Smith ◽  
...  
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Neuropsychiatric Symptoms ◽  
Affective Dysregulation ◽  
Prodromal Alzheimer’S Disease ◽  
Amyloid Aβ ◽  
Β Amyloid ◽  
Normal Cognition

AbstractIntroductionSimple markers are required to recognize older adults at higher risk for neurodegenerative disease. Mild behavioural impairment (MBI) and plasma β-amyloid (Aβ) have been independently implicated in the development of incident cognitive decline and dementia. Here we studied the associations between MBI and plasma Aβ42/Aβ40.MethodsParticipants with normal cognition (n = 86) or mild cognitive impairment (n = 53) were selected from the Alzheimer’s Disease Neuroimaging Initiative. MBI scores were derived from Neuropsychiatric Inventory items. Plasma Aβ42/Aβ40 ratios were assayed using mass spectrometry. Linear regressions were fitted to assess the association between MBI total score as well as MBI domain scores with plasma Aβ42/Aβ40.ResultsLower plasma Aβ42/Aβ40 was associated with higher MBI total score (p = 0.04) and greater affective dysregulation (p = 0.04), but not with impaired drive/motivation (p = 0.095) or impulse dyscontrol (p = 0.29) MBI domains.ConclusionIn persons with normal cognition or mild cognitive impairment, MBI was associated with low plasma Aβ42/Aβ40. Incorporating MBI into case detection can help capture preclinical and prodromal Alzheimer’s disease.

scholarly journals ALZHEIMER’S DISEASE, CEREBROVASCULAR DISEASE AND DEMENTIA: THEIR ASSOCIATION AND PREVENTION

2016 ◽  
pp. 1-6
Author(s):  
D.A. Davey
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Cognitive Impairment ◽  
Cerebrovascular Disease ◽  
Social Factors ◽  
Sufficient Evidence ◽  
Personal Health ◽  
Health Initiatives ◽  
Normal Cognition ◽  
Public Health Initiatives

Alzheimer’s disease (AD) and cerebrovascular disease (CVD) frequently co-exist and CVD acts additionally and synergistically with AD in ageing–related impairment of cognitive function and dementia. A significant number of men and women with normal cognition at the time of death have the neurodegenerative and cerebrovascular changes of AD and CVD and are regarded as having high cognitive reserve or cognitive resilience. Many measures used to prevent and treat cardiovascular disease, decrease the incidence, or delay the onset of ageing-related cognitive impairment and dementia. Ageing-related cognitive impairment and dementia are increased by adverse psycho-social factors and can be prevented or mitigated by appropriate psycho-social measures. There is now more than sufficient evidence to implement, as a matter of urgency, personal health and life-style measures and public health initiatives in the endeavor to prevent, postpone or ameliorate ageing-related cognitive impairment and dementia and to decrease its burden world-wide.

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