Relationship between comprehensive geriatric assessment and amyloid PET in older persons with MCI

Abstract Background The association between amyloid deposition and cognitive, behavioral and physical performance in mild cognitive impairment (MCI) due to Alzheimer’s disease (AD) has been poorly investigated, especially in older persons. Methods We studied the in vivo correlation between the amyloid deposition at Positron Emission Tomography (amyloid-PET) and the presence of memory loss, reduced executive function, neuropsychiatric symptoms and physical performance in older persons with MCI. Amyloid-PET was performed with 18F-flutemetamol and quantitatively analyzed. Results We evaluated 48 subjects, 21 men and 27 women. We performed in each patient a comprehensive geriatric assessment (CGA) including Mini Mental State Examination (MMSE), Clock Drawing Test (CDT), Activity Daily Living (ADL), Instrumental Activity of Daily Living (IADL), Neuropsychiatric inventory (NPI) questionnaire, 15 Geriatric Depression Scale (GDS), Short Physical Performance Battery (SPPB) and Hand Grip strength. Then, each patient underwent amyloid-PET. Mean age of the enrolled subjects was 74.6 ± 7.8 years. All of these subjects showed preserved cognitive function at MMSE > 24, while 29 of 48 subjects (61.0%) had altered CDT. Mean NPI score was 6.9 ± 5.9. The mean value of SPPB score was 9.0 ± 2.6, while the average muscle strength of the upper extremities measured by hand grip was 25.6 ± 7.7 Kg. CT/MRI images showed cortical atrophic changes in 26 of the 48 examined subjects (54.0%), while cerebrovascular modifications were present in 31 subjects (64.5%). Pathological burden of amyloid deposits was detected in 25 of 48 (52.0%) patients with a mean value of global z-score of 2.8 (subjects defined as MCI due to AD). After stratifying subjects in subclasses of clinical alterations, more probability of pathological amyloid deposition was found in subjects with impaired CDT and higher NPI score (O.R. = 3.45 [1.01–11.2], p = 0.04), with both impaired CDT and low physical performance (O.R. = 5.80 [1.04–32.2], p = 0.04), with altered CDT and high NPI score (O.R. = 7.98 [1.38–46.0], p = 0.02), and finally in those subjects with altered CDT, high NPI and low physical performance (O.R. = 5.80 [1.05–32.2], p = 0.04). Conclusion Our findings support the recent hypothesis that amyloid deposition could be associated with multiple cerebral dysfunction, mainly affecting executive, behavioral and motor abilities.

Download Full-text

Relationship between comprehensive geriatric assessment and amyloid PET in older persons with MCI

10.21203/rs.2.20283/v2 ◽

2020 ◽

Author(s):

Fulvio Lauretani ◽

Livia Ruffini ◽

Maura Scarlattei ◽

Marcello Maggio

Keyword(s):

Physical Performance ◽

Geriatric Assessment ◽

Comprehensive Geriatric Assessment ◽

Daily Living ◽

Older Persons ◽

Neuropsychiatric Symptoms ◽

Mean Value ◽

Amyloid Deposition ◽

Amyloid Pet ◽

Hand Grip

Abstract Background. The association between amyloid deposition and cognitive, behavioral and physical performance in mild cognitive impairment (MCI) due to Alzheimer's disease (AD) has been poorly investigated, especially in older persons. Methods. We studied the in vivo correlation between the amyloid deposition at Positron Emission Tomography (amyloid-PET) and the presence of memory loss, reduced executive function, physical performance and neuropsychiatric symptoms in older persons with MCI. Amyloid-PET was performed with 18F-flutemetamol and quantitatively analyzed. Results. We evaluated 48 subjects, 21 men and 27 women. We performed in each patient a comprehensive geriatric assessment (CGA) including Mini Mental State Examination (MMSE), Clock Drawing Test (CDT), Activity Daily Living (ADL), Instrumental Activity of Daily Living (IADL), Neuropsychiatric inventory (NPI) questionnaire, 15 Geriatric Depression Scale (GDS), Short Physical Performance Battery (SPPB) and Hand Grip strength. Then, each patient underwent amyloid-PET. Mean age of the enrolled subjects was 74.6 ± 7.8 years. All of these subjects showed preserved cognitive function at MMSE > 24, while 29 of 48 subjects (61.0 %) had altered CDT. Mean NPI score was 6.9 ± 5.9. The mean value of SPPB score was 9.0 ± 2.6, while the average muscle strength of the upper extremities measured by hand grip was 25.6±7.7 Kg. CT/MRI images showed cortical atrophic changes in 26 of the 48 examined subjects (54.0 %), while cerebrovascular modifications were present in 31 subjects (64.5 %). Pathological burden of amyloid deposits was detected in 25 of 48 (52.0 %) patients with a mean value of global z-score of 2.8 (subjects defined as MCI due to AD). After stratifying subjects in subclasses of clinical alterations, more probability of pathological amyloid deposition was found in subjects with impaired CDT and higher NPI score (O.R.= 3.45 [1.01-11.2], p=0.04), with both impaired CDT and low physical performance (O.R.= 5.80 [1.04-32.2], p=0.04), with altered CDT and high NPI score (O.R.=7.98 [1.38-46.0], p=0.02), and finally in those subjects with altered CDT, high NPI and low physical performance (O.R.= 5.80 [1.05-32.2], p=0.04). Conclusion. Our findings support the recent hypothesis that amyloid deposition could be associated with multiple cerebral dysfunction, mainly affecting executive, behavioral and motor abilities.

Download Full-text

Validation of the Freund Clock Drawing Test as a screening tool to detect cognitive dysfunction in elderly cancer patients undergoing comprehensive geriatric assessment

Psycho-Oncology ◽

10.1002/pon.3540 ◽

2014 ◽

Vol 23 (10) ◽

pp. 1172-1177 ◽

Cited By ~ 13

Author(s):

Michelle Lycke ◽

Lore Ketelaars ◽

Tom Boterberg ◽

Lies Pottel ◽

Hans Pottel ◽

...

Keyword(s):

Cancer Patients ◽

Cognitive Dysfunction ◽

Geriatric Assessment ◽

Comprehensive Geriatric Assessment ◽

Screening Tool ◽

Elderly Cancer Patients ◽

Clock Drawing Test ◽

Clock Drawing ◽

Drawing Test

Download Full-text

The Clock-Drawing Test in Elderly Italian Community Dwellers: Associations with Sociodemographic Status and Risk Factors for Vascular Cognitive Impairment

Dementia and Geriatric Cognitive Disorders ◽

10.1159/000072815 ◽

2003 ◽

Vol 16 (4) ◽

pp. 287-295 ◽

Cited By ~ 15

Author(s):

G. Ravaglia ◽

P. Forti ◽

F. Maioli ◽

G. Arnone ◽

G. Pantieri ◽

...

Keyword(s):

Risk Factors ◽

Cognitive Impairment ◽

Vascular Cognitive Impairment ◽

Clock Drawing Test ◽

Clock Drawing ◽

Drawing Test ◽

Italian Community ◽

Community Dwellers

Download Full-text

The Clock Drawing Test: Performance differences between the free-drawn and incomplete-copy versions in patients with MCI and dementia

Dementia & Neuropsychologia ◽

10.1590/s1980-5764-2016dn1003009 ◽

2016 ◽

Vol 10 (3) ◽

pp. 227-231 ◽

Cited By ~ 2

Author(s):

Bárbara Costa Beber ◽

Renata Kochhann ◽

Bruna Matias ◽

Márcia Lorena Fagundes Chaves

Keyword(s):

Cognitive Impairment ◽

Test Performance ◽

Diagnostic Value ◽

Control Group ◽

Cognitive Screening ◽

Scoring Method ◽

Clock Drawing Test ◽

Clock Drawing ◽

Healthy Elderly ◽

Drawing Test

ABSTRACT Background: The Clock Drawing Test (CDT) is a brief cognitive screening tool for dementia. Several different presentation formats and scoring methods for the CDT are available in the literature. Objective: In this study we aimed to compare performance on the free-drawn and "incomplete-copy" versions of the CDT using the same short scoring method in Mild Cognitive Impairment (MCI) and dementia patients, and healthy elderly participants. Methods: 90 participants (controlled for age, sex and education) subdivided into control group (n=20), MCI group (n=30) and dementia group (n=40) (Alzheimer's disease - AD=20; Vascular Dementia - VD=20) were recruited for this study. The participants performed the two CDT versions at different times and a blinded neuropsychologist scored the CDTs using the same scoring system. Results: The scores on the free-drawn version were significantly lower than the incomplete-copy version for all groups. The dementia group had significantly lower scores on the incomplete-copy version of the CDT than the control group. MCI patients did not differ significantly from the dementia or control groups. Performance on the free-drawn copy differed significantly among all groups. Conclusion: The free-drawn CDT version is more cognitively demanding and sensitive for detecting mild/early cognitive impairment. Further evaluation of the diagnostic value (accuracy) of the free-drawn CDT in Brazilian MCI patients is needed.

Download Full-text

DCDT: A Digital Clock Drawing Test System for Cognitive Impairment Screening

2020 IEEE 36th International Conference on Data Engineering (ICDE) ◽

10.1109/icde48307.2020.00164 ◽

2020 ◽

Author(s):

Feiyang Xu ◽

Yue Ding ◽

Zhenhua Ling ◽

Xin Li ◽

Yunxia Li ◽

...

Keyword(s):

Cognitive Impairment ◽

Test System ◽

Clock Drawing Test ◽

Digital Clock ◽

Clock Drawing ◽

Drawing Test

Download Full-text

USE OF THE AUTOMATIC CLOCK DRAWING TEST TO RAPIDLY SCREEN FOR COGNITIVE IMPAIRMENT IN OLDER ADULTS, DRIVERS, AND THE PHYSICALLY CHALLENGED

Journal of the American Geriatrics Society ◽

10.1111/j.1532-5415.2007.01055.x ◽

2007 ◽

Vol 55 (2) ◽

pp. 310-311 ◽

Cited By ~ 3

Author(s):

Sandy Helene Straus

Keyword(s):

Older Adults ◽

Cognitive Impairment ◽

Clock Drawing Test ◽

Clock Drawing ◽

Drawing Test ◽

Physically Challenged

Download Full-text

Is the Clock Drawing Test a screening tool for the diagnosis of mild cognitive impairment? A systematic review

International Psychogeriatrics ◽

10.1017/s1041610209990676 ◽

2009 ◽

Vol 22 (1) ◽

pp. 56-63 ◽

Cited By ~ 44

Author(s):

Lena Ehreke ◽

Melanie Luppa ◽

Hans-Helmut König ◽

Steffi G. Riedel-Heller

Keyword(s):

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Literature Search ◽

Screening Tool ◽

Cognitive Screening ◽

Clock Drawing Test ◽

Clock Drawing ◽

Drawing Test ◽

Diagnosis Of Dementia ◽

Mean Differences

ABSTRACTBackground:The clock drawing test (CDT) is a common and widely used cognitive screening instrument for the diagnosis of dementia. However, it has remained unclear whether it is a suitable method to identify mild cognitive impairment (MCI). The aim of this paper is to review systematically the studies concerning the utility of the CDT in diagnosing MCI.Method:A systematic literature search was conducted. All studies dealing with utility of CDT in diagnosing MCI regardless of the applied CDT scoring system and MCI concept were selected.Results:Nine relevant studies were identified. The majority of the studies compared average CDT scores of cognitively healthy and mildly impaired subjects, and four of them identified significant mean differences. If reported, sensitivity and specificity have been mostly unsatisfactory.Conclusion:CDT should not be used for MCI-screening.

Download Full-text