scholarly journals ACCURACY OF NEUROPSYCHOLOGICAL TESTS IN PATIENTS WITH BIOLOGICAL DIAGNOSIS OF ALZHEIMER’S DISEASE

2021 ◽  
Author(s):  
Patrícia Peles ◽  
Larissa Salvador ◽  
Luciano Mariano ◽  
Viviane Carvalho ◽  
Clarisse Frieldlaender ◽  
...  

Background: Neuropsychological tests are important tools for the diagnosis of mild cognitive impairment or dementia due to Alzheimer’s disease (AD). Objective: To investigate the accuracy of common neuropsychological tests used in the clinical setting for AD diagnosis. Methods: Forty two patients with diagnosis of AD continuum [A+T+/-(N)+/-] and 32 non-AD [A-T+/-(N)+/-]. All participants were submitted to a thorough neuropsychological assessment with the following instruments: Mattis Dementia Rating Scale (DRS), Rey’s Auditory Verbal Learning Test (RAVLT), Boston naming-Consortium to Establish a Registry for Alzheimer’s Disease, a reduced version of the CERAD, Digit Span Forward (DSF), Digit Span Backward (DSB) and Cubes from The Wechsler Adult Intelligence Scale (WAIS), verbal fluency – animals (VF-A), and FAS. Results: Memory (MEM) and Initiation/Perseveration (I/P) subscales of the DRS, FAS, Digit Span Backward (DSB) and Boston naming displayed good discrimination between AD and non-AD patients. The MEM subscale of the DRS, RAVLT A6 and FAS presented high sensitivity (90% or more) for AD diagnosis, while DSF displayed high specificity. Non-AD patients had greater difficulty in FAS, DSB and in Boston naming. Conclusion: Performance of patients with biological diagnosis of AD on MEM and I/P of DRS, and RAVLT A7 was significantly different from that of non-AD subjects.

2020 ◽  
Vol 35 (6) ◽  
pp. 801-801
Author(s):  
Kaylegian J ◽  
Ritter A ◽  
Caldwell J

Abstract Objective The present study investigated frequency and 12-month persistence of discrepant Clinical Dementia Rating (CDR) and comprehensive neuropsychological assessment ratings of impairment. Methods We examined CDR and neuropsychological test scores from year 1 and 2 visits of 162 adults enrolled in a longitudinal observational study. Neuropsychological measures included Wide Range Achievement Test, American National Adult Reading Test, Rey Auditory Verbal Learning Test, Brief Visuospatial Memory Test-Revised, Dementia Rating Scale 2nd edition, Boston Naming, Verbal Fluency/Color Word Interference from the Delis-Kaplan Executive Function System, Judgment of Line Orientation, Trail Making Test, Symbol Digit Modalities Test, and Digit Span/Letter Number Sequencing from The Wechsler Adult Intelligence Scale 4th edition. Discrepancies were defined as: CDR = 0 and 2 test impairments, CDR = 0.5 and > 5 or 0 impairments, CDR = 1 and 0 impairments. Results Including all test domains, 40.1% of participants in year 1 and 44.3% in year 2 showed discrepancies. 69% maintained this discrepancy at year 2 and 68% of these showed no change in discrepancy type. Considering only memory tests, 37% of participants in year 1 and 28.4% in year 2 showed discrepancies, with 45% maintaining at year 2 (74% showing no change in discrepancy type). A majority of discrepancies observed in both years 1 and 2 revealed the CDR was under reporting impairment compared to the neuropsychological battery year. Conclusions The results provide evidence that within our study population, impairment as rated by the CDR frequently does not match the level of measured cognitive impairment and this observation is stable year to year.


2022 ◽  
Vol 14 (1) ◽  
pp. 90-98
Author(s):  
Vaitsa Giannouli ◽  
Magda Tsolaki

Research in the last decade has focused on assessing financial capacity and incapacity mainly in old age, but new research has turned to address the question of how financial incapacity can be predicted by cognitive factors. The aim of this study was to identify which cognitive domains predict financial capacity and the relevant cognitive skills of patients with mild Alzheimer’s disease (AD) in order to assist neurologists in functional assessment and further patient referral. In this study, 109 patients diagnosed with mild AD were examined with a number of neuropsychological tests: Mini-Mental State Examination (MMSE), Functional Rating Scale for Symptoms of Dementia (FRSSD), Functional Cognitive Assessment Scale (FUCAS), Trail Making Test (TMT)-Part B, Rey-Osterrieth Complex Figure Test (ROCFT)-copy condition and delayed recall condition, Rey Auditory Verbal Learning Test (RAVLT), Boston Naming Test, Rivermead Behavioural Memory Test (RBMT), digit span forward and backward, WAIS-R digit symbol substitution test, Neuropsychiatric Inventory (NPI), Geriatric Depression Scale (GDS-15), and the Legal Capacity for Property Law Transactions Assessment Scale (LCPLTAS). LCPLTAS total score and relevant subdomains were best predicted only by the score of one item coming from MMSE: subtraction of serial sevens. This is the only measure of arithmetic testing in use for the Greek geriatric population. Financial capacity is severely impaired in the group of mild AD patients. In order to prevent financial exploitation cases, neurologists, neuropsychologists, psychiatrists, and geriatrists should pay close attention to the information from the relevant arithmetic question of MMSE, as it is one of the most widely administered screening tests in clinical settings.


2012 ◽  
Vol 70 (1) ◽  
pp. 17-21 ◽  
Author(s):  
Sergilaine Pereira Martins ◽  
Benito Pereira Damasceno

OBJECTIVES: To verify the accuracy of prospective memory (ProM) tests in Alzheimer's disease (AD). METHODS: Twenty mild AD patients (CDR 1), and 20 controls underwent Digit Span (DS), Trail Making (TM) A and B, visual perception, Rey Auditory-Verbal Learning tests, and Cornell Scale for Depression. AD diagnosis was based on DSM-IV and NINCDS-ADRDA criteria. ProM was assessed with the appointment and belonging subtests of Rivermead Behavioral Memory Test (RBMT); and with two new tests (the clock and animal tests). RESULTS: AD patients had a worse performance than controls on the majority of tests, except DS forward and TM-A. There was no correlation between RBMT and the new ProM tests. As for accuracy, the only significant difference concerned the higher sensitivity of our animal test versus the RBMT belonging test. CONCLUSIONS: The clock and the animal tests showed similar specificity, but higher sensitivity than the RBMT subtests.


BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e036990 ◽  
Author(s):  
MengFei He ◽  
Li Sun ◽  
Wenhui Cao ◽  
Changhao Yin ◽  
Wenqiang Sun ◽  
...  

IntroductionNeurogranin is known to be significantly elevated in patients with Alzheimer’s disease (AD) and may be an effective clinical predictor of cognitive decline and neurodegeneration. Amnestic mild cognitive impairment (aMCI) is an intermediate disease state between normal cognitive ageing and dementia, the latter of which can easily revert to AD. There remains significant uncertainty regarding the conversion of aMCI to AD, and therefore, elucidating such progression is paramount to the field of cognitive neuroscience. In this protocol study, we therefore aim to investigate the changes in plasma neurogranin in the early stage of AD and the mechanism thereof regarding the cognitive progression towards AD.Methods and analysisIn this study, patients with aMCI and AD patients (n=70 each) will be recruited at the memory clinic of the Department of Neurology of Hongqi Hospital affiliated with the Mudanjiang Medical University of China. Healthy older controls (n=70) will also be recruited from the community. All subjects will undergo neuroimaging and neuropsychological evaluations in addition to blood collection at the first year and the third year. We hope to identify a new biomarker of cognitive decline associated with AD and characterise its behaviour throughout the progression of aMCI to AD. This work will reveal novel targets for the therapeutic prevention, diagnosis and treatment of AD. The primary outcome measures will be (1) neuropsychological evaluation, including Mini-Mental State Examination, Montreal Cognitive Assessment, Clinical Dementia Rating scale, Shape Trail Test-A&B, Auditory Verbal Learning Test-HuaShan version; (2) microstructural alterations and hippocampal features from MRI scans; and (3) neurogranin levels in the neuronal-derived exosomes from peripheral blood samples.Ethics and disseminationThe ethics committee of the Hongqi Hospital affiliated with the Mudanjiang Medical University of China has approved this study protocol. The results will be published in peer-reviewed journals and presented at national or international scientific conferences.Trial registration numberChiCTR2000029055.


2009 ◽  
Vol 16 (1) ◽  
pp. 77-83 ◽  
Author(s):  
MELISSA LAMAR ◽  
DAVID J. LIBON ◽  
ANGELA V. ASHLEY ◽  
JAMES J. LAH ◽  
ALLAN I. LEVEY ◽  
...  

AbstractRecent evidence suggests that patients with Alzheimer’s disease (AD) and vascular comorbidities (VC) perform worse across measures of verbal reasoning and abstraction when compared to patients with AD alone. We performed a qualitative error analysis of Wechsler Adult Intelligence Scale-III Similarities zero-point responses in 45 AD patients with varying numbers of VC, including diabetes, hypertension, and hypercholesterolemia. Errors were scored in set if the answer was vaguely related to how the word pair was alike (e.g., dog-lion: “they can be trained”) and out of set if the response was unrelated (“a lion can eat a dog”). AD patients with 2–3 VC did not differ on Similarities total score or qualitative errors from AD patients with 0–1 VC. When analyzing the group as a whole, we found that increasing numbers of VC were significantly associated with increasing out of set errors and decreasing in set errors in AD. Of the vascular diseases investigated, it was only the severity of diastolic blood pressure that significantly correlated with out of set responses. Understanding the contribution of VC to patterns of impairment in AD may provide support for directed patient and caregiver education concerning the presentation of a more severe pattern of cognitive impairment in affected individuals. (JINS, 2010, 16, 77–83.)


2005 ◽  
Vol 100 (1) ◽  
pp. 69-76 ◽  
Author(s):  
Francis McCarthy ◽  
William J. Burns ◽  
Alfred H. Sellers

The declining cognitive functioning typically found in patients with Alzheimer's disease presents an opportunity to study that decline. The changing magnitude of ever widening discrepancies between premorbid estimators of IQ and observed IQ increases as severity of the disease increases. Premorbid IQs estimated by these scores (the National Adult Reading Test–Revised, the reading tests of the Revised and Third Editions of the Wide Range Achievement Test, and a demographically based regression index for the Wechsler Adult Intelligence Scale–Revised) had relatively similar discrepancies from obtained WAIS–R Full Scale IQs in samples of normal elderly ( n = 30), and elderly patients diagnosed with mild ( n = 30) and moderate Alzheimer's disease ( n = 30) dementia. The discrepancies became larger, regardless of premorbid estimator, as disease severity progressed from none to mild to moderate across the samples.


2003 ◽  
Vol 33 (6) ◽  
pp. 1039-1050 ◽  
Author(s):  
C. A. DE JAGER ◽  
E. HOGERVORST ◽  
M. COMBRINCK ◽  
M. M. BUDGE

Background. Early diagnosis of dementia is important for those who might benefit from treatment. We designed a brief comprehensive neuropsychological test battery to help differentiate control subjects from patients with mild cognitive impairment (MCI) and dementia.Method. The battery included tests of memory, attention, executive function, speed, perception and visuospatial skills. It was administered to subjects from the OPTIMA cohort: 51 controls, 29 with MCI, 60 with ‘possible’ or ‘probable’ Alzheimer's disease (AD) (NINCDS/ADRDA) and 12 with cerebrovascular disease (CVD). Mann–Whitney U tests were used to compare performance of controls with other diagnostic groups. The sensitivity and specificity of the tests were determined using Receiver Operating Characteristic curve analyses. The effects of age, gender and years of education on test performance were determined with Spearman's rank correlations.Results. The AD group performed worse than controls on all tests except an attention task. The Hopkins Verbal Learning Test and The Placing Test for episodic memory showed significant discriminative capacity between controls and other groups. Attention and processing speed tests discriminated CVD from controls. Category fluency, episodic memory tests and the CLOX test for executive function distinguished MCI from AD. Spearman's correlations showed negative associations between age and processing speed. Years of education affected performance on all tests, except The Placing Test.Conclusions. Certain neuropsychological tests have been shown to be sensitive and specific in the differential diagnosis of various types of dementia and may prove to be useful for detection of MCI.


Assessment ◽  
2021 ◽  
pp. 107319112199122
Author(s):  
Lauren T. Olson ◽  
Alan Smerbeck ◽  
Christina M. Figueroa ◽  
Jeremy M. Raines ◽  
Kinga Szigeti ◽  
...  

Methods We administered the Global Neuropsychological Assessment (GNA), an abbreviated cognitive battery, to 105 adults aged 73.0 ± 7.1 years, including 28 with probable Alzheimer’s disease, 9 with amnestic mild cognitive impairment, and 68 healthy controls. We examined group differences in baseline performance, test–retest reliability, and correlations with other conventional tests. Results Healthy adults outperformed patients on all five GNA subtests. Test–retest intraclass correlation coefficients were significant for all GNA subtests. Among patients with healthy controls, GNA Story Memory correlated best with Wechsler Memory Scale–Revised (WMS-R) Logical Memory for learning and delayed recall, GNA Digit Span correlated most highly with the Wechsler Adult Intelligence Scale–Third Edition (WAIS-III) Digit Span, GNA Perceptual Comparison correlated most highly with the Trail Making Test, and GNA Animal Naming correlated most highly with Supermarket Item Naming. Conclusions Preliminary findings suggest that the GNA shows good test–retest validity, clear convergent and discriminant construct validity, and excellent diagnostic criterion validity for dementia and mild cognitive impairment in an American sample.


2020 ◽  
Author(s):  
Chih-Sung Liang ◽  
Kuan-Pin Su ◽  
Chia-Lin Tsai ◽  
Jiunn-Tay Lee ◽  
Che-Sheng Chu ◽  
...  

Abstract Background: The neuroprotective role of Interleukin (IL)-33 is supported in numerous pre-clinical studies but remains mostly uninvestigated in clinical studies of Alzheimer’s disease (AD). We aimed to examine the association between human blood levels of IL-33 and cognitive preservation in amnestic mild cognitive impairment (aMCI) and AD.Methods: A total of 100 participants (26 controls, 35 aMCI patients, and 39 AD patients) were completed twice Mini Mental State Examination (MMSE) over a 1-year interval. At the second MMSE, the 100 participants examined the plasma levels of IL-33, IL-β, IL-1 receptor agonist (IL-1RA), beta amyloid (Aβ), and tau and apolipoprotein E (ApoE) genotyping, and Hopkins Verbal Learning Test, Trail Making Test, forward and backward digit span, and Clinical Dementia Rating were performed as well. Results: IL-33 expression showed a positive trend among controls (1/26 = 3.8%), aMCI (9/35 = 25.7%), and AD (17/39 = 43.6%) (trend analysis: P < 0.001). The patients expressing IL-33 preserved their cognitive function compared with IL-33 non-expressing patients (1-year ΔMMSE: 0.16 ± 1.6 vs -1.5 ± 2.6; P = 0.006). The cognitive preservation was not associated with the lower levels of Aβ, tau, and AopE ε4, while higher levels of AopE ε4 and phosphorylated tau were indeed associated with cognitive decline. The aMCI patients with AD conversion during study period had higher proportion of IL-33(-) than non-AD converters (0.9% vs 53.3%, P = 0.04).Conclusions: IL-33 or its associated signaling pathways may represent a new treatment paradigm for aMCI and AD.


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