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Marier A, Dadar M, Bouhali F, Montembeault M. Irregular word reading as a marker of semantic decline in Alzheimer's disease: implications for premorbid intellectual ability measurement. Alzheimers Res Ther 2024; 16:96. [PMID: 38698406 PMCID: PMC11064305 DOI: 10.1186/s13195-024-01438-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 03/25/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND Irregular word reading has been used to estimate premorbid intelligence in Alzheimer's disease (AD) dementia. However, reading models highlight the core influence of semantic abilities on irregular word reading, which shows early decline in AD. The primary objective of this study is to ascertain whether irregular word reading serves as an indicator of cognitive and semantic decline in AD, potentially discouraging its use as a marker for premorbid intellectual abilities. METHOD Six hundred eighty-one healthy controls (HC), 104 subjective cognitive decline, 290 early and 589 late mild cognitive impairment (EMCI, LMCI) and 348 AD participants from the Alzheimer's Disease Neuroimaging Initiative were included. Irregular word reading was assessed with the American National Adult Reading Test (AmNART). Multiple linear regressions were conducted predicting AmNART score using diagnostic category, general cognitive impairment and semantic tests. A generalized logistic mixed-effects model predicted correct reading using extracted psycholinguistic characteristics of each AmNART words. Deformation-based morphometry was used to assess the relationship between AmNART scores and voxel-wise brain volumes, as well as with the volume of a region of interest placed in the left anterior temporal lobe (ATL), a region implicated in semantic memory. RESULTS EMCI, LMCI and AD patients made significantly more errors in reading irregular words compared to HC, and AD patients made more errors than all other groups. Across the AD continuum, as well as within each diagnostic group, irregular word reading was significantly correlated to measures of general cognitive impairment / dementia severity. Neuropsychological tests of lexicosemantics were moderately correlated to irregular word reading whilst executive functioning and episodic memory were respectively weakly and not correlated. Age of acquisition, a primarily semantic variable, had a strong effect on irregular word reading accuracy whilst none of the phonological variables significantly contributed. Neuroimaging analyses pointed to bilateral hippocampal and left ATL volume loss as the main contributors to decreased irregular word reading performances. CONCLUSIONS While the AmNART may be appropriate to measure premorbid intellectual abilities in cognitively unimpaired individuals, our results suggest that it captures current semantic decline in MCI and AD patients and may therefore underestimate premorbid intelligence. On the other hand, irregular word reading tests might be clinically useful to detect semantic impairments in individuals on the AD continuum.
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Affiliation(s)
- Anna Marier
- Douglas Research Centre & Department of Psychiatry, McGill University, 6875 Boulevard LaSalle, Montréal, QC, H4H 1R3, Canada
- Department of Psychology, Université de Montréal, Succursale Centre-Ville, Montréal, QC, C.P. 6128, H3C 3J7, Canada
| | - Mahsa Dadar
- Douglas Research Centre & Department of Psychiatry, McGill University, 6875 Boulevard LaSalle, Montréal, QC, H4H 1R3, Canada
| | | | - Maxime Montembeault
- Douglas Research Centre & Department of Psychiatry, McGill University, 6875 Boulevard LaSalle, Montréal, QC, H4H 1R3, Canada.
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Marier A, Dadar M, Bouhali F, Montembeault M. Irregular word reading as a marker of cognitive and semantic decline in Alzheimer's disease rather than an estimate of premorbid intellectual abilities. RESEARCH SQUARE 2023:rs.3.rs-3381469. [PMID: 37841870 PMCID: PMC10571618 DOI: 10.21203/rs.3.rs-3381469/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Background Irregular word reading has been used to estimate premorbid intelligence in Alzheimer's disease (AD) dementia. However, reading models highlight the core influence of semantic abilities on irregular word reading, which shows early decline in AD. The general aim of this study is to determine whether irregular word reading is a valid estimate of premorbid intelligence, or a marker of cognitive and semantic decline in AD. Method 681 healthy controls (HC), 104 subjective cognitive decline, 290 early and 589 late mild cognitive impairment (EMCI, LMCI) and 348 AD participants from the Alzheimer's Disease Neuroimaging Initiative were included. Irregular word reading was assessed with the American National Adult Reading Test (AmNART). Multiple linear regressions were conducted predicting AmNART score using diagnostic category, general cognitive impairment and semantic tests. A generalized logistic mixed-effects model predicted correct reading using extracted psycholinguistic characteristics of each AmNART words. Deformation-based morphometry was used to assess the relationship between AmNART scores and voxel-wise brain volumes, as well as with the volume of a region of interest placed in the left anterior temporal lobe (ATL). Results EMCI, LMCI and AD patients made significantly more errors in reading irregular words compared to HC, and AD patients made more errors than all other groups. Across the AD continuum, as well as within each diagnostic group, irregular word reading was significantly correlated to measures of general cognitive impairment / dementia severity. Neuropsychological tests of lexicosemantics were moderately correlated to irregular word reading whilst executive functioning and episodic memory were respectively weakly and not correlated. Age of acquisition, a primarily semantic variable, had a strong effect on irregular word reading accuracy whilst none of the phonological variables significantly contributed. Neuroimaging analyses pointed to bilateral hippocampal and left ATL volume loss as the main contributors to decreased irregular word reading performances. Conclusions Irregular word reading performances decline throughout the AD continuum, and therefore, premorbid intelligence estimates based on the AmNART should not be considered accurate in MCI or AD. Results are consistent with the theory of irregular word reading impairments as an indicator of disease severity and semantic decline.
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Affiliation(s)
- Anna Marier
- Department of Psychology, Université de Montréal, C.P. 6128, succursale Centre-Ville, Montréal, QC, Canada, H3C 3J7
| | - Mahsa Dadar
- Douglas Research Centre & Department of Psychiatry, McGill University, 6875 Boulevard LaSalle, Montréal, QC, Canada, H4H 1R3
| | | | - Maxime Montembeault
- Douglas Research Centre & Department of Psychiatry, McGill University, 6875 Boulevard LaSalle, Montréal, QC, Canada, H4H 1R3
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Ruchinskas R, Goette W. Reynolds Intellectual Screening Instrument 1st versus 2nd Edition in a Memory Disorder Sample. Arch Clin Neuropsychol 2021; 36:570-577. [PMID: 32853358 DOI: 10.1093/arclin/acaa064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/26/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The Reynolds Intellectual Screening Instrument (RIST) and its second edition (RIST-2) are brief intelligence screening instruments that potentially have value in older populations as their norms extend over age 90. This study examined performance on these two instruments in a sample of individuals presenting for evaluation in a memory disorder clinic. METHOD A sample of 1,145 subjects over the age of 50 was chosen from 1,761 consecutive referrals. Individuals who obtained a consensus diagnosis of Mild Cognitive Impairment (MCI; n = 536), possible dementia of the Alzheimer Type (DAT; n = 400), or those with subjective cognitive complaints (SCC; n = 209) and who completed a neuropsychological battery that included either the RIST (n = 747) or the RIST-2 (n = 398) were included in the sample. No clinically significant demographic or neuropsychological performance differences were found for those taking either version of the RIST. RESULTS Unlike the original version, RIST-2 Total and subtest scores were well below the mean for the DAT group and over 1 SD mean difference was seen for the DAT group when comparing the RIST and RIST-2 Totals. Diagnostic accuracy calculations suggested that the RIST-2 showed greater discrimination between the three groups although both versions achieved greater sensitivity than specificity. CONCLUSIONS Performance differences were evident when comparing the RIST and RIST-2, particularly for the DAT group. Although the RIST-2 evidenced greater diagnostic accuracy than its predecessor it should not be utilized in isolation for the clinical determination of DAT or MCI.
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Affiliation(s)
- Robert Ruchinskas
- Department of Psychiatry; Department of Neurology & Neurotherapeutics, UT Southwestern Medical Center, TX 75390-8869, USA
| | - William Goette
- Department of Psychology, UT Southwestern School of Biomedical Sciences, 6000 Harry HInes Blvd., Dallas, TX 75235, USA
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Moore RC, Hussain MA, Watson CWM, Fazeli PL, Marquine MJ, Yarns BC, Jeste DV, Moore DJ. Grit and Ambition are Associated with Better Neurocognitive and Everyday Functioning Among Adults Living with HIV. AIDS Behav 2018; 22:3214-3225. [PMID: 29455265 DOI: 10.1007/s10461-018-2061-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Grit and ambition are psychological factors that may protect neurocognitive function among persons living with HIV (PLWH). We examined associations between grit, ambition, premorbid verbal intellectual function, and current neurocognitive and everyday functioning among PLWH and persons without HIV (HIV-). 120 PLWH and 94 HIV- adults completed the Grit Scale (includes total score and consistency of interests and perseverance of effort subscales), ambition scale, and a comprehensive neurobehavioral battery. PLWH had lower grit scores than HIV- adults. The two groups did not differ on ambition. No relationship was observed between grit and cognition among HIV- adults. Among PLWH, however, higher perseverance of effort and more ambition was related to better global neurocognitive functioning, and higher grit, but not ambition, was related to independence in daily functioning. Longitudinal studies are needed to elucidate these relationships over time and examine whether grit or ambition have protective effects on cognitive outcomes among PLWH.
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Affiliation(s)
- Raeanne C Moore
- Department of Psychiatry, University of California, San Diego, 220 Dickinson Drive, St B (8231), San Diego, CA, 92103-8231, USA.
- VA San Diego Healthcare System, San Diego, CA, USA.
| | - Mariam A Hussain
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University, University of California, San Diego, CA, USA
| | - Caitlin W-M Watson
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University, University of California, San Diego, CA, USA
| | - Pariya L Fazeli
- Department of Family, Community, and Health Systems, School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - María J Marquine
- Department of Psychiatry, University of California, San Diego, 220 Dickinson Drive, St B (8231), San Diego, CA, 92103-8231, USA
| | - Brandon C Yarns
- Department of Medicine, Division of General Internal Medicine, UCLA David Geffen School of Medicine, Los Angeles, CA, USA
- Department of Psychiatry (BCY), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Dilip V Jeste
- Department of Psychiatry, University of California, San Diego, 220 Dickinson Drive, St B (8231), San Diego, CA, 92103-8231, USA
- Department of Neurosciences, University of California, San Diego, CA, USA
- Sam and Rose Stein Institute for Research on Aging, University of California, San Diego, CA, USA
| | - David J Moore
- Department of Psychiatry, University of California, San Diego, 220 Dickinson Drive, St B (8231), San Diego, CA, 92103-8231, USA
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Olsen JP, Fellows RP, Rivera-Mindt M, Morgello S, Byrd DA. Reading Ability as an Estimator of Premorbid Intelligence: Does It Remain Stable Among Ethnically Diverse HIV+ Adults? Clin Neuropsychol 2015; 29:1034-52. [PMID: 26689235 DOI: 10.1080/13854046.2015.1122085] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
UNLABELLED The Wide Range Achievement Test, 3rd edition, Reading Recognition subtest (WRAT-3 RR) is an established measure of premorbid ability. Furthermore, its long-term reliability is not well documented, particularly in diverse populations with CNS-relevant disease. OBJECTIVE We examined test-retest reliability of the WRAT-3 RR over time in an HIV+ sample of predominantly racial/ethnic minority adults. METHOD Participants (N = 88) completed a comprehensive neuropsychological battery, including the WRAT-3 RR, on at least two separate study visits. Intraclass correlation coefficients (ICCs) were computed using scores from baseline and follow-up assessments to determine the test-retest reliability of the WRAT-3 RR across racial/ethnic groups and changes in medical (immunological) and clinical (neurocognitive) factors. Additionally, Fisher's Z tests were used to determine the significance of the differences between ICCs. RESULTS The average test-retest interval was 58.7 months (SD = 36.4). The overall WRAT-3 RR test-retest reliability was high (r = .97, p < .001) and remained robust across all demographic, medical, and clinical variables (all r's > .92). ICCs did not differ significantly between the subgroups tested (all Fisher's Z p's > .05). CONCLUSIONS Overall, this study supports the appropriateness of word-reading tests, such as the WRAT-3 RR, for use as stable premorbid IQ estimates among ethnically diverse groups. Moreover, this study supports the reliability of this measure in the context of change in health and neurocognitive status and in lengthy inter-test intervals. These findings offer strong rationale for reading as a "hold" test, even in the presence of a chronic, variable disease such as HIV.
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Affiliation(s)
- James P Olsen
- a Department of Neurology , The Icahn School of Medicine at Mount Sinai , New York , NY , USA.,c Department of Psychology , Fordham University , New York , NY , USA
| | - Robert P Fellows
- a Department of Neurology , The Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Monica Rivera-Mindt
- a Department of Neurology , The Icahn School of Medicine at Mount Sinai , New York , NY , USA.,b Department of Psychiatry , The Icahn School of Medicine at Mount Sinai , New York , NY , USA.,c Department of Psychology , Fordham University , New York , NY , USA
| | - Susan Morgello
- a Department of Neurology , The Icahn School of Medicine at Mount Sinai , New York , NY , USA.,d Department of Neuroscience , The Icahn School of Medicine at Mount Sinai , New York , NY , USA
| | - Desiree A Byrd
- a Department of Neurology , The Icahn School of Medicine at Mount Sinai , New York , NY , USA.,b Department of Psychiatry , The Icahn School of Medicine at Mount Sinai , New York , NY , USA
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Contador I, Bermejo-Pareja F, Del Ser T, Benito-León J. Effects of education and word reading on cognitive scores in a community-based sample of Spanish elders with diverse socioeconomic status. J Clin Exp Neuropsychol 2015; 37:92-101. [DOI: 10.1080/13803395.2014.989819] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Sierra Sanjurjo N, Montañes P, Sierra Matamoros FA, Burin D. Estimating Intelligence in Spanish: Regression Equations With the Word Accentuation Test and Demographic Variables in Latin America. APPLIED NEUROPSYCHOLOGY-ADULT 2014; 22:252-61. [DOI: 10.1080/23279095.2014.918543] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Patricia Montañes
- Facultad de Psicología, Universidad Nacional de Colombia, Bogota, Colombia
| | | | - Debora Burin
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
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Casaletto KB, Cattie J, Franklin DR, Moore DJ, Woods SP, Grant I, Heaton RK. The Wide Range Achievement Test-4 Reading subtest "holds" in HIV-infected individuals. J Clin Exp Neuropsychol 2014; 36:992-1001. [PMID: 25283135 DOI: 10.1080/13803395.2014.960370] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND In order to detect HIV-associated neurocognitive decline, it is important to accurately estimate individuals' premorbid levels of cognitive functioning. Although previous studies have operated under the assumption that word reading tests are valid and stable indicators of premorbid abilities in HIV infection, studies of other populations have found that this is not always the case. Therefore, it is important to empirically examine the validity of word reading tests as estimates of premorbid functioning specifically within the HIV population. METHOD The Wide Range Achievement Test-4 Reading subtest (WRAT-4 Reading) was administered along with comprehensive neurocognitive assessments to 150 HIV seropositive (HIV+) and 76 HIV seronegative (HIV-) age-, education-, and sex-matched participants; a subset of 48 HIV+ individuals completed a second study visit (M = 14.4 months), in which the alternate version of the WRAT-4 was administered. RESULTS Although HIV+ individuals evidenced worse current neurocognitive functioning than HIV- participants, WRAT-4 Reading performance was comparable between groups. Longitudinally, HIV+ participants evidenced improved disease and neuropsychological functioning, yet WRAT-4 Reading demonstrated strong test-retest reliability and no practice effect, and did not differ between the initial and follow-up assessments. Test-retest differences in reading performance were minor and were not associated with changes in neurocognitive performance or changes in HIV disease. CONCLUSIONS We found no evidence of WRAT-4 Reading performance decline in HIV infection, despite HIV+/HIV- group differences in neurocognitive functioning. Additionally, reading performances among HIV+ individuals demonstrated consistency across study visits. These results begin to support the validity of the WRAT-4 Reading subtest as an indicator of premorbid cognitive functioning in HIV+ individuals.
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Affiliation(s)
- Kaitlin B Casaletto
- a San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology , San Diego , CA , USA
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Vocabulary is an appropriate measure of premorbid intelligence in a sample with heterogeneous educational level in Brazil. Behav Neurol 2014; 2014:875960. [PMID: 24803737 PMCID: PMC4006600 DOI: 10.1155/2014/875960] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 02/13/2014] [Accepted: 03/03/2014] [Indexed: 11/18/2022] Open
Abstract
Crystallized intelligence refers to one's knowledge base and can be measured by vocabulary tests. Fluid intelligence is related to nonverbal aspects of intelligence, depends very little on previously acquired knowledge, and can be measured by tests such as Block Design (BD) and Raven Colored Matrices (RCM). Premorbid intelligence quotient (IQ) refers to one's intellectual ability level previous to the onset of disorders like mild cognitive impairment (MCI) and Alzheimer's disease (AD) and it is important to estimate disease severity. The objective was to compare performance in tests that measure crystallized and fluid intelligence in healthy subjects and patients with amnestic MCI (aMCI) and AD. One hundred forty-four participants (aMCI (n = 38), AD (n = 45), and healthy controls (n = 61)) were submitted to neuropsychological tests (WAIS-III vocabulary, BD, and RCM). There were significant among groups, except for vocabulary, indicating a relative stability of crystallized intelligence in the continuum from normal to pathological cognitive decline. Vocabulary seems to be stable during the progression of the disease and useful as a measure of premorbid intelligence, that is, to estimate previous function in relation to the level of education and, as a collateral measure of cognition in people with low education.
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Abstract
Patterns of verbal fluency deficits have been explored across different neurodegenerative disorders. This study sought to investigate the specific pattern of verbal fluency performance in cerebral small vessel disease (SVD), which is the most common cause of vascular cognitive impairment, and compare this with Alzheimer's disease (AD). Participants with SVD (n = 45), AD (n = 24) and healthy controls (n = 80) completed assessments of semantic and phonemic fluency. Mixed-model analyses of covariance were used to compare performance on the different fluency tasks between the groups, and a discriminant function analysis was conducted to examine group differentiation. The SVD group was impaired in both fluency tasks when compared to the controls. In contrast, the AD group displayed impairment in semantic fluency only. Discriminant function analysis revealed that fluency scores correctly classified 80% of SVD patients and 92% of AD patients. The pattern of performance observed in the SVD group may reflect deficits in executive function and processing speed impacting equivalently on semantic and phonemic fluency. The differences between the SVD and AD groups highlighted in this study may be useful for distinguishing between these conditions.
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Jones GN, Proto DA, Musso MW, Barker AA, Gouvier WD. Using the NAART to Estimate WRAT-4 Reading Grade Level in a Predominantly African American Sample. APPLIED NEUROPSYCHOLOGY-ADULT 2012; 19:257-62. [DOI: 10.1080/09084282.2011.643966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Glenn N. Jones
- a Department of Family Medicine , Louisiana State University Health Sciences Center , Baton Rouge , Louisiana
| | - Daniel A. Proto
- b Department of Psychology , Louisiana State University , Baton Rouge , Louisiana
| | - Mandi W. Musso
- b Department of Psychology , Louisiana State University , Baton Rouge , Louisiana
| | - Alyse A. Barker
- b Department of Psychology , Louisiana State University , Baton Rouge , Louisiana
| | - W. Drew Gouvier
- b Department of Psychology , Louisiana State University , Baton Rouge , Louisiana
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Martyr A, Clare L, Nelis SM, Marková IS, Roth I, Woods RT, Whitaker CJ, Morris RG. Verbal fluency and awareness of functional deficits in early-stage dementia. Clin Neuropsychol 2012; 26:501-19. [PMID: 22394254 DOI: 10.1080/13854046.2012.665482] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Assessment of activities of daily living is an important element in the diagnosis of dementia, with research suggesting a link between functional ability and cognition. We investigated the relationship between self- and informant ratings of instrumental activities of daily living (iADL) and verbal executive functioning in early-stage dementia. A total of 96 people with early-stage Alzheimer's disease or vascular or mixed dementia and their carers completed the Functional Activities Questionnaire; people with dementia also completed a test of letter fluency. Letter fluency was associated with self-ratings of iADL, while informant ratings of iADL were associated with the age and Mini-Mental State Examination score of the person with dementia. Self-ratings of perceived functioning suggested significantly less impairment than informant ratings. Those with impaired letter fluency rated themselves as having greater difficulties in iADLs than those who performed better. People with early-stage dementia vary in their subjective level of awareness of their iADL functioning, and difficulties with language production may contribute to better awareness of iADL impairments.
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Quality, and not just quantity, of education accounts for differences in psychometric performance between african americans and white non-hispanics with Alzheimer's disease. J Int Neuropsychol Soc 2012; 18:277-85. [PMID: 22300593 PMCID: PMC3685288 DOI: 10.1017/s1355617711001688] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The effect of race on cognitive test performance in the evaluation of Alzheimer's disease (AD) remains controversial. One factor that may contribute substantially to differences in cognitive test performance in diverse populations is education. The current study examined the extent to which quality of education, even after controlling for formal years of education, accounts for differences in cognitive performance between African Americans and White Non-Hispanics (WNHs). The retrospective cohort included 244 patients diagnosed with AD who self-identified as African Americans (n = 51) or WNHs (n = 193). The Wechsler Test of Adult Reading (WTAR) was used as an estimate of quality of education. In an analysis that controlled for traditional demographics, including age, sex, and years of formal education, African Americans scored significantly lower than WNHs on the Mini-Mental State Examination, as well as on neuropsychological tests of memory, attention, and language. However, after also adjusting for reading level, all previously observed differences were significantly attenuated. The attenuating effect remained even after controlling for disease severity, indicating that reading scores are not confounded by severity of dementia. These findings suggest that quality, and not just quantity, of education needs to be taken into account when assessing cognitive performance in African Americans with AD.
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Lowe DA, Rogers SA. Estimating Premorbid Intelligence among Older Adults: The Utility of the AMNART. J Aging Res 2011; 2011:428132. [PMID: 21629758 PMCID: PMC3100635 DOI: 10.4061/2011/428132] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2010] [Revised: 01/07/2011] [Accepted: 02/24/2011] [Indexed: 11/20/2022] Open
Abstract
This study examines the utility of the American version of the National Adult Reading Test (AMNART) as a measure of premorbid intelligence for older adults. In a sample of 130 older adults, aged 56 to 104, the AMNART was compared to other tests of premorbid intelligence. The results revealed that AMNART-estimated IQ was significantly higher than other premorbid estimates. Across specific educational groups (i.e., 0–12, 13–16, and 17 or more years of education), AMNART-estimated IQ was inflated relative to all other premorbid estimates. The AMNART also declined as cognitive impairment increased, and there was a significant interaction between aging-related diagnostic group and premorbid estimate. The AMNART may therefore overestimate premorbid ability relative to other premorbid measures, particularly among those with greater cognitive impairment and lower levels of education. These results suggest that the AMNART should be used cautiously among older adults and in conjunction with other estimates of premorbid ability.
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Affiliation(s)
- Deborah A Lowe
- Department of Psychology, Westmont College, 955 La Paz Road, Santa Barbara, CA 93108, USA
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O'Rourke JJ, Adams WH, Duff K, Byars J, Nopoulos P, Paulsen JS, Beglinger LJ. Estimating premorbid functioning in huntington's disease: the relationship between disease progression and the wide range achievement test reading subtest. Arch Clin Neuropsychol 2011; 26:59-66. [PMID: 21147861 PMCID: PMC3021970 DOI: 10.1093/arclin/acq088] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2010] [Indexed: 11/13/2022] Open
Abstract
The estimation of premorbid abilities is an essential part of a neuropsychological evaluation, especially in neurodegenerative conditions. Although word pronunciation tests are one standard method for estimating the premorbid level, research suggests that these tests may not be valid in neurodegenerative diseases. Therefore, the current study sought to examine two estimates of premorbid intellect, the Wide Range Achievement Test (WRAT) Reading subtest and the Barona formula, in 93 patients with mild to moderate Huntington's disease (HD) to determine their utility and to investigate how these measures relate to signs and symptoms of disease progression. In 89% of participants, WRAT estimates were below the Barona estimates. WRAT estimates were related to worsening memory and motor functioning, whereas the Barona estimates had weaker relationships. Neither estimate was related to depression or functional capacity. Irregular word reading tests appear to decline with HD progression, whereas estimation methods based on demographic factors may be more robust but overestimate premorbid functioning.
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Affiliation(s)
- Justin J.F. O'Rourke
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Counseling Psychology, University of Iowa, Iowa City, IA, USA
| | - William H. Adams
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Kevin Duff
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
| | - Joanne Byars
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Peg Nopoulos
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Jane S. Paulsen
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
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Minati L, Edginton T, Bruzzone MG, Giaccone G. Current concepts in Alzheimer's disease: a multidisciplinary review. Am J Alzheimers Dis Other Demen 2009; 24:95-121. [PMID: 19116299 PMCID: PMC10846154 DOI: 10.1177/1533317508328602] [Citation(s) in RCA: 190] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
This comprehensive, pedagogically-oriented review is aimed at a heterogeneous audience representative of the allied disciplines involved in research and patient care. After a foreword on epidemiology, genetics, and risk factors, the amyloid cascade model is introduced and the main neuropathological hallmarks are discussed. The progression of memory, language, visual processing, executive, attentional, and praxis deficits, and of behavioral symptoms is presented. After a summary on neuropsychological assessment, emerging biomarkers from cerebrospinal fluid assays, magnetic resonance imaging, nuclear medicine, and electrophysiology are discussed. Existing treatments are briefly reviewed, followed by an introduction to emerging disease-modifying therapies such as secretase modulators, inhibitors of Abeta aggregation, immunotherapy, inhibitors of tau protein phosphorylation, and delivery of nerve growth factor.
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Affiliation(s)
- Ludovico Minati
- Science Direction Unit, Fondazione IRCCS Istituto Nazionale Neurologico Carlo Besta, Milano, Italy.
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Almkvist O, Adveen M, Henning L, Tallberg IM. Estimation of premorbid cognitive function based on word knowledge: The Swedish Lexical Decision Test (SLDT). Scand J Psychol 2007; 48:271-9. [PMID: 17518919 DOI: 10.1111/j.1467-9450.2007.00575.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In clinical neuropsychology, the present status of a patient is evaluated in relation to the assumed premorbid status. However, in Sweden, existing methods to assess premorbid status are far from optimal. In the present study, the design and evaluation of a Swedish Lexical Decision Test (SLDT) for premorbid global cognitive function (i.e., premorbid intelligence) is described. The design was based on the empirical finding that, in general adult population, word knowledge is strongly associated with measures of global cognitive functioning. Linear stepwise regression analysis demonstrated that SLDT findings accounted for 48% of the variance of global cognitive function as assessed by the Full Scale Intelligence Quotient (FSIQ) from the Wechsler Adult Intelligence Scale Revised (WAIS-R). Demographic variables alone accounted for 31% and a combination of SLDT results and demographics accounted for 60%. Psychometric properties are presented using data from 109 healthy individuals stratified according to age, gender, and level of education. In addition, a case of Alzheimer's disease is presented to illustrate the relationship between SLDT performance and cognitive function. Finally, the theoretical foundation for the relationship between word knowledge and global cognitive function is discussed.
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Affiliation(s)
- O Almkvist
- Department of Psychology, Stockholm University, Sweden.
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Pavlik VN, Doody RS, Massman PJ, Chan W. Influence of premorbid IQ and education on progression of Alzheimer's disease. Dement Geriatr Cogn Disord 2007; 22:367-77. [PMID: 16954693 DOI: 10.1159/000095640] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2006] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Lower education is associated with a higher risk of developing Alzheimer's disease (AD). Years of education and measures of general intellectual function (IQ) are highly correlated. It is important to determine whether there is a relationship between education and AD outcomes that is independent of IQ. OBJECTIVE To test the hypothesis that premorbid IQ is a stronger predictor of cognitive decline, global progression, and overall survival, than education in patients with AD. METHODS The study included 478 probable AD patients (322 women and 156 men, mean age 74.5 years) followed in a large AD referral center for a mean of 3.2 years. Eligible participants had a baseline estimate of premorbid IQ using the American version of the Nelson Adult Reading Test (AMNART) and at least one follow-up visit with complete neuropsychological assessment. We used random effects linear regression analysis, and Cox proportional hazards analysis to determine whether or not education and/or premorbid IQ were independently associated with cognitive decline, global progression of AD, and survival. RESULTS When the baseline AMNART score was included in regression models along with education and other demographic variables, AMNART score, but not education, was associated with a higher baseline score and slower rate of decline in MMSE and ADAS-Cog scores, and the Clinical Dementia Rating sum of boxes score. Neither higher premorbid IQ nor higher education was associated with longer survival. CONCLUSIONS We conclude that a baseline AMNART score is a better predictor of cognitive change in AD than education, but neither variable is associated with survival after diagnosis.
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Affiliation(s)
- V N Pavlik
- Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX 77098-3926, USA.
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Matsuoka K, Uno M, Kasai K, Koyama K, Kim Y. Estimation of premorbid IQ in individuals with Alzheimer's disease using Japanese ideographic script (Kanji) compound words: Japanese version of National Adult Reading Test. Psychiatry Clin Neurosci 2006; 60:332-9. [PMID: 16732750 DOI: 10.1111/j.1440-1819.2006.01510.x] [Citation(s) in RCA: 371] [Impact Index Per Article: 20.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The National Adult Reading Test (NART) is widely used as a measure of premorbid IQ of the English-speaking patients with dementia. The purpose of the present study was to develop a Japanese version of the NART (JART), using 50 Japanese irregular words, all of which are Kanji (ideographic script) compound words. Reading performance based on JART and IQ as measured by the Wechsler Adult Intelligence Scale-Revised (WAIS-R) was examined in a sample of 100 normal elderly (NE) persons and in 70 age-, sex-, and education-matched patients with Alzheimer's disease (AD). The NE group was randomly divided into the NE calculation group (n=50) and the NE validation group (n=50). Using the NE calculation group, a linear regression equation was obtained in which the observed full-scale IQ (FSIQ) was regressed on the reading errors of the JART. When the regressed equation computed from the NE calculation group was applied to the NE validation group, the predicted FSIQ adequately fit the observed FSIQ (R2=0.78). Further, independent t-tests showed that the JART-predicted IQs were not significantly different between the NE and AD groups, whereas the AD group performed worse in the observed IQs. The reading ability of Kanji compound words is well-preserved in Japanese patients with AD. The JART is a valid scale for evaluating premorbid IQ in patients with AD.
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Rosenstein LD. Differential diagnosis of the major progressive dementias and depression in middle and late adulthood: a summary of the literature of the early 1990s. Neuropsychol Rev 1998; 8:109-67. [PMID: 9834489 DOI: 10.1023/a:1025628925796] [Citation(s) in RCA: 44] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
There is a preponderance of research on the neuropsychology of the various dementias. There are also direct comparisons between two or more dementias available in the literature. This paper sought to summarize the most recent literature, primarily from 1990 through mid-1996, including recent reviews of the literature from previous decades. The purpose was to provide, in one location, a summary of neuropsychological (i.e., cognitive, motor, and psychiatric) characteristics of major noninfectious, progressive dementias and depression of middle and late adulthood. It is hoped that this review, particularly a summary table provided, will serve as a guide in the differential diagnosis of the dementias by clinicians. In addition to Alzheimer's disease, vascular dementias, Parkinson's disease, Lewy body dementia, Huntington's disease, and frontal lobe dementia, the impact of depression on cognitive functioning is covered given the frequency with which neuropsychologists are asked to differentiate depression from primary dementia.
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Affiliation(s)
- L D Rosenstein
- Department of Psychiatry, Scott & White Clinic and Memorial Hospital, Temple, Texas 76508, USA
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