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Alzola P, Carnero C, Bermejo-Pareja F, Sánchez-Benavides G, Peña-Casanova J, Puertas-Martín V, Fernández-Calvo B, Contador I. Neuropsychological Assessment for Early Detection and Diagnosis of Dementia: Current Knowledge and New Insights. J Clin Med 2024; 13:3442. [PMID: 38929971 PMCID: PMC11204334 DOI: 10.3390/jcm13123442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 06/06/2024] [Accepted: 06/10/2024] [Indexed: 06/28/2024] Open
Abstract
Dementia remains an underdiagnosed syndrome, and there is a need to improve the early detection of cognitive decline. This narrative review examines the role of neuropsychological assessment in the characterization of cognitive changes associated with dementia syndrome at different states. The first section describes the early indicators of cognitive decline and the major barriers to their identification. Further, the optimal cognitive screening conditions and the most widely accepted tests are described. The second section analyzes the main differences in cognitive performance between Alzheimer's disease and other subtypes of dementia. Finally, the current challenges of neuropsychological assessment in aging/dementia and future approaches are discussed. Essentially, we find that current research is beginning to uncover early cognitive changes that precede dementia, while continuing to improve and refine the differential diagnosis of neurodegenerative disorders that cause dementia. However, neuropsychology faces several barriers, including the cultural diversity of the populations, a limited implementation in public health systems, and the adaptation to technological advances. Nowadays, neuropsychological assessment plays a fundamental role in characterizing cognitive decline in the different stages of dementia, but more efforts are needed to develop harmonized procedures that facilitate its use in different clinical contexts and research protocols.
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Affiliation(s)
- Patricia Alzola
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Sciences, University of Salamanca, 37005 Salamanca, Spain;
| | - Cristóbal Carnero
- Neurology Department, Granada University Hospital Complex, 18014 Granada, Spain
| | - Félix Bermejo-Pareja
- Centro de Investigación Biomédica en Red de Enfermedades Neurodegenerativas (CIBERNED), Institute of Health Carlos III, 28029 Madrid, Spain
- Institute of Research i+12, University Hospital “12 de Octubre”, 28041 Madrid, Spain
| | | | | | | | | | - Israel Contador
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Sciences, University of Salamanca, 37005 Salamanca, Spain;
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Lee S, Jia Y, Snitz BE, Chang CCH, Ganguli M. Assessing Social Cognition in Older Adults: A Population-Based Study. Alzheimer Dis Assoc Disord 2022; 36:103-110. [PMID: 35288520 PMCID: PMC9149050 DOI: 10.1097/wad.0000000000000497] [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: 10/10/2021] [Accepted: 01/03/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVES In a population-based study of mild cognitive impairment (MCI), to validate the assessment of social cognition in older adults. METHODS Cross-sectional study of 902 adults aged 65+ with mean age 76.6 years (SD 8.06). We created a social cognition composite comprising standardized z scores on the Social Norms Questionnaire and the 10-item Reading the Mind in the Eyes Test. We identified associated factors and compared sensitivity, specificity, and the area under the curve of social cognition, for MCI defined as Clinical Dementia Rating (CDR)=0.5, to those of other cognitive domains. We calculated the impact of including social cognition on the proportion neuropsychologically classified as MCI. RESULTS Better social cognition was associated with younger age, female sex, higher education, better general cognition (mini-mental state examination), fewer depressive symptoms, and lower CDR. Adjusting for demographics, associations with mini-mental state examination, depressive symptoms, anxiety symptoms, and subjective cognitive complaints remained significant. The sensitivity and specificity of social cognition for CDR=0.5 were comparable to those of the traditional 5 cognitive domains. Including social cognition as a sixth domain of cognition resulted in a 5% increase in the proportion classified as MCI. CONCLUSIONS Brief objective assessment of social cognition may enhance cognitive assessment of older adults.
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Affiliation(s)
- Soyoung Lee
- Department of Psychiatry, School of Medicine, University of Maryland
| | - Yichen Jia
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh
| | - Beth E. Snitz
- Department of Neurology, School of Medicine, University of Pittsburgh
| | - Chung-Chou H. Chang
- Department of Biostatistics, Graduate School of Public Health, University of Pittsburgh
- Department of Medicine, School of Medicine, University of Pittsburgh
| | - Mary Ganguli
- Department of Neurology, School of Medicine, University of Pittsburgh
- Department of Psychiatry, School of Medicine, University of Pittsburgh
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh
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3
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Evaluation of Available Cognitive Tools Used to Measure Mild Cognitive Decline: A Scoping Review. Nutrients 2021; 13:nu13113974. [PMID: 34836228 PMCID: PMC8623828 DOI: 10.3390/nu13113974] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 11/17/2022] Open
Abstract
Cognitive decline is a broad syndrome ranging from non-pathological/age-associated cognitive decline to pathological dementia. Mild cognitive impairment MCI) is defined as the stage of cognition that falls between normal ageing and dementia. Studies have found that early lifestyle interventions for MCI may delay its pathological progression. Hence, this review aims to determine the most efficient cognitive tools to discriminate mild cognitive decline in its early stages. After a systematic search of five online databases, a total of 52 different cognitive tools were identified. The performance of each tool was assessed by its psychometric properties, administration time and delivery method. The Montreal Cognitive Assessment (MoCA, n = 15), the Mini-Mental State Examination (MMSE, n = 14) and the Clock Drawing Test (CDT, n = 4) were most frequently cited in the literature. The preferable tools with all-round performance are the Six-item Cognitive Impairment Test (6CIT), MoCA (with the cut-offs of ≤24/22/19/15.5), MMSE (with the cut-off of ≤26) and the Hong Kong Brief Cognitive Test (HKBC). In addition, SAGE is recommended for a self-completed survey setting whilst a 4-point CDT is quick and easy to be added into other cognitive assessments. However, most tools were affected by age and education levels. Furthermore, optimal cut-off points need to be cautiously chosen while screening for MCI among different populations.
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Chehrehnegar N, Nejati V, Shati M, Rashedi V, Lotfi M, Adelirad F, Foroughan M. Early detection of cognitive disturbances in mild cognitive impairment: a systematic review of observational studies. Psychogeriatrics 2020; 20:212-228. [PMID: 31808989 DOI: 10.1111/psyg.12484] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 09/11/2019] [Accepted: 09/21/2019] [Indexed: 11/28/2022]
Abstract
Mild cognitive impairment (MCI) is an intermediate state between normal cognition and early dementia and is not considered as a typical outcome of brain aging. It has been estimated that 10% to 20% of individuals above 65 years of age will be diagnosed as having MCI. The increased rate of dementia and the importance of early detection of its forerunners have encouraged researchers to focus on detecting MCI and modifiable risk factors with the hope of developing better ways of managing dementia and its consequences. The main aim of this study was to systematically review the related literature concerning the cognitive changes in the spectrum of cognitive aging to cognitive impairment. Articles included in this review were identified through searching the databases of PubMed, Psych Info, Embase, ProQuest, and Scopus. Many domains like verbal memory, language, executive function, visual memory, attentional skills, and working memory showed acceptable predictive power. Testing subdomains such as executive function, speed of processing, working memory and semantic language are critical and others may indicate some suggestions for further clinical deteriorations in normal individuals. Although various cognitive instruments have been used for evaluation of impaired cognitive domains, it remains challenging to select the most appropriate ones having high-level accuracy and their related cognitive subdomains. It also revealed that none of the identified cognitive domains solely fulfilled the criteria for MCI screening; in clinical settings, multiple neuropsychological batteries may be used for one single cognitive domain, while longitudinal studies prefer the use of at least two cognitive measures for each domain to improve accuracy and research settings might focus on only a single neuropsychological test. However, along with episodic memory, testing for amnestic MCI, executive function could increase the chance of early detection of MCI. Executive control has been found to deteriorate the earliest in MCI patients.
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Affiliation(s)
- Negin Chehrehnegar
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.,Occupational Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahid Nejati
- Department of Psychology and Educational Sciences, Shahid Behehsti University Tehran, Tehran, Iran.,Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Mohsen Shati
- Mental Health Research Centre, School of Behavioural Science and Mental health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Vahid Rashedi
- School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadsajad Lotfi
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fatemeh Adelirad
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahshid Foroughan
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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5
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Abd Razak MA, Ahmad NA, Chan YY, Mohamad Kasim N, Yusof M, Abdul Ghani MKA, Omar M, Abd Aziz FA, Jamaluddin R. Validity of screening tools for dementia and mild cognitive impairment among the elderly in primary health care: a systematic review. Public Health 2019; 169:84-92. [PMID: 30826688 DOI: 10.1016/j.puhe.2019.01.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 12/14/2018] [Accepted: 01/02/2019] [Indexed: 12/30/2022]
Abstract
OBJECTIVES This systematic review aims to provide updated and comprehensive evidence on the validity and feasibility of screening tools for mild cognitive impairment (MCI) and dementia among the elderly at primary healthcare level. STUDY DESIGN A review of articles was performed. METHODS A search strategy was used by using electronic bibliographic databases including PubMed, Embase and CENTRAL for published studies and reference list of published studies. The articles were exported to a bibliographic database for further screening process. Two reviewers worked independently to screen results and extract data from the included studies. Any discrepancies were resolved and confirmed by the consensus of all authors. RESULTS There were three screening approaches for detecting MCI and dementia - screening by a healthcare provider, screening by a self-administered questionnaire and caretaker informant screening. Montreal Cognitive Assessment (MoCA) was the most common and preferable tool for MCI screening (sensitivity [Sn]: 81-97%; specificity [Sp]: 60-86%), whereas Addenbrooke's Cognitive Examination (ACE) was the preferable tool for dementia screening (Sn: 79-100%; Sp: 86%). CONCLUSION This systematic review found that there are three screening approaches for detecting early dementia and MCI at primary health care. ACE and MoCA are recommended tools for screening of dementia and MCI, respectively.
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Affiliation(s)
- M A Abd Razak
- Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, W.P. Kuala Lumpur, Malaysia.
| | - N A Ahmad
- Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, W.P. Kuala Lumpur, Malaysia.
| | - Y Y Chan
- Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, W.P. Kuala Lumpur, Malaysia.
| | - N Mohamad Kasim
- Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, W.P. Kuala Lumpur, Malaysia.
| | - M Yusof
- Women and Child Hospital Kuala Lumpur, Ministry of Health Malaysia, Jalan Dr Latiff, 50586 Kuala Lumpur, W.P. Kuala Lumpur, Malaysia.
| | - M K A Abdul Ghani
- Klinik Rafeeq & Nurul, Sungai Rengit, 81620 Pengerang, Johor, Malaysia.
| | - M Omar
- Kuala Selangor Health District, Ministry of Health Malaysia, Jalan Semarak, 45000 Kuala Selangor, Selangor, Malaysia.
| | - F A Abd Aziz
- Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, W.P. Kuala Lumpur, Malaysia.
| | - R Jamaluddin
- Institute for Public Health, Ministry of Health Malaysia, Jalan Bangsar, 50590 Kuala Lumpur, W.P. Kuala Lumpur, Malaysia.
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Hernández-Gallego J, Llamas-Velasco S, Bermejo-Pareja F, Vega S, Tapias-Merino E, Rodríguez-Sánchez E, Boycheva E, Serrano JI, Gil-García JF, Trincado R, Sánchez-Rodrigo JMV, Cacho J, Contador I, Garcia-Ptacek S, Sierra-Hidalgo F, Cubo E, Carro E, Villarejo-Galende A, García García-Patino R, Benito-León J. Neurological Disorders in Central Spain, Second Survey: Feasibility Pilot Observational Study. JMIR Res Protoc 2019; 8:e10941. [PMID: 30632964 PMCID: PMC6329894 DOI: 10.2196/10941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 07/16/2018] [Accepted: 07/17/2018] [Indexed: 11/13/2022] Open
Abstract
Background The Neurological Disorders in Central Spain, second survey (NEDICES-2) is a population-based, closed-cohort study that will include over 8000 subjects aged ≥55 years. It will also include a biobank. Objective The objective of this study was to evaluate all major aspects of the NEDICES-2 (methods, database, screening instruments, and questionnaires, as well as interexpert rating of the neurological diagnoses) in each one of the planned areas (all of them in central Spain) and to test the possibility of obtaining biological samples from each participant. Methods A selection of patients and participants of the planned NEDICES-2 underwent face-to-face interviews including a comprehensive questionnaire on demographics, current medications, medical conditions, and lifestyle habits. Biological samples (blood, saliva, urine, and hair) were also obtained. Furthermore, every participant was examined by a neurologist. Results In this pilot study, 567 study participants were enrolled (196 from hospitals and 371 from primary care physician lists). Of these 567, 310 completed all study procedures (questionnaires and the neurological evaluation). The study was time-consuming for several primary care physicians. Hence, a few primary care physicians from some areas refused to participate, which led to a reconfiguration of study areas. In addition, the central biobank needed to be supplemented by the biobanks of local Spanish National Health System hospitals. Conclusions Population-based epidemiological surveys, such as the NEDICES-2, require a pilot study to evaluate the feasibility of all aspects of a future field study (population selection, methods and instruments to be used, neurological diagnosis agreement, and data collection).
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Affiliation(s)
- Jesús Hernández-Gallego
- Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.,Spanish Network for Biomedical Research in Neurodegenerative Diseases, Carlos III Research Institute, Madrid, Spain.,Department of Medicine, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
| | - Sara Llamas-Velasco
- Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.,Spanish Network for Biomedical Research in Neurodegenerative Diseases, Carlos III Research Institute, Madrid, Spain.,Group of Neurodegenerative Diseases, Research Institute, University Hospital "12 de Octubre", Madrid, Spain
| | - Felix Bermejo-Pareja
- Spanish Network for Biomedical Research in Neurodegenerative Diseases, Carlos III Research Institute, Madrid, Spain.,Department of Medicine, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain.,Group of Neurodegenerative Diseases, Research Institute, University Hospital "12 de Octubre", Madrid, Spain
| | | | - Ester Tapias-Merino
- Group of Neurodegenerative Diseases, Research Institute, University Hospital "12 de Octubre", Madrid, Spain.,Comillas Health Center, Madrid, Spain
| | | | - Elina Boycheva
- Group of Neurodegenerative Diseases, Research Institute, University Hospital "12 de Octubre", Madrid, Spain
| | - José Ignacio Serrano
- Neural and Cognitive Engineering Group, Centro de Automática y Robótica, Spanish National Research Council, Arganda del Rey (Madrid), Spain
| | | | - Rocio Trincado
- Spanish Network for Biomedical Research in Neurodegenerative Diseases, Carlos III Research Institute, Madrid, Spain
| | | | - Jesús Cacho
- Department of Neurology, University Hospital of Salamanca, Salamanca, Spain
| | - Israel Contador
- Department of Basic Psychology, Psychobiology and Methodology of Behavioural Sciences, University of Salamanca, Salamanca, Spain
| | - Sara Garcia-Ptacek
- Department of Geriatric Medicine, Karolinska University Hospital, Huddinge, Sweden.,Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Esther Cubo
- Department of Neurology, University Hospital "General Yagüe", Burgos, Spain
| | - Eva Carro
- Spanish Network for Biomedical Research in Neurodegenerative Diseases, Carlos III Research Institute, Madrid, Spain.,Group of Neurodegenerative Diseases, Research Institute, University Hospital "12 de Octubre", Madrid, Spain
| | - Alberto Villarejo-Galende
- Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.,Spanish Network for Biomedical Research in Neurodegenerative Diseases, Carlos III Research Institute, Madrid, Spain.,Department of Medicine, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain.,Group of Neurodegenerative Diseases, Research Institute, University Hospital "12 de Octubre", Madrid, Spain
| | | | - Julián Benito-León
- Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.,Spanish Network for Biomedical Research in Neurodegenerative Diseases, Carlos III Research Institute, Madrid, Spain.,Department of Medicine, Faculty of Medicine, Complutense University of Madrid, Madrid, Spain.,Group of Neurodegenerative Diseases, Research Institute, University Hospital "12 de Octubre", Madrid, Spain
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7
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Boycheva E, Contador I, Fernández-Calvo B, Ramos-Campos F, Puertas-Martín V, Villarejo-Galende A, Bermejo-Pareja F. Spanish version of the Mattis Dementia Rating Scale-2 for early detection of Alzheimer's disease and mild cognitive impairment. Int J Geriatr Psychiatry 2018; 33:832-840. [PMID: 28332732 DOI: 10.1002/gps.4707] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 02/13/2017] [Indexed: 11/05/2022]
Abstract
OBJECTIVE We aimed to analyse the clinical utility of the Mattis Dementia Rating Scale (MDRS-2) for early detection of Alzheimer's disease (AD) and amnestic mild cognitive impairment (MCI) in a sample of Spanish older adults. METHODS A total of 125 participants (age = 75.12 ± 6.83, years of education =7.08 ± 3.57) were classified in three diagnostic groups: 45 patients with mild AD, 37 with amnestic MCI-single and multiple domain and 43 cognitively healthy controls (HCs). Reliability, criterion validity and diagnostic accuracy of the MDRS-2 (total and subscales) were analysed. The MDRS-2 scores, adjusted by socio-demographic characteristics, were calculated through hierarchical multiple regression analysis. RESULTS The global scale had adequate reliability (α = 0.736) and good criterion validity (r = 0.760, p < .001) with the Mini-Mental State Examination. The optimal cut-off point between AD patients and HCs was 124 (sensitivity [Se] = 97% and specificity [Sp] = 95%), whereas 131 (Se = 89%, Sp = 81%) was the optimal cut-off point between MCI and HCs. An optimal cut-off point of 123 had good Se (0.97), but poor Sp (0.56) to differentiate AD and MCI groups. The Memory and Initiation/Perseveration subscales had the highest discriminative capacity between the groups. CONCLUSIONS The MDRS-2 is a reliable and valid instrument for the assessment of cognitive impairment in Spanish older adults. In particular, optimal capacity emerged for the detection of early AD and MCI. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- Elina Boycheva
- Clinical Research Unit of the University Hospital 12 de Octubre (i+12), Madrid, Spain
| | - Israel Contador
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Science, University of Salamanca, Salamanca, Spain
| | | | - Francisco Ramos-Campos
- Department of Personality, Assessment and Psychological Treatment, University of Salamanca, Salamanca, Spain
| | | | | | - Félix Bermejo-Pareja
- Clinical Research Unit of the University Hospital 12 de Octubre (i+12), Madrid, Spain.,Faculty of Medicine, Complutense University, Madrid, Spain
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8
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Weissberger GH, Strong JV, Stefanidis KB, Summers MJ, Bondi MW, Stricker NH. Diagnostic Accuracy of Memory Measures in Alzheimer's Dementia and Mild Cognitive Impairment: a Systematic Review and Meta-Analysis. Neuropsychol Rev 2017; 27:354-388. [PMID: 28940127 PMCID: PMC5886311 DOI: 10.1007/s11065-017-9360-6] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Accepted: 08/16/2017] [Indexed: 11/26/2022]
Abstract
With an increasing focus on biomarkers in dementia research, illustrating the role of neuropsychological assessment in detecting mild cognitive impairment (MCI) and Alzheimer's dementia (AD) is important. This systematic review and meta-analysis, conducted in accordance with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) standards, summarizes the sensitivity and specificity of memory measures in individuals with MCI and AD. Both meta-analytic and qualitative examination of AD versus healthy control (HC) studies (n = 47) revealed generally high sensitivity and specificity (≥ 80% for AD comparisons) for measures of immediate (sensitivity = 87%, specificity = 88%) and delayed memory (sensitivity = 89%, specificity = 89%), especially those involving word-list recall. Examination of MCI versus HC studies (n = 38) revealed generally lower diagnostic accuracy for both immediate (sensitivity = 72%, specificity = 81%) and delayed memory (sensitivity = 75%, specificity = 81%). Measures that differentiated AD from other conditions (n = 10 studies) yielded mixed results, with generally high sensitivity in the context of low or variable specificity. Results confirm that memory measures have high diagnostic accuracy for identification of AD, are promising but require further refinement for identification of MCI, and provide support for ongoing investigation of neuropsychological assessment as a cognitive biomarker of preclinical AD. Emphasizing diagnostic test accuracy statistics over null hypothesis testing in future studies will promote the ongoing use of neuropsychological tests as Alzheimer's disease research and clinical criteria increasingly rely upon cerebrospinal fluid (CSF) and neuroimaging biomarkers.
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Affiliation(s)
- Gali H Weissberger
- Brain, Behavior, and Aging Research Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
| | - Jessica V Strong
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA
- New England Geriatric Research, Education and Clinical Center (GRECC), Boston VA Healthcare System, Boston, MA, USA
| | - Kayla B Stefanidis
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Mathew J Summers
- Sunshine Coast Mind and Neuroscience - Thompson Institute, University of the Sunshine Coast, Sippy Downs, Queensland, Australia
| | - Mark W Bondi
- VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Nikki H Stricker
- Psychology Service, VA Boston Healthcare System, Boston, MA, USA.
- Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA.
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9
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Contador I, Fernández-Calvo B, Boycheva E, Rueda L, Bermejo-Pareja F. Normative Data of the Story and Six-Object Memory Recall Tests in Older Spanish Adults: NEDICES Population-Based Cohort. Arch Clin Neuropsychol 2017; 32:992-1000. [PMID: 28184429 DOI: 10.1093/arclin/acx015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 01/22/2017] [Indexed: 11/13/2022] Open
Abstract
Objective We provide normative data for the story and six-object recall tasks, stratified by age and education in a large population-based cohort of older Spanish adults. Method The sample consisted of 2,581 participants without dementia (age range: 67-98 years) from different socioeconomic areas of central Spain. Normative data are presented in percentile ranks and divided into four overlapping age tables with different midpoints. Results Spearman correlations and shared variances were calculated to evaluate the effects of sociodemographic variables on both tasks. Our findings showed that age and education influence the scores in the story and six-object recall tasks, whereas sex had null effect on story recall and an almost negligible on object recall, respectively. Conclusion The norms presented herein are important for the correct interpretation of scores in the story and six-object recall tasks when assessing older adults in Spain.
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Affiliation(s)
- Israel Contador
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Science, University of Salamanca, Salamanca, Spain
| | | | - Elina Boycheva
- Research Institute of Hospital "12 de Octubre" (i+12), Madrid, Spain
| | - Laura Rueda
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Science, University of Salamanca, Salamanca, Spain
| | - Félix Bermejo-Pareja
- The Biomedical Research Centre Network for Neurodegenerative Diseases (CIBERNED), Carlos III Research Institute, Madrid, Spain.,Faculty of Medicine, Complutense University, Madrid, Spain
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10
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Contador I, Almondes K, Fernández-Calvo B, Boycheva E, Puertas-Martín V, Benito-León J, Bermejo-Pareja F. Semantic Verbal Fluency: Normative Data in Older Spanish Adults From NEDICES Population-Based Cohort. Arch Clin Neuropsychol 2016; 31:954-962. [PMID: 27600449 DOI: 10.1093/arclin/acw071] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2016] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE We aimed to provide the normative data stratified by age, sex and educational attainment for two semantic categories (animal and fruits) in older Spanish adults. METHOD A representative sample of 2,744 non-demented older individuals with different socioeconomic background was selected from the Neurological Disorders in Central Spain (NEDICES), a population-based study. Normative data are presented in percentile ranks and divided into four age-tables with different midpoints, using the overlapping interval procedure. RESULTS Correlation analyses showed that age, education and sex influence significantly the scores in both semantic tasks. Normative data presented here covered two urban (Margaritas & Lista) and one rural areas (Arévalo). CONCLUSION These norms may provide useful data for screening cognitive impairment more accurately in Spanish older adults.
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Affiliation(s)
- Israel Contador
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Science, University of Salamanca, Salamanca, Spain
| | - Katie Almondes
- Department of Psychology, Federal University of Rio Grande do Norte , Brazil
| | | | - Elina Boycheva
- Research Institute of Hospital "12 de Octubre" (i+12) , Madrid, Spain
| | | | - Julián Benito-León
- Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.,The Biomedical Research Centre Network for Neurodegenerative Diseases (CIBERNED), Carlos III Research Institute , Madrid, Spain.,Faculty of Medicine, Complutense University, Madrid, Spain
| | - Félix Bermejo-Pareja
- Research Institute of Hospital "12 de Octubre" (i+12) , Madrid, Spain.,The Biomedical Research Centre Network for Neurodegenerative Diseases (CIBERNED), Carlos III Research Institute , Madrid, Spain.,Faculty of Medicine, Complutense University, Madrid, Spain
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11
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Bermejo-Pareja F, Contador I, Trincado R, Lora D, Sánchez-Ferro Á, Mitchell AJ, Boycheva E, Herrero A, Hernández-Gallego J, Llamas S, Villarejo Galende A, Benito-León J. Prognostic Significance of Mild Cognitive Impairment Subtypes for Dementia and Mortality: Data from the NEDICES Cohort. J Alzheimers Dis 2016; 50:719-31. [PMID: 26757038 DOI: 10.3233/jad-150625] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND The predictive value of diverse subtypes of mild cognitive impairment (MCI) for dementia and death is highly variable. OBJECTIVE To compare the predictive value of several MCI subtypes in progression to dementia and/or mortality in the NEDICES (Neurological Disorders in Central Spain) elderly cohort. METHODS Retrospect algorithmic MCI subgroups were established in a non-dementia baseline NEDICES cohort using Spanish adaptations of the original Mini-Mental State Examination (MMSE-37) and Pfeffer's Functional Activities Questionnaire (Pfeffer-11). The presence of MCI was defined according two cognitive criteria: using two cut-offs points on the total MMSE-37 score. Five cognitive domains were used to establish the MCI subtypes. Functional capacity (Pfeffer-11) was preserved or minimally impaired in all MCI participants. The incident dementia diagnoses were established by specialists and the mortality data obtained from Spanish official registries. RESULTS 3,411 participants without dementia were assessed in 1994-5. The baseline prevalence of MCI varied according to the MCI definition (4.3%-31.8%). The follow-up was a mean of 3.2 years (1997-8). The dementia incidence varied between 14.9 and 71.8 per 1,000/person-years. The dementia conversion rate was increased in almost all MCI subgroups (p > 0.01), and mortality rate was raised only in four MCI subtypes. The amnestic-multi-domain MCI (aMd-MCI) had the best dementia predictive accuracy (highest positive likelihood ratio and highest clinical utility when negative). CONCLUSIONS Those with aMd-MCI were at greatest risk of progression to dementia, as in other surveys and might be explored with increased attention in MCI research and in dementia preventive trials.
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Affiliation(s)
- Félix Bermejo-Pareja
- Consultant Neurologist of the Clinical Research Unit (Imas12), University Hospital "12 de Octubre", Madrid, Spain.,Ciberned, Carlos III Research Institute, Madrid, Spain
| | - Israel Contador
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Sciences, University of Salamanca, Spain
| | | | - David Lora
- Clinical Research Unit (Imas12- CIBERESP), University Hospital "12 de Octubre", Madrid, Spain
| | - Álvaro Sánchez-Ferro
- Research Laboratory of Electronics, Massachusetts Institute of Technology, Cambridge, MA, USA.,Centro Integral de Neurociencias A.C., Fundación Hospitales de Madrid, Móstoles, Madrid, Spain
| | - Alex J Mitchell
- Department of Cancer and Molecular Medicine, University of Leicester, UK
| | - Elina Boycheva
- Clinical Research Unit (Imas12- CIBERESP), University Hospital "12 de Octubre", Madrid, Spain
| | - Alejandro Herrero
- Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain
| | - Jesús Hernández-Gallego
- Ciberned, Carlos III Research Institute, Madrid, Spain.,Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain.,Department of Medicine, Complutense University (UCM), Madrid, Spain
| | - Sara Llamas
- Clinical Research Unit (Imas12- CIBERESP), University Hospital "12 de Octubre", Madrid, Spain
| | - Alberto Villarejo Galende
- Ciberned, Carlos III Research Institute, Madrid, Spain.,Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain
| | - Julián Benito-León
- Ciberned, Carlos III Research Institute, Madrid, Spain.,Department of Neurology, University Hospital "12 de Octubre", Madrid, Spain
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Benito-León J, Contador I, Louis ED, Cosentino S, Bermejo-Pareja F. Education and risk of incident dementia during the premotor and motor phases of essential tremor (NEDICES). Medicine (Baltimore) 2016; 95:e4607. [PMID: 27537597 PMCID: PMC5370823 DOI: 10.1097/md.0000000000004607] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Individuals with late-onset essential tremor (ET) (e.g., older adults) seem to have an increased prevalence of mild cognitive impairment and dementia, and a higher risk of incident dementia. It is well-known that education has a protective role against dementia in individuals without a pre-existing neurologic disorder, but evidence regarding the maintenance of this effect during the premotor and motor phases of ET is unknown. Our aim was to determine the influence of education on the risk of dementia in a population-based cohort of ET patients and controls. In a prospective study (Neurological Disorders in Central Spain), participants ≥65 years old were evaluated twice: at baseline (1994-1995) and at follow-up (1997-1998). There were 3 groups: premotor (i.e., participants first diagnosed with incident ET at follow-up), prevalent ET (i.e., participants diagnosed with ET at baseline and at follow-up), and controls. Participants were stratified into lower education (≤primary studies) versus higher education (≥secondary studies) categories. Dementia risk was estimated using Cox proportional-hazards models (higher education control group = reference category). Among the participants, 3878 had a mean duration of follow-up of 3.2 years. Eight (16.7%) of 48 lower education premotor ET patients developed incident dementia versus 1 (3.3%) of 30 higher education premotor ET patients, 9 (7.1%) of 126 lower education prevalent ET patients, 7 (8.8%) of 80 higher education prevalent ET patients, and 92 (4.9%) of 1892 lower education controls (P < 0.001). In comparison to the higher education controls, the adjusted hazard ratios for incident dementia were 5.84 (lower education premotor ET, P < 0.001); 1.36 (higher education premotor ET, P = 0.76); 2.13 (lower education prevalent ET, P = 0.04); 2.79 (higher education prevalent ET, P = 0.01); and 1.66 (lower education controls, P = 0.01). Our results suggest that a higher educational attainment may ameliorate the risk of incident dementia during the premotor phase of ET, but not in the motor phase.
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Affiliation(s)
- Julián Benito-León
- Department of Neurology, University Hospital “12 de Octubre”, Madrid, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Department of Medicine, Complutense University, Madrid, Spain
- Correspondence: Julián Benito-León, Avda, de la Constitución 73, portal 3, 7° Izquierda, E-28821 Coslada, Madrid, Spain (e-mail: )
| | - Israel Contador
- Department of Basic Psychology, Psychobiology and Methodology of Behavioral Science, University of Salamanca, Salamanca, Spain
| | - Elan D. Louis
- Department of Neurology, Yale School of Medicine
- Department of Chronic Disease Epidemiology, Yale School of Public Health
- Center for Neuroepidemiology and Clinical Neurological Research, Yale School of Medicine and Yale School of Public Health, New Haven, CT
| | - Stephanie Cosentino
- Cognitive Neuroscience Division of the Gertrude H. Sergievsky Center
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain
- Department of Neurology, Columbia University Medical Center, New York, NY
| | - Félix Bermejo-Pareja
- Department of Neurology, University Hospital “12 de Octubre”, Madrid, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain
- Department of Medicine, Complutense University, Madrid, Spain
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Physical Activity as Protective Factor against Dementia: A Prospective Population-Based Study (NEDICES). J Int Neuropsychol Soc 2015; 21:861-7. [PMID: 26581797 DOI: 10.1017/s1355617715000831] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The aim of this study was to analyze whether physical activity (PA) is a protective factor for the incidence of dementia after 3 years of follow-up. The Neurological Disorders in Central Spain (NEDICES) is a prospective population-based survey of older adults (age 65 years and older) that comprised 5278 census-based participants at baseline (1994-1995). A broad questionnaire was used to assess participants' sociodemographic characteristics, health status, and lifestyle. Subsequently, a modified version of Rosow-Breslau questionnaire was applied to classify individuals' baseline PA into groups (i.e., sedentary, light, moderate, and high). Cox regression models adjusted for several covariates (age, sex, education, previous stroke, alcohol consumption, hypertension, health related variables) were carried out to estimate the association between the PA groups and risk of dementia at the 3-year follow-up (1997-1998). A total of 134 incident dementia cases were identified among 3105 individuals (56.6% female; mean age=73.15 ± 6.26) after 3 years. Hazard ratios (HRs) of the light, moderate, and high PA groups (vs. sedentary group) were 0.40 (95% confidence interval {CI} [0.26, 0.62]; p<.001), 0.32 (95% CI [0.20, 0.54]; p<.001) and 0.23 (95% CI [0.13, 0.40]; p<.001), respectively. Even after controlling for covariates and the exclusion of doubtful dementia cases, HRs remained significant. However, a supplementary analysis showed that the dose-effect hypothesis did not reach statistical significance. PA is a protective factor of incident dementia in this population-based cohort.
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