A Computerized Test May Help Detect Cognitive Impairment

The study covered in this summary was published on researchsquare.com as a preprint and has not yet been peer reviewed.

Key Takeaways

  • The Loewenstein-Acevedo Scales for Semantic Interference and Learning, Brief Computerized Version (LASSI-BC) measured early cognitive change in patients with Alzheimer’s disease (AD) and was able to differentiate between cognitively unimpaired (CU) and amnestic mild cognitive impairment (aMCI). groups.

  • Performance on LASSI-BC was associated with volumetric reductions in AD-prone regions on MRI including the hippocampus, amygdala, inferior temporal lobes, and precuneus and posterior cingulate on MRI.

Why This Matters

  • Computerized tests have lacked the sensitivity and specificity needed to detect dementia or mild cognitive impairment.

  • The LASSI-BC is a brief computerized exam that does not require a skilled examiner, is appropriate for use among older adults from varying ethnic and cultural backgrounds, and has good test-retest reliability in patients with mild cognitive impairment (MCI).

Study Design

  • This study examined 127 community-dwelling older adults from a National Institute on Aging-funded RO1 study.

  • Patients were excluded if they met DSM-V criteria for major neurocognitive disorder, an active mood or psychotic disorder, or any other DSM-V axis I neuropsychiatric disorder.

  • A total of 46 patients were determined to have aMCI with a Clinical Dementia Rating (CDR) Scale score of 0.5 and evidence of single amnestic deficits. The average age of aMCI participants was 73.8 years.

  • A total of 81 patients were considered cognitively unimpaired, defined as having a global CDR score of 0 and without evidence of memory or cognitive decline. The average age of the CU group was 69.8.

  • Of these patients, 87 (36 with aMCI and 51 with CU) underwent MRI imaging and 12 AD-prone brain regions were evaluated for volumetric loss. The volumes of 12 AD-prone brain regions were related to LASSI-BC and other memory indices to correct for false discovery rate.

Key Results

  • A logistic regression model controlling for age, sex, education, testing language, and mini mental status exam (MMSE) showed that the failure to recover from proactive semantic interference (frPSI) on LASSI-BC differentiated between CU and aMCI groups even after adjusting for initial learning ability.

  • Using Receiver Operator Characteristic analysis, patients with an optimal combination of frPSI and maximum learning capacity scores of LASSI-BC had an area under the curve of .876 (76.1% sensitivity, 82.7% specificity).

  • Maximum learning capacity and frPSI on LASSI-BC are uniquely associated with volumetric loss in AD-prone areas on MRI including the hippocampus, precuneus, inferior temporal lobules, rostral middle frontal areas, and temporal poles.

Limitations

  • The presence of aMCI and volume loss signaling neurodegeneration does not conform to AD pathology. Amyloid PET scans and fluid-based markers for AD were not assessed and may better relate to LASSI-BC findings to AD.

  • There were few participants with aMCI who had neuroimaging.

Disclosures

  • The study received no commercial funding.

  • The LASSI-BC measure was developed by and is an intellectual property held by David A. Loewenstein, PhD, and Rosie Curiel Cid, PsyD, at the University of Miami School of Medicine, Miami, Florida. For all other authors there were no disclosed conflicts of interest.

This is a summary of a preprint research study, “ A novel computerized cognitive test for the detection of MCI and its association with neurodegeneration in Alzheimer’s disease regions prone brain ,” written by researchers at the University of Miami School of Medicine, Department of Radiology, Miami, Florida, published on researchsquare.com and provided to you by Medscape.

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