Detection and staging of dementia in Alzheimer's disease. Use of the neuropsychological measures developed for the Consortium to Establish a Registry for Alzheimer's Disease

K. A. Welsh, N. Butters, J. P. Hughes, R. C. Mohs and A. Heyman
Joseph and Kathleen Bryan Alzheimer's Disease Research Center, Duke University Medical Center, Durham, NC 27710.

Our earlier studies using the Consortium to Establish a Registry of Alzheimer's Disease neuropsychological battery showed that delayed recall was a highly sensitive indicator of early Alzheimer's disease. None of the learning and memory measures in the battery were found to be useful in staging the severity of this form of dementia. This study explores the nonmemory functions (fluency, naming, and praxis) of the Consortium to Establish a Registry of Alzheimer's Disease battery and asks whether performance on any of these measures adds to the detection of early Alzheimer's disease or is sensitive to the later progression of the illness. We stratified patients with this disease according to severity (mild, moderate, severe), and compared them with age-, education-, and gender-matched control subjects (group N = 49 each). Multivariate procedures and cutting scores were used to determine the efficacy of the various measures in distinguishing between the cases and control subjects. Impairment of delayed recall was again found to be the best discriminator for detecting mild cases of Alzheimer's disease. Confrontation naming was the only nonmemory factor that assisted in this discrimination. For staging the illness, a combination of measures including fluency, praxis, and recognition memory best differentiated cases with mild dementia from those with either moderate or severe stages of disease. Measures of delayed recall quickly "bottomed out" in the patients with Alzheimer's disease and proved of little value in staging the disorder.(ABSTRACT TRUNCATED AT 250 WORDS)

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Lack of Practice Effects on Neuropsychological Tests as Early Cognitive Markers of Alzheimer Disease?
Zehnder et al.
AM J ALZHEIMERS DIS OTHER DEMEN 2007;22:416-426.
ABSTRACT  

Prevalence of dementia in Chamorros on Guam: Relationship to age, gender, education, and APOE
Galasko et al.
Neurology 2007;68:1772-1781.
ABSTRACT | FULL TEXT  

Cognitive and motor assessment in autopsy-proven corticobasal degeneration
Murray et al.
Neurology 2007;68:1274-1283.
ABSTRACT | FULL TEXT  

Utility of the Clinical Dementia Rating in Asian Populations
Lim et al.
Clin Med Res 2007;5:61-70.
ABSTRACT | FULL TEXT  

Word Reading and Posterior Temporal Dysfunction in Amnestic Mild Cognitive Impairment
Vandenbulcke et al.
Cereb Cortex 2007;17:542-551.
ABSTRACT | FULL TEXT  

Effects of Healthy Aging on Hippocampal and Rhinal Memory Functions: An Event-Related fMRI Study
Daselaar et al.
Cereb Cortex 2006;16:1771-1782.
ABSTRACT | FULL TEXT  

Alzheimer's centennial legacy: origins, landmarks and the current status of knowledge concerning cognitive aspects.
Hodges
Brain 2006;129:2811-2822.
ABSTRACT | FULL TEXT  

Age, gender, and education norms on the CERAD neuropsychological battery in the oldest old.
Beeri et al.
Neurology 2006;67:1006-1010.
ABSTRACT | FULL TEXT  

Neuropsychological Testing in the Diagnosis of Dementia
Sano
J Geriatr Psychiatry Neurol 2006;19:155-159.
ABSTRACT  

Neuropsychological tests accurately predict incident Alzheimer disease after 5 and 10 years
Tierney et al.
Neurology 2005;64:1853-1859.
ABSTRACT | FULL TEXT  

Neuropsychological predictors of dependency in patients with Alzheimer disease
Sarazin et al.
Neurology 2005;64:1027-1031.
ABSTRACT | FULL TEXT  

Self-Administered Screening for Mild Cognitive Impairment: Initial Validation of a Computerized Test Battery
Tornatore et al.
J. Neuropsychiatry Clin. Neurosi. 2005;17:98-105.
ABSTRACT | FULL TEXT  

Methodology and Preliminary Results From the Neurocognitive Outcomes of Depression in the Elderly Study
Steffens et al.
J Geriatr Psychiatry Neurol 2004;17:202-211.
ABSTRACT  

Differential Vulnerability of Anterior White Matter in Nondemented Aging with Minimal Acceleration in Dementia of the Alzheimer Type: Evidence from Diffusion Tensor Imaging
Head et al.
Cereb Cortex 2004;14:410-423.
ABSTRACT | FULL TEXT  

Neuropsychological stydy of familial Alzheimer's disease caused by mutation E280A in the presenilin 1 gene
Lasprilla et al.
AM J ALZHEIMERS DIS OTHER DEMEN 2003;18:137-146.
ABSTRACT  

Relation of cerebral infarctions to dementia and cognitive function in older persons
Schneider et al.
Neurology 2003;60:1082-1088.
ABSTRACT | FULL TEXT  

Apolipoprotein E {epsilon}4 allele, AD pathology, and the clinical expression of Alzheimer's disease
Bennett et al.
Neurology 2003;60:246-252.
ABSTRACT | FULL TEXT  

Visual association test to detect early dementia of the Alzheimer type
Lindeboom et al.
J. Neurol. Neurosurg. Psychiatry 2002;73:126-133.
ABSTRACT | FULL TEXT  

Natural history of mild cognitive impairment in older persons
Bennett et al.
Neurology 2002;59:198-205.
ABSTRACT | FULL TEXT  

Accelerated Plaque Accumulation, Associative Learning Deficits, and Up-regulation of alpha 7 Nicotinic Receptor Protein in Transgenic Mice Co-expressing Mutant Human Presenilin 1 and Amyloid Precursor Proteins
Dineley et al.
J. Biol. Chem. 2002;277:22768-22780.
ABSTRACT | FULL TEXT  

MRI measures of entorhinal cortex vs hippocampus in preclinical AD
Killiany et al.
Neurology 2002;58:1188-1196.
ABSTRACT | FULL TEXT  

Current Concepts in Mild Cognitive Impairment
Petersen et al.
Arch Neurol 2001;58:1985-1992.
ABSTRACT | FULL TEXT  

Memory decline in healthy older people: Implications for identifying mild cognitive impairment
Collie et al.
Neurology 2001;56:1533-1538.
ABSTRACT | FULL TEXT  

Memory Testing in Dementia: How Much Is Enough?
Derrer et al.
J Geriatr Psychiatry Neurol 2001;14:1-6.
ABSTRACT  

Cognitive tests that best discriminate between presymptomatic AD and those who remain nondemented
Chen et al.
Neurology 2000;55:1847-1853.
ABSTRACT | FULL TEXT  

Novel Method to Quantify Neuropil Threads in Brains from Elders With or Without Cognitive Impairment
Mitchell et al.
J. Histochem. Cytochem. 2000;48:1627-1638.
ABSTRACT | FULL TEXT  

FDG PET Imaging in Patients with Pathologically Verified Dementia
Hoffman et al.
JNM 2000;41:1920-1928.
ABSTRACT | FULL TEXT  

Variability in Annual Mini-Mental State Examination Score in Patients With Probable Alzheimer Disease: A Clinical Perspective of Data From the Consortium to Establish a Registry for Alzheimer's Disease
Clark et al.
Arch Neurol 1999;56:857-862.
ABSTRACT | FULL TEXT  

Attention and executive deficits in Alzheimer's disease: A critical review
Perry and Hodges
Brain 1999;122:383-404.
ABSTRACT | FULL TEXT  

Cognitive and neurobiologic markers of early Alzheimer disease
Albert
Proc. Natl. Acad. Sci. USA 1996;93:13547-13551.
ABSTRACT | FULL TEXT