Objective: Appropriate screening is integral to the early diagnosis and management of Alzheimer’s Dementia (AD). The Paired Associates Learning (PAL) task is a digital cognitive task that is free of cultural, language, and educational biases. This study examined the association between the PAL task performance and global cognition and the usefulness of the PAL task as a screening tool for AD. Design: Cross-sectional. Setting: Academic hospital. Methods: Twenty-five participants with AD and 22 healthy comparators (HC) were included. The Cambridge Neuropsychological Test Automated Battery PAL task and the Montreal Cognitive Assessment (MoCA) were used to assess cognition. We assessed the relationship between the PAL task and MoCA performance using Pearson correlation and linear regression. We also examined the PAL task’s ability to distinguish between AD and HC participants using Receiver Operating Characteristic curve (ROC) analysis. Measurements: MoCA Total Score had a strong positive correlation with PAL Stages Completed score (r = 0.8, p < 0.001), and a strong negative correlation with PAL Total Errors (adjusted) score (r = −0.9, p < 0.001). Further, PAL Total Errors (adjusted) score predicted the MoCA Total Score (F (4, 46) = 37.2, p < 0.001). On ROC analysis, PAL Total Errors (adjusted) score cut-off of 54 errors had 92% sensitivity and 86% specificity to detect AD. Conclusions: Performance on the PAL task is highly associated with global cognition. Further, the PAL task can differentiate patients with AD from HCs with high sensitivity and specificity. Thus, the PAL task may hold potential usage as an easy-to-administer screening tool for AD.

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The above article (Hicks et al., 2020) published with an incorrect affiliation for Wei Wang.

Background A high anticholinergic burden has been associated with deleterious effects on cognition, especially in the elderly. We developed a new serum anticholinergic assay (SAA) to measure the anticholinergic burden, and report on validating this new SAA using established anticholinergic burden scales and cognitive assessments in older patients with mild cognitive impairment (MCI) or major depressive disorder (MDD). Method Baseline serum samples were collected from 311 participants (154 with MCI, 57 with MDD, and 100 with MCI + MDD). The new SAA assay uses radio‐ligand binding to cultured cells stably expressing the muscarinic M1 receptors, with an added procedure to remove potential confounds associated with the effects of proteins in serum. We then calculated correlations between new SAA scores and each of the Anticholinergic Burden Scale (ACB) and Anticholinergic Drug Scale (ADS) total scores. Multiple regression models assessed the relationships between SAA and cognitive performance on a comprehensive cognitive battery. Result Baseline serum samples were collected from 311 participants (154 with MCI, 57 with MDD, and 100 with MCI + MDD). The mean SAA value was 1.65 pmol/L, SD = 1.83). Mean age of the sample was 71.96 years, range 60‐90 years, SD=6.2. 38.7 % were males. In both the ACB and ADS scores, participants with the highest total scores had the highest SAA values. ADS: F (2,98) = 7.84, p = 0.001, SAA (3+) > SAA (1); ACB: F (2,121) = 5.89, p = 0.004, SAA (3+) > SAA (1) and > SAA (2). SAA was significantly associated with performance on executive function after adjusting for age, gender, education, diagnosis, controlling for multiple testing. (β = ‐0.152, SE = 0.024, p = 0.007) There was no association with overall cognitive composite score combining all domains. Conclusion The above results support the use of the new SAA as a measure of anticholinergic burden. Of note, the effect of SAA on executive function was almost equivalent, though in the opposite direction, to the effect of education on executive function.