‘Alzheimer's disease’: more data, but are we any more informed?

Förstl, Hans

doi:10.1097/01.yco.0000185717.57117.08

Cited by 4 publications

(3 citation statements)

References 61 publications

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“…It is noteworthy that designing alternative administration procedures and interpretations to improve diagnostic limitations of commonly used neuropsychological tests has been previously proposed (Chertkow, Bergman, Schipper, Gauthier, Bouchard, Fontaine, & Clarfield, 2001; Chertkow, 2000; Förstl, 2005; Kilada et al, 2005; Mungas, Reed, & Kramer, 2003; Rentz et al, 2004). …”

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Extending the Administration Time of the Letter Fluency Test Increases Sensitivity to Cognitive Status in Aging

Goldin

Donovick

2009

Expt. Aging Res.

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We examined whether extending the administration time of letter fluency from one minute per letter trial (standard administration) to two minutes increased the sensitivity of this test to cognitive status in aging. Participants (mean age = 84.6) were assigned to cognitive impairment (n=20) and control (n=40) groups. Pearson correlations and scatter plot analyses showed that associations between the Dementia Rating Scale scores and letter fluency were higher and less variable when performance on the latter was extended to two minutes. ANOVA showed that the cognitive impairment group generated fewer words in the second minute of the letter fluency task compared to the control group. Finally, discriminant function analyses revealed that extending the letter fluency trials to two minutes increased discrimination between the control and cognitive impairment groups. Keywords letter fluency; aging; cognitive impairmentVerbal Fluency tasks require the production of words with specific restrictions in a specified amount of time (Lezak, Loring & Howieson, 2004). Two types of verbal fluency tasks have been described in neuropsychological literature, both of which rely on verbal memory (Moscovitch, 1994). Category fluency requires production of words from a particular category, such as fruits or animals. This test is believed to tap semantic abilities and to rely heavily on left temporal regions (Moscovitch, 1994;Pihlajamaki et al., 2000). Letter fluency requires generation of words cued with a specific letter and depends on phonemic abilities (Benton & Hamsher, 1976). It has been suggested that letter fluency relies more on left frontal regions (Audenaert et al., 2000;Phelps, Hyder, Blamire, & Shulman 1997) and is the more difficult of the two tasks for older adults (Lezak, 1995). Norms for letter and category fluency are based on one-minute trials per individual letter (Lezak, 1995;Spreen & Strauss, 1998).Letter fluency is sensitive the cognitive decline observed in Alzheimer's (Duff Canning, Leach, Stuss, & Black, 2004;Lafosse et al., 1997), vascular (Duff et al., 2004 and frontotemporal (Robertson et al., 2005;Vicioso, 2002) dementias. Decline in performance on letter fluency is a risk factor for rapid disease progression and reduced survival (Robertson et al., 2005;Schupf et al., 2005 However, whether extending the standard administration time of letter fluency (60 sec) increases demands on cognitive resources and thereby improves the test's sensitivity to cognitive status in aging has not been examined. It is noteworthy that designing alternative administration procedures and interpretations to improve diagnostic limitations of commonly used neuropsychological tests has been previously proposed (Chertkow, Bergman, Schipper, Gauthier, Bouchard, Fontaine, & Clarfield, 2001;Chertkow, 2000;Förstl, 2005;Kilada et al., 2005;Mungas, Reed, & Kramer, 2003;Rentz et al., 2004).Herein we examined whether increasing demands on cognitive resources by extending the administration time of a single letter trial from one to two...

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confidence: 99%

Extending the Administration Time of the Letter Fluency Test Increases Sensitivity to Cognitive Status in Aging

Goldin

Donovick

2009

Expt. Aging Res.

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“…The concept of VMCI may be useful especially in the lacunar stroke subtype, as many of these patients have cognitive complaints [31] . However, a problem in studying VMCI is some heterogeneity in the use of the concept, regarding both its causes and clinical expression [3,32] . Our definition of VMCI was somewhat broader than the traditional criteria proposed by Petersen et al [25] , which focused on amnestic disorders [9] .…”

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confidence: 99%

Vascular Mild Cognitive Impairment Is Highly Prevalent after Lacunar Stroke but Does Not Increase over Time: A 2-Year Follow-Up Study

Rasquin¹,

Oostenbrugge

Verhey

et al. 2007

Dement Geriatr Cogn Disord

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Although ample research has been done into cognitive disorders occurring after stroke, relatively few data are available on the development and the course of vascularmild cognitive impairment (VMCI) after first-ever lacunar stroke. Methods: A cohort of 95 patients with a first-ever symptomaticlacunar infarct, older than 40 years, MMSE ≧15 and no other neurological or major psychiatric deficits were included. Patients were assessed (clinically and with a neuropsychological test battery) at 1 and 24 months after stroke, and CT was repeated. VMCI was diagnosed when patients had a deficit in at least one cognitive domain, in the absence of dementia. Results: Approximately 75% of the patients had VMCI at 1 month; this percentage was somewhat lower at 2 years. Only initial stroke severity was an independent predictor of VMCI after stroke. Conclusion: VMCI is highly prevalent after lacunar stroke, but does not increase during the first 2 years thereafter.

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“…A further difficulty is that, when the brains of demented persons are examined neuropathologically at autopsy, multiple potential causes of dementia are often found, not all of which were necessarily clinically relevant during life (indeed, non-demented persons often have such findings as well). In particular, the neuropathological correlates of Alzheimer's disease and of vascular dementia often appear simultaneously; thus, there is some debate at present over whether these two entities are really distinct or simply represent two opposite, idealized poles of a continuum of diseases (5). Likewise, in the case of Lewy-body dementia and Parkinsonian dementia, one may ask whether these are not simply two different types of clinical course that can arise in patients with one and the same underlying disease.…”

Section: Early Recognition By Diagnostic Evaluationmentioning

confidence: 99%

The Investigation and Differential Diagnosis of Dementias

Mahlberg¹

2010

Deutsches Ärzteblatt International

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‘Alzheimer's disease’: more data, but are we any more informed?

Cited by 4 publications

References 61 publications

Extending the Administration Time of the Letter Fluency Test Increases Sensitivity to Cognitive Status in Aging

Extending the Administration Time of the Letter Fluency Test Increases Sensitivity to Cognitive Status in Aging

Vascular Mild Cognitive Impairment Is Highly Prevalent after Lacunar Stroke but Does Not Increase over Time: A 2-Year Follow-Up Study

The Investigation and Differential Diagnosis of Dementias

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