Cross-validation of a Shortened Battery for the Assessment of Dysexecutive Disorders in Alzheimer Disease

Abstract

The frequency of executive disorders in mild-to-moderate Alzheimer disease (AD) has been demonstrated by the application of a comprehensive battery. The present study analyzed data from 2 recent multicenter studies based on the same executive battery. The objective was to derive a shortened battery by using the GREFEX population as a training dataset and by cross-validating the results in the REFLEX population. A total of 102 AD patients of the GREFEX study (MMSE=23.2±2.9) and 72 patients of the REFLEX study (MMSE=20.8±3.5) were included. Tests were selected and receiver operating characteristic curves were generated relative to the performance of 780 controls from the GREFEX study. Stepwise logistic regression identified 3 cognitive tests (Six Elements Task, categorical fluency and Trail Making Test B error) and behavioral disorders globally referred as global hypoactivity (P=0.0001, all). This shortened battery was as accurate as the entire GREFEX battery in diagnosing dysexecutive disorders in both training group and the validation group. Bootstrap procedure confirmed the stability of AUC. A shortened battery based on 3 cognitive tests and 3 behavioral domains provides a high diagnosis accuracy of executive disorders in mild-to-moderate AD.

Un nouveau test évaluant les fonctions exécutives cognitives voit le jour !

“…La place et l'intérêt de cette épreuve au sein de l'arsenal des tests évaluant les fonctions exécutives cognitives nécessiteront des travaux futurs. En effet les épreuves disponibles sont bien standardisées et normalisées ; elles explorent les processus exécutifs perturbés par les principales pathologies cérébrales avec des fréquences de déficits qui permettent même la mise en place de batteries abrégées pour les maladies d'Alzheimer [7], de Parkinson [8], les accidents vasculaires cérébraux [9], les tumeurs cérébrales [10] et les traumatismes crâniens sévères [11] ; surtout elles alimentent les critères diagnostiques du syndrome dysexécutif qui constitue un facteur indépendant des difficultés dans les activités de vie quotidiennes [12] montrant ainsi leur validité écologique.…”