Detection of Cognitive Dysfunction in Elderly with a Low Educational Level Using a Reaction-Time Attention Task

Abstract

Background: Scales for cognitive deterioration usually depend on education level. Objective: We aimed to study the clinical utility of a culture-free Go/No-Go task in a multi-ethnic cohort with low education level. Methods: Sixty-four participants with less than 4 years of formal education were included and divided on the basis of their Clinical-Dementia-Rate scores (CDR) into cognitively unimpaired (CDR = 0), mild cognitive impairment (MCI; CDR = 0.5), and early Alzheimer’s disease (AD, CDR = 1). All underwent a 90-s Continuous Visual Attention Test. This test consisted of a 90-s Go/No-go task with 72 (80%) targets and 18 (20%) non-targets. For each participant, reaction times and intraindividual variability of reaction times of all correct target responses, as well as the number of omission and commission errors were evaluated. Coefficient of variability was calculated for each participant by dividing the standard deviation of the reaction times by the mean reaction time. A MANCOVA was performed to examine between-group differences using age and sex as covariates. Discriminate analysis was performed to find the most reliable test-variable to discriminate the three groups. Results: Commission error, intraindividual variability of reaction time, and coefficient of variability progressively worsened with increasing CDR level. Discriminant analysis demonstrated that coefficient of variability was the best discriminant factor, followed by intraindividual variability of reaction time and commission error. Conclusion: The Go/No-Go task was able to discriminate people with MCI or early AD from controls in the setting of illiteracy.

Comparing online and face-to-face administration of a neuropsychological computerized attention test: Assessment modality does not influence performance

“…ICC for VRT reached significance. VRT is considered the best predictor of attention deficits in Alzheimer’s disease ( Munro Cullum et al, 2014 ; Schmidt et al, 2020 ), ADHD ( Schmidt et al, 2019 ), Mild Cognitive Impairment ( Schmidt et al, 2020 ), Chronic Pain ( Schmidt et al, 2022 ), and post-COVID patients who presented early gastrointestinal symptoms ( Schmidt et al, 2023 ). Therefore, our result shows that we can reliably measure the VRT variable independent of the way the test is administered.…”

“…The Continuous Visual Attention Test (CVAT) is Go/no-go task ( Schmidt et al, 2020 ) that has been frequently used to assess the attention subdomains in several neurologic diseases ( Simões et al, 2018 ; Schmidt et al, 2021 ). The number of omission errors (OE) reflects problems on focused attention, whereas the number of incorrect hits or false alarms (no-go) indicates response inhibition, i.e., commission errors (CE; Sessler et al, 2002 ).…”

“…It has been proven to provide useful information on cognition in different clinical scenarios. In elderly patients with mild cognitive impairment and early Alzheimer’s disease, the VRT variable of the short version of the CVAT has been shown to progressively worsen with increasing level of cognitive impairment ( Schmidt et al, 2020 ). Also, individuals recovering from COVID-19 present worsened performance on some variables of the short version of the CVAT ( Do Carmo Filho et al, 2022 ; Schmidt et al, 2023 ).…”

Attention deficits in Brazilian health care workers with chronic pain

“…In this study, HWCs with CP had more significant response time fluctuations than those without CP. There is literature available to support the hypothesis that a greater VRT is observed in several neurological conditions, such as Alzheimer’s disease or mild cognitive impairment ( Schmidt et al, 2020 , 2021 ). In addition, VRT was found to predict progression of cognitive decline from healthy aging to mild cognitive impairment ( Cherbuin et al, 2010 ; Haynes et al, 2017 ).…”

Hepatitis C Virus (HCV) Infection and Neurocognitive Impairment in Subjects with Mild Liver Disease

“…VRT was estimated by a per-person measure of the standard deviation (SD) of individual RTs for the correctly signaled targets. To exclude the possibility that a participant’s VRT might be related to RT, we calculated the coefficient of variability (CV = VRT/RT) [ 37 , 48 ].…”