Diagnostic utility of the Key Search Test as a measure of executive functions

Abstract

Background: Executive function deficits are commonly observed in many clinical populations, highlighting the importance of appropriate diagnostic tools to screen for these deficits. Most neuropsychological tests of executive function, however, are time-consuming and difficult to administer in the case of moderate to severe cognitive decline. The aim of the present study was to examine whether the Key Search Test, a short and easy to administer test, is a useful indicator of executive function deficits in a study sample with a diagnosis of cognitive impairment. Methods: Participants consisted of elderly people visiting the memory clinic at the department of geriatrics of a university medical center (n = 140) and of elderly controls (n = 37). Next to the Key Search Test, other executive function tests and a memory test were administered. Results: Low to moderate correlations were found between the Key Search Test and other executive function tests. Furthermore, although the Key Search Test discriminated significantly between intact and impaired executive function (AUC = 0.677, P < 0.001), sensitivity and specificity were low and no optimal cut-off point could be determined. Conclusion:The Key Search test might not be an appropriate measure of executive functions in cognitively impaired individuals.

Intranasal Insulin in Alzheimer’s Disease: A Pragmatic Account

“…Nevertheless, fMRI studies of other visual-spatial planning task tests (Tower of London, Tower of Hanoi) show prefrontal cortex activity (the right ventrolateral and leftrostrolateral) which Amanzio et al [59] hypothesize as involving a similar neural network. The "key search" task of the BADS test reached a "medium" correlation with the "Rey Complex Figure", another executive function test measuring planning and organizational capacity [61,62]. AR actually improved his score on the Rey Complex test by 9.2% (2014-2015) after 2 years on intranasal insulin, showed no deterioration in Digit Span and WORLD executive-functioning tests (2014-2015) [5].…”

“…Amanzio et al [59] found novel metaphor comprehension in AD was predicted by the "key search" task of the Behavioral Assessment of the Dysexecutive Syndrome (BADS) test which explores planning in the visual-spatial domain. The BADS "key search" task test has been found to be an accurate, general discriminator of executive functioning impairment versus non-impairment despite problems in further differentiating levels of executive impairment in MCI & AD patients [61]. There is no functional neuroimaging study of the neural correlates of the specific tasks.…”

Elderly depression and diffusion tensor imaging

“…In the clinical setting, depression in the elderly needs to be differentially diagnosis from neurodegenerative diseases causing dementia, 3 including Alzheimer's disease, 4 diffuse Lewy body disease, 5 frontotemporal dementia, 6 and Parkinson's disease 7 , but this is sometimes difficult, even with neuropsychological, 8,9 biochemical, 10–12 electrophysiological, 13,14 or brain imaging examinations 15–18 . For dementia patients with depression, effective pharmacological 4 and non‐pharmacological 19–22 interventions are sometimes required to control agitation, irritation, negativism, and violent and suicidal behaviors 11 …”

The Role of Neuropsychological Performance in the Relationship Between Chronic Pain and Functional Physical Impairment

“…Finally, one point of consideration concerns the low internal consistency of the executive function domain score, because of which it was decided to use the separate executive function tests instead. Many previous studies also reported small to moderate correlations between executive function tests [45–48], which is inherently due to the heterogeneous nature of executive function. The use of separate test scores may actually be the reason for not finding a relationship with pain, because composite scores increase the signal‐to‐noise ratio [45].…”