Dimensions of Cognitive Ability in Dementia: Differential Sensitivity to Degree of Impairment in Alzheimer's Disease

Mungas, Dan M; Wallace, R. Bruce; Reed, Bruce R

doi:10.1076/clin.12.2.129.1996

Cited by 4 publications

(4 citation statements)

References 26 publications

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“…Serial word-list learning and memory tests have been shown to be highly sensitive to episodic memory dysfunction (Delis et al, 1994) and to dementia (Cahn et al, 1995;Knopman & Ryberg, 1989;Mungas et al, 1998;Welsh et al, 1991). In addition, they are popular because a single test can offer measures of learning and forgetting, as well as other facets of memory performance (e.g., California Verbal Learning Test; Delis et al, 1987).…”

Section: Introductionmentioning

confidence: 98%

A new verbal learning and memory test for English- and Spanish-speaking older people

González

Mungas

Reed

et al. 2001

J Int Neuropsychol Soc

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Word-list verbal learning and memory tests with appropriate normative data can be highly sensitive to cognitive decline, but there are significant limitations of such tests available for use with older Hispanic and non-Hispanic people living in the US. The purpose of this study was to (1) create a new word-list learning and memory test in both English and Spanish and, (2) validate it with respect to sensitivity to cognitive impairment, and (3) develop statistical corrections for the effects of significant demographic variables, including ethnicity, language of administration, age, education, and gender. A community dwelling sample of 801 English-and Spanish-speaking older people was employed. Recall on learning trials and the delayed recall trial of the word-list learning test were strongly related to the Mini-Mental State Examination (MMSE), moderately related to age, and weakly related to gender and education. The relationship of word-list variables and the MMSE did not significantly differ across ethnicity0language groups. Regression coefficients for demographic variables were used in a statistical correction formula to adjust raw word-list scores, and then to develop specific percentile cut-off values. (JINS, 2001, 7, 544-555.)

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Section: Introductionmentioning

confidence: 98%

A new verbal learning and memory test for English- and Spanish-speaking older people

González

Mungas

Reed

et al. 2001

J Int Neuropsychol Soc

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“…While global functioning measures frequently have been used both for initial diagnosis and for quantitation of course, these are independent functions, and a measure might be good for one but be of limited use for the other. For example, memory measures are highly sensitive indicators of dementia in Alzheimer's disease [8][9][10], even in very mildly impaired patients. However, highsensitivity memory tests are less useful as measures of change due to the presence of a oor e ect in which performance drops to a near-zero level at a relatively early stage of progression of the dementia [10].…”

Section: Introductionmentioning

confidence: 99%

“…For example, memory measures are highly sensitive indicators of dementia in Alzheimer's disease [8][9][10], even in very mildly impaired patients. However, highsensitivity memory tests are less useful as measures of change due to the presence of a oor e ect in which performance drops to a near-zero level at a relatively early stage of progression of the dementia [10]. Similarly, measures that might be good for assessing progression through levels of functioning may have limited diagnostic sensitivity for mild cases of dementia.…”

Section: Introductionmentioning

confidence: 99%

Application of item response theory for development of a global functioning measure of dementia with linear measurement properties

Mungas

Reed

2000

Statist. Med.

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An ideal measure of global functioning for patients with dementia would discriminate at very high and very low levels of functioning and would have linear measurement properties such that a given change in score corresponds to the same amount of change in underlying ability at any part of the ability continuum. Using item response theory methods, linearity of test measurement can be directly assessed and items can be selected to construct a test with desired measurement characteristics. The purpose of this study was to apply item response theory methods to evaluating and developing global functioning scales. Subjects were 1207 patients who had received comprehensive dementia evaluations. Items were selected from two measures of cognitive functioning (Mini Mental State Examination, MMS; Blessed Information Memory Concentration Test, BIMCT) and one measure of independent functioning (Blessed-Roth Dementia Rating Scale, BRDRS). The MMS and BIMCT showed signiÿcant non-linearity of measurement, especially at low and high ability levels. A brief composite measure was created by selecting from the three instruments 25 items that ÿt a uniform distribution of item di culty across the entire range of ability measured by the three instruments. This composite measure and the BRDRS showed better linearity of measurement than the other two instruments. Results have implications for development of a psychometrically sophisticated, brief measure of global functioning for clinical and research use in dementia. Copyright ? 2000 John Wiley & Sons, Ltd.

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“…Marked global cognitive impairment on the Mini-Mental State Examination 8 appears to predict mortality most consistently, 4, 9 however, ceiling effects render this test less useful in early AD when patients achieve relatively high scores. 10 In contrast, heterogeneous neuropsychological profiles across individuals with early AD offer the opportunity to evaluate the prognostic value of differential deficits in specific cognitive domains for disease course, or mortality 11-13 . Although patients with AD exhibit a core memory deficit, there is considerable variability in performance on measures of executive functioning, language, and visuospatial skills, so much so that various "subtypes" of AD including frontal and posterior variants have been described. 12, 14-17 Functional neuroimaging and neuropathological studies have suggested that distinct neuropsychological profiles map onto differential distributions of neuropathology reflected through regional hypometabolism 11, 18, 19 and burden of amyloid plaques on autopsy.…”

Section: Introductionmentioning

confidence: 99%

Verbal Fluency Predicts Mortality in Alzheimer Disease

Cosentino¹,

Scarmeas²,

Albert³

et al. 2006

Cognitive and Behavioral Neurology

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Objectives-To assess the predictive value of neuropsychological profiles, at diagnosis, for mortality in incident Alzheimer's disease (AD).Background-Rate of AD progression varies significantly across individuals for reasons that are not well understood. Several studies have linked rapid decline with disproportionately impaired executive functioning, presumably reflecting greater impairment of frontal networks. To the extent that differential neuropsychological profiles reflect various neuropathologic presentations of AD, such profiles may inform survival estimates early in the disease.

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Dimensions of Cognitive Ability in Dementia: Differential Sensitivity to Degree of Impairment in Alzheimer's Disease

Cited by 4 publications

References 26 publications

A new verbal learning and memory test for English- and Spanish-speaking older people

A new verbal learning and memory test for English- and Spanish-speaking older people

Application of item response theory for development of a global functioning measure of dementia with linear measurement properties

Verbal Fluency Predicts Mortality in Alzheimer Disease

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