Reliability of Repeated Cognitive Assessment of Dementia Using a Brief Computerized Battery

Hammers, Dustin B.; Spurgeon, Elizabeth; Ryan, Kelly A.; Persad, Carol; Heidebrink, Judith L.; Barbas, Nancy R.; Albin, Roger L.; Frey, Kirk A.; Darby, David; Giordani, Bruno

doi:10.1177/1533317511411907

Cited by 64 publications

(60 citation statements)

References 28 publications

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“…Once the CogState rules are learned, every presentation is still a novel challenge that is cognitively demanding (Hammers et al , 2011). In contrast, performance on the standard exam is susceptible to practice effects (Bartels et al , 2010; Beglinger et al , 2005; Heilbronner et al , 2010), which may mask cognitive decline as increasing familiarity with the tasks leads to improved performance.…”

Section: Discussionmentioning

confidence: 99%

Utility of a brief computerized battery to assess HIV-associated neurocognitive impairment in a resource-limited setting

et al. 2016

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Despite the persistently high prevalence of neurocognitive impairment in HIV-positive patients, routine HIV care in many resource-limited settings does not include neuropsychological assessment. The objective of this study was to examine the utility of a brief computerized battery for identifying neurocognitive impairment in a busy HIV clinic in Uganda. Specifically, we compared performance on a gold standard neuropsychological exam to that on the CogState Brief Battery. In this cross-sectional study, 181 HIV-positive patients completed both assessment batteries in a randomized order. The primary outcome measures were neurocognitive impairment on the standard exam defined by the global deficit score and cumulative performance on the CogState Brief Battery. Sixty-nine participants (38%) were classified as impaired on the standard neuropsychological exam, and participants who were classified as impaired performed significantly worse on CogState compared to those who were unimpaired (p<0.001). CogState had adequate specificity but low sensitivity, suggesting that it may not be a clinically useful screening tool to identify patients who likely have neurocognitive impairment in Uganda. This study supports the feasibility of using a computerized battery for assessing neurocognitive impairment in HIV-positive patients in resource-limited settings, but additional research is needed to identify screening tools with higher sensitivity for use in HIV clinics.

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Section: Discussionmentioning

confidence: 99%

Utility of a brief computerized battery to assess HIV-associated neurocognitive impairment in a resource-limited setting

et al. 2016

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“…A detailed review of University of Michigan PiB imaging procedures can be found in reviews 13,21 . Briefly, participants underwent equilibrium [ 11 C]-PiB PET imaging on a Siemens ECAT HR+ camera operated in three-dimensional mode (septa retracted).…”

Section: Methodsmentioning

confidence: 99%

“…Alternatively, PiB binding in FTD is thought to occur in much lower rates relative to AD, based on the decreased involvement of amyloid pathology in FTD. Rowe and colleagues 12 reported no PiB binding present in a clinically diagnosed FTD population, whereas others have identified PiB+ rates of 20–25% in clinically diagnosed FTD populations 8,9,13 , although these higher rates were suggested to be a function of the population having mixed FTD/AD dementia or frontal variant AD 9 .…”

Section: Introductionmentioning

confidence: 98%

Agreement among neuropsychological and behavioral data and PiB findings in diagnosing Frontotemporal Dementia

Ryan

Hammers

DeLeon

et al. 2017

Journal of Clinical Neuroscience

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Diagnostic inaccuracies have been reported in Alzheimer’s disease (AD) and Frontotemporal dementia (FTD) using clinical data alone. The [11C]-PiB PET scan offers a new method of identifying AD based on the detection of amyloid deposits. Our study investigated whether there was an agreement between neuropsychological and behavioral data and PiB findings in the diagnosis of FTD. Participants were 32 patients diagnosed with suspected FTD by clinical consensus. All participants underwent neuropsychological testing and PiB imaging. In addition, caregivers completed behavioral ratings of participants’ memory, frontal behaviors, and mood. Seventeen participants were classified as PiB positive (+). Results of MANOVA and subsequent ANOVA analyses showed a significant difference on memory performance between the PiB− and PiB+ groups, with the PiB− group performing better than the PiB+ group. There were no significant differences between the groups on cognitive or behavioral measures of executive/frontal impairment, mood. Both groups showed similar severity of dementia. These findings provide evidence for the utility of the [11C]-PiB PET scan in distinguishing between AD and FTD, with evaluation of memory at clinical diagnosis serving as a valuable indicator of the absence of FTD and consideration for an AD diagnosis. Our results would support the concern that patients who may present with primary behavioral or executive dysfunction may not necessarily have FTD, particularly if memory deficits are evident.

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“…No floor or ceiling effects 214,215 Sensitive to cognitive changes in dementia across three studies [214][215][216] No information found 179 Good ability to detect change in mild to moderate dementia 179,199,219 No information found [345][346][347][348] No information found…”

Section: No Information Foundmentioning

confidence: 99%

Development of a core outcome set for disease modification trials in mild to moderate dementia: a systematic review, patient and public consultation and consensus recommendations

Webster

Groskreutz

Grinbergs-Saull

et al. 2017

Health Technol Assess

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Background: There is currently no disease-modifying treatment available to halt or delay the progression of the disease pathology in dementia. An agreed core set of the best-available and most appropriate outcomes for disease modification would facilitate the design of trials and ensure consistency across disease modification trials, as well as making results comparable and meta-analysable in future trials. Objectives: To agree a set of core outcomes for disease modification trials for mild to moderate dementia with the UK dementia research community and patient and public involvement (PPI). Data sources: We included disease modification trials with quantitative outcomes of efficacy from (1) references from related systematic reviews in workstream 1; (2) searches of the Cochrane Dementia and Cognitive Improvement Group study register, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Latin American and Caribbean Health Sciences Literature and PsycINFO on 11 December 2015, and clinical trial registries [International Standard Randomised Controlled Trial Number (ISRCTN) and clinicaltrials.gov] on 22 and 29 January 2016; and (3) hand-searches of reference lists of relevant systematic reviews from database searches. Review methods: The project consisted of four workstreams. (1) We obtained related core outcome sets and work from co-applicants. (2) We systematically reviewed published and ongoing disease modification trials to identify the outcomes used in different domains. We extracted outcomes used in each trial, recording how many used each outcome and with how many participants. We divided outcomes into the domains measured and searched for validation data. (3) We consulted with PPI participants about recommended outcomes. (4) We presented all the synthesised information at a conference attended by the wider body of National Institute for Health Research (NIHR) dementia researchers to reach consensus on a core set of outcomes. Results: We included 149 papers from the 22,918 papers screened, referring to 125 individual trials. Eighty-one outcomes were used across trials, including 72 scales [31 cognitive, 12 activities of daily living (ADLs), 10 global, 16 neuropsychiatric and three quality of life] and nine biological techniques. We consulted with 18 people for PPI. The conference decided that only cognition and biological markers are core measures of disease modification. Cognition should be measured by the Mini Mental State Examination (MMSE) or the Alzheimer’s Disease Assessment Scale – Cognitive subscale (ADAS-Cog), and brain changes through structural magnetic resonance imaging (MRI) in a subset of participants. All other domains are important but not core. We recommend using the Neuropsychiatric Inventory for neuropsychiatric symptoms: the Disability Assessment for Dementia for ADLs, the Dementia Quality of Life Measure for quality of life and the Clinical Dementia Rating scale to measure dementia globally. Limitations: Most of the trials inclu...

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Reliability of Repeated Cognitive Assessment of Dementia Using a Brief Computerized Battery

Cited by 64 publications

References 28 publications

Utility of a brief computerized battery to assess HIV-associated neurocognitive impairment in a resource-limited setting

Utility of a brief computerized battery to assess HIV-associated neurocognitive impairment in a resource-limited setting

Agreement among neuropsychological and behavioral data and PiB findings in diagnosing Frontotemporal Dementia

Development of a core outcome set for disease modification trials in mild to moderate dementia: a systematic review, patient and public consultation and consensus recommendations

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