Typical performance of elderly patients with Alzheimer disease on the Wisconsin Card Sorting Test (WCST)

Abstract

The Wisconsin Card Sorting Test (WCST) is a neuropsychological assessment tool designed to assess executive functions, frequently used in cases of cognitive disorders. However, Brazilian neuroscientific settings lack standardization studies of psychological assessment instruments, especially in the neuropsychological area. Thus, the assessment of clinical groups including dementias and particularly Alzheimer's disease (AD) patients, may be compromised by the lack of analytical references.ObjectiveTo characterize the performance of elderly patients with Alzheimer's disease on the WCST, aiming at establishing preliminary evaluative norms.MethodThirty-six elderly patients (mean age of 75.8 years) with mild AD from a teaching hospital were assessed using the printed form of the WCST.ResultsThe elderly patients with AD had impaired performance on the various WCST technical indicators, highlighting cognitive deficit with traces of stereotyped behavior and failures in working memory, conceptualization and learning. The results allowed preliminary norms to be defined for elderly AD patients on the various WCST indicators, grading their performance in eight diagnostic areas and yielding the identification of different levels of impairment of executive functions in these elderly patients.ConclusionsThe results demonstrated specific aspects of performance on the WCST by elderly people with AD, highlighting the effect of the disease on cognitive performance and executive functioning. Those normative references, although preliminary make a significant contribution to the neuropsychological assessment of AD patients in the Brazilian context, within the informative scope of the WCST.

Centella asiatica attenuates hippocampal mitochondrial dysfunction and improves memory and executive function in β-amyloid overexpressing mice

“…In this task subjects are required to adapt behavioral responses to choose the “correct” stimulus array based on sudden rule changes across multiple modalities (Eling 2008). Performance in this task declines with age and is impaired in AD (Silva-Filho 2007, Ashendorf 2008). The ODRL, also called attention set shifting task, is a parallel test that has been developed for rats and, more recently, mice (Birrell 2000, Garner 2006).…”

Executive functions in the elderly with mild cognitive impairment: a systematic review on motor and cognitive inhibition, conflict control and cognitive flexibility

“…These results are replicated by studies using the classic version and those using the modified version of the WCST. Although the revised version of WCST would seem the golden standard to evaluate individuals with different neurological diseases (e.g., Parkinson's disease, chronic alcoholism, Alzheimer's disease; Nagahama et al, 2003;Silva-Filho, Pasian & Vale, 2007), to assess people with MCI even the standard version of WCST shows an adequate sensitivity in discriminating people with MCI from healthy people. The only study that showed no significant differences between groups did not perform specific statistical comparisons between the groups; however, given the reported means one could hypothesise a worse performance of the group with MCI compared to the control group (Rabin et al, 2006).…”

Diagnostic Utility of the Shortened Version of the Wisconsin Card Sorting Test in Patients With Sporadic Late Onset Alzheimer Disease

“…13 “Percentage of errors” increases in the second deck, but only in the AD group, although the differences are not significant when they are analyzed for each of the groups. This decrease in performance as the test progresses could be explained by the long time it takes to administer (30–60 minutes), being particularly complicated for the patients with AD 30 or CG participants. 31 This situation justifies the need to utilize the shortened version of the WCST for a reliable test to evaluate the EFs in elderly populations or populations with neurodegenerative diseases.…”