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Clinical utility of the cogstate brief battery in identifying cognitive impairment in mild cognitive impairment and Alzheimer's disease.

Maruff P, Lim YY, Darby D, Ellis KA, Pietrzak RH, Snyder PJ, Bush AI, Szoeke C, Schembri A, Ames D, Masters CL, AIBL Research Gro - BMC Psychol (2013)

Bottom Line: Both composite scores showed high test-retest reliability (r = 0.95) over four months.Poorer performance on the memory composite was also associated with worse performance on the Mini Mental State Exam and increasing severity on the Clinical Dementia Rating Scale sum of boxes score.Results of this study suggest that the CogState learning/working memory composite score is reduced significantly in CI and AD, correlate well with measures of disease classification and are useful in identifying memory impairment related to MCI- and AD.

View Article: PubMed Central - PubMed

Affiliation: The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria Australia ; CogState Ltd, Melbourne, Victoria Australia.

ABSTRACT

Background: Previous studies have demonstrated the utility and sensitivity of the CogState Brief Battery (CBB) in detecting cognitive impairment in Alzheimer's disease (AD) and mild cognitive impairment (MCI) and in assessing cognitive changes in the preclinical stages of AD. Thus, the CBB may be a useful screening tool to assist in the management of cognitive function in clinical settings. In this study, we aimed to determine the utility of the CBB in identifying the nature and magnitude of cognitive impairments in MCI and AD.

Methods: Healthy adults (n = 653) adults with amnestic MCI (n = 107), and adults with AD (n = 44) who completed the CBB participated in this study. Composite Psychomotor/Attention and Learning/Working Memory scores were computed from the individual CBB tests. Differences in composite scores were then examined between the three groups; and sensitivity and specificity analyses were conducted to determine cut scores for the composite scores that were optimal in identifying MCI- and AD-related cognitive impairment.

Results: Large magnitude impairments in MCI (g = 2.2) and AD (g = 3.3) were identified for the learning/working memory composite, and smaller impairments were observed for the attention/psychomotor composite (g's = 0.5 and 1, respectively). The cut-score associated with optimal sensitivity and specificity in identifying MCI-related cognitive impairment on the learning/working memory composite was -1SD, and in the AD group, this optimal value was -1.7SD. Both composite scores showed high test-retest reliability (r = 0.95) over four months. Poorer performance on the memory composite was also associated with worse performance on the Mini Mental State Exam and increasing severity on the Clinical Dementia Rating Scale sum of boxes score.

Conclusions: Results of this study suggest that the CogState learning/working memory composite score is reduced significantly in CI and AD, correlate well with measures of disease classification and are useful in identifying memory impairment related to MCI- and AD.

No MeSH data available.


Related in: MedlinePlus

ROC curve for performance of the MCI group (a) and the AD group (b) relative to the HC group on the learning/working memory composite and the attention/psychomotor composite.
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Fig1: ROC curve for performance of the MCI group (a) and the AD group (b) relative to the HC group on the learning/working memory composite and the attention/psychomotor composite.

Mentions: Inspection of the AUC statistics from the ROC analyses indicated that, by convention, the ROC curves for the learning/working memory composite showed excellent classification accuracy in both MCI and AD ((Swets 1996); Table 2; Figure 1). Accuracy of classification of both MCI and AD was lower for the attention/psychomotor composite (see Table 2, Figure 1). AUC values for the learning/working memory composite were significantly larger (i.e. no overlap between 95% CIs for AUC values) than for those for the attention/psychomotor composite and for classifying cognitive impairment in both MCI and AD (Table 2). Using the same criteria, the AUC for the learning/working memory composite was also significantly greater than the AUC for MMSE for classifying cognitive impairment in MCI (Table 2). Inspection of the Youden J statistics for the ROC curve for the learning/working memory composite indicated that the cut score that had optimal sensitivity and specificity in classifying cognitive impairment in MCI was 90 (i.e., z < = -1 SD). Application of this same cut score to classification of cognitive impairment in AD yielded a sensitivity of 100% at the same specificity (Table 2).Table 2


Clinical utility of the cogstate brief battery in identifying cognitive impairment in mild cognitive impairment and Alzheimer's disease.

Maruff P, Lim YY, Darby D, Ellis KA, Pietrzak RH, Snyder PJ, Bush AI, Szoeke C, Schembri A, Ames D, Masters CL, AIBL Research Gro - BMC Psychol (2013)

ROC curve for performance of the MCI group (a) and the AD group (b) relative to the HC group on the learning/working memory composite and the attention/psychomotor composite.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4269990&req=5

Fig1: ROC curve for performance of the MCI group (a) and the AD group (b) relative to the HC group on the learning/working memory composite and the attention/psychomotor composite.
Mentions: Inspection of the AUC statistics from the ROC analyses indicated that, by convention, the ROC curves for the learning/working memory composite showed excellent classification accuracy in both MCI and AD ((Swets 1996); Table 2; Figure 1). Accuracy of classification of both MCI and AD was lower for the attention/psychomotor composite (see Table 2, Figure 1). AUC values for the learning/working memory composite were significantly larger (i.e. no overlap between 95% CIs for AUC values) than for those for the attention/psychomotor composite and for classifying cognitive impairment in both MCI and AD (Table 2). Using the same criteria, the AUC for the learning/working memory composite was also significantly greater than the AUC for MMSE for classifying cognitive impairment in MCI (Table 2). Inspection of the Youden J statistics for the ROC curve for the learning/working memory composite indicated that the cut score that had optimal sensitivity and specificity in classifying cognitive impairment in MCI was 90 (i.e., z < = -1 SD). Application of this same cut score to classification of cognitive impairment in AD yielded a sensitivity of 100% at the same specificity (Table 2).Table 2

Bottom Line: Both composite scores showed high test-retest reliability (r = 0.95) over four months.Poorer performance on the memory composite was also associated with worse performance on the Mini Mental State Exam and increasing severity on the Clinical Dementia Rating Scale sum of boxes score.Results of this study suggest that the CogState learning/working memory composite score is reduced significantly in CI and AD, correlate well with measures of disease classification and are useful in identifying memory impairment related to MCI- and AD.

View Article: PubMed Central - PubMed

Affiliation: The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria Australia ; CogState Ltd, Melbourne, Victoria Australia.

ABSTRACT

Background: Previous studies have demonstrated the utility and sensitivity of the CogState Brief Battery (CBB) in detecting cognitive impairment in Alzheimer's disease (AD) and mild cognitive impairment (MCI) and in assessing cognitive changes in the preclinical stages of AD. Thus, the CBB may be a useful screening tool to assist in the management of cognitive function in clinical settings. In this study, we aimed to determine the utility of the CBB in identifying the nature and magnitude of cognitive impairments in MCI and AD.

Methods: Healthy adults (n = 653) adults with amnestic MCI (n = 107), and adults with AD (n = 44) who completed the CBB participated in this study. Composite Psychomotor/Attention and Learning/Working Memory scores were computed from the individual CBB tests. Differences in composite scores were then examined between the three groups; and sensitivity and specificity analyses were conducted to determine cut scores for the composite scores that were optimal in identifying MCI- and AD-related cognitive impairment.

Results: Large magnitude impairments in MCI (g = 2.2) and AD (g = 3.3) were identified for the learning/working memory composite, and smaller impairments were observed for the attention/psychomotor composite (g's = 0.5 and 1, respectively). The cut-score associated with optimal sensitivity and specificity in identifying MCI-related cognitive impairment on the learning/working memory composite was -1SD, and in the AD group, this optimal value was -1.7SD. Both composite scores showed high test-retest reliability (r = 0.95) over four months. Poorer performance on the memory composite was also associated with worse performance on the Mini Mental State Exam and increasing severity on the Clinical Dementia Rating Scale sum of boxes score.

Conclusions: Results of this study suggest that the CogState learning/working memory composite score is reduced significantly in CI and AD, correlate well with measures of disease classification and are useful in identifying memory impairment related to MCI- and AD.

No MeSH data available.


Related in: MedlinePlus