Abstract
BackgroundPrevious 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.MethodsHealthy 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.ResultsLarge 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.ConclusionsResults 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.
Highlights
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
Post-hoc comparisons indicated that adults with MCI and AD performed significantly worse than Healthy controls (HC) on the learning/working memory composite, and the magnitudes of these differences were, by convention, large (MCI g = 2.15, 95% CI = 1.91, 2.38; AD g = 3.18, 95% CI = 2.91, 3.28)
The AD group performed significantly worse than the MCI group on the learning/ working memory score with this difference moderate in magnitude (g = 0.84 95% CI = 0.49, 1.18; p < 0.01)
Summary
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. The simple stimuli, rules and responses have been combined to generate cognitive paradigms that have been well-validated in neuropsychological and cognitive studies These include measures of psychomotor function (Detection task), visual attention (Identification task), working memory (One Back task) and visual learning set within a pattern separation model (One Card Learning task, (Fredrickson et al 2010; Maruff et al 2009)). The simplicity of the CBB has allowed it to be applied successfully to the measurement of cognitive function in healthy older adults and in adults with clinically diagnosed and prodromal AD (Darby et al 2009; Lim et al 2012a, b) These studies have found that performance on the CBB working memory and learning tasks are sensitive to cognitive impairment in clinically diagnosed AD as well as its prodromal stage; amnestic MCI. The CBB has been shown to be sensitive to AD-related cognitive decline in healthy older adults and in adults with amnestic MCI (Darby et al 2002, 2012; Lim et al 2013a, b) as well as to improvement in cognition arising from treatment with putative cognitive enhancing drugs such as donepezil (Jaeger et al 2011), histamine H3 antagonists (Nathan et al 2013) and testosterone (Davison et al 2011) in older people
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