Detecting early Alzheimer’s disease using neuropsychological assessment and structural neuroimaging

Abstract

AbstractBackgroundAlzheimer’s disease (AD) can be challenging to diagnose early as cognitive changes are mild. Neuropsychological assessment, in contrast to cognitive screening or isolated cognitive tests, are more sensitive to the mild cognitive changes in early AD. Magnetic resonance imaging (MRI) can detect early structural brain changes in AD, particularly entorhinal cortex, transentorhinal cortex, and hippocampal atrophy. Combining neuropsychological assessment with MRI examination may yield improved ability to detect early AD. The current study examined combining neuropsychological and MRI measures to detect patients with mild cognitive impairment (MCI) in a memory clinic sample.MethodNeuropsychological assessment and entorhinal cortex, transentorhinal cortex, and hippocampal volume measurement were conducted in memory clinic patients, including 38 with memory symptoms, 16 with MCI, and 16 with dementia due to AD, and in 40 healthy controls. Backward stepwise multinomial logistic regression was used to compare the neuropsychological measures and MRI measures.ResultAmong the neuropsychological measures, memory and processing speed were the most important measures that contributed to group membership prediction. All MRI measures contributed to group membership prediction. The neuropsychological measures were more accurate than the MRI measures at detecting patients with MCI. Combining the MRI measures with the neuropsychological measures did not improve group membership prediction.ConclusionNeuropsychological assessment is an important tool to support MCI diagnosis. MRI measures contribute little diagnostic value over and above neuropsychological assessment. Further advancement in deriving MRI‐based measurements is required to achieve clinical utility.