CERAD Neuropsychological Assessment Battery Research Articles

More extensive hypometabolism and higher mortality risk in patients with right- than left-predominant neurodegeneration of the anterior temporal lobe

BackgroundLeft-predominant neurodegeneration of the anterior temporal lobe (ATL) and the associated syndrome termed semantic variant primary progressive aphasia (svPPA) are well characterized. Less is known about right-predominant neurodegeneration of the ATL, which has been associated with the clinical syndrome named right temporal variant of frontotemporal dementia (rtvFTD). Here, we assessed glucose metabolism across the brain, cognitive performance, and mortality in patients with right-predominant neurodegeneration of the ATL.MethodsPatients with predominant hypometabolism of the ATL on FDG PET (as a measure of neurodegeneration) were retrospectively identified and categorized into those with asymmetrical right, left, or symmetric bilateral involvement (N = 10, 17, and 8). We compared whole-brain, normalized regional glucose metabolism using SPM12, cognitive performance on the CERAD Neuropsychological Assessment Battery, and mortality risk (age- and sex-adjusted Cox proportional hazard model) between groups.ResultsHypometabolism was most pronounced and extensive in patients with right-predominant neurodegeneration of the ATL. Beyond the right temporal lobe, right frontal and left temporal lobes were affected in these patients. Cognitive performance was similarly impaired in all three groups, with predominant naming and hippocampal-dependent memory deficits. Mortality risk was 6.1 times higher in patients with right- than left-predominant ATL neurodegeneration (p < 0.05). Median survival duration after PET was shortest in patients with right- and longest in patients with left-predominant ATL neurodegeneration (5.7 vs 8.3 years after examination).DiscussionMore extensive neurodegeneration and shorter survival duration in patients with right- than left-predominant neurodegeneration of the ATL might indicate that the former consult memory clinics at a later disease stage, when symptoms like naming and episodic memory deficits have already emerged. At the time of diagnosis, the shorter survival duration of patients with right- than left-predominant ATL neurodegeneration should be kept in mind when counseling patients and caregivers.

Regional Cerebral Associations Between Psychometric Tests and Imaging Biomarkers in Alzheimer's Disease.

Recently, imaging biomarkers have gained importance for the characterization of patients with Alzheimer’s disease; however, the relationship between regional biomarker expression and cognitive function remains unclear. In our study, we investigated associations between scores on CERAD neuropsychological assessment battery (CERAD-NAB) subtests with regional glucose metabolism, cortical thickness and amyloid deposition in patients with early Alzheimer’s disease (AD) using [18F]-fluorodeoxyglucose (FDG), structural MRI, and 11C-Pittsburgh Compound B (PiB) positron emission tomography (PET), respectively. A total of 76 patients (mean age 68.4 ± 8.5 years, 57.9% male) with early AD (median global clinical dementia rating (CDR) score = 0.5, range: 0.5–2.0) were studied. Associations were investigated by correlation and multiple regression analyses. Scores on cognitive subtests were most closely predicted by regional glucose metabolism with explained variance up to a corrected R² of 0.518, followed by cortical thickness and amyloid deposition. Prediction of cognitive subtest performance was increased up to a corrected R² of 0.622 for Word List—Delayed Recall, when biomarker information from multiple regions and multiple modalities were included. For verbal, visuoconstructive and mnestic domains the closest associations with FDG-PET imaging were found in the left lateral temporal lobe, right parietal lobe, and posterior cingulate cortex, respectively. Decreased cortical thickness in parietal regions was most predictive of impaired subtest performance. Remarkably, cerebral amyloid deposition significantly predicted cognitive function in about half of the subtests but with smaller extent of variance explained (corrected R² ≤ 0.220). We conclude that brain metabolism and atrophy affect cognitive performance in a regionally distinct way. Significant predictions of cognitive function by PiB-PET in half of CERAD-NAB subtests suggest functional relevance even in symptomatic patients with AD, challenging the concept of plateauing cortical amyloid deposition early in the disease course. Our results underscore the complex spatial relationship between different imaging biomarkers.

Lifetime musical training and cognitive performance in a memory clinic population: A cross-sectional study.

Background:Music training has been found to be beneficial for young and healthy participants but the associations between musical training and the cognitive functioning of elderly participants have not been reported consistently. We examined whether lifetime musical training is associated with neuropsychological performance in a memory clinic population of older patients.Methods:A total of 478 patients (54.2% female, mean age 73.70 ± 6.22, mean Mini Mental State Examination score 25 ± 3) were included in the cross-sectional analyses. All patients were referred to the memory clinic due to cognitive impairments. During the course of diagnosis, all patients underwent neuropsychological tests using the CERAD neuropsychological assessment battery. Patients provided information on whether they ever learned to play an instrument for at least five years in their life.Results:Neuropsychological test results differed based on musical training (p = .042). Overall, there were no differences in any domains of cognitive functioning, other than that patients with musical training performed worse on word list memory (p = .008). However, this relationship varied based on the extent of cognitive impairments. Patients who were cognitively unimpaired (Mini Mental State Examination score 27–30) and had musical training showed better word list learning, whereas patients with cognitive impairments (Mini Mental State Examination score < 27) and musical training performed worse in word list learning (p = .042) and word list recall (p = .045).Discussion:Overall, there was little evidence of associations between specific neuropsychological test results and musical training. Only in cognitively unimpaired patients was there evidence that musical training had beneficial associations. In patients with cognitive impairment, there were suggestions of negative associations with verbal memory. Future research should longitudinally investigate the beneficial effects of musical training in people with and without cognitive impairments.

Early prediction of donepezil cognitive response in Alzheimer's disease by brain perfusion single photon emission tomography.

Currently, there is no effective means to evaluate donepezil response. We evaluated brain perfusion change at 4h after donepezil administration (4h DNPZ) to predict cognitive responses after 6months of medication. CERAD neuropsychological assessment battery was used to define cognitive response at 6months. We compared 4h DNPZ to baseline single photon emission tomography (SPECT) by statistical parametric mapping to identify perfusion changes in responders (N = 16) and non-responders (N = 7). In responders, there were significant relatively increase in perfusion in left parietal lobe (BA39, 7, 1), right superior frontal gyrus (BA6) and right middle occipital gyrus (BA39). In the non-responders, perfusion was relatively increase in the left parietal lobe (BA39) only. In an explorative analysis, we found a significant correlation between perfusion changes in right BA6 and CERAD score changes at 6months. Different SPECT perfusion changes at 4h after donepezil administration were demonstrated in the group of responders and non-responders with potential correlation with CERAD score change. Thus, 4h DNPZ brain perfusion SPECT can be used to predict donepezil response at 6months.

Age-, sex-, and education-specific norms for an extended CERAD Neuropsychological Assessment Battery-Results from the population-based LIFE-Adult-Study.

To provide new age-, sex-, and education-specific reference values for an extended version of the well-established Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Assessment Battery (CERAD-NAB) that additionally includes the Trail Making Test and the Verbal Fluency Test-S-Words. Norms were calculated based on the cognitive performances of n = 1,888 dementia-free participants (60-79 years) from the population-based German LIFE-Adult-Study. Multiple regressions were used to examine the association of the CERAD-NAB scores with age, sex, and education. In order to calculate the norms, quantile and censored quantile regression analyses were performed estimating marginal means of the test scores at 2.28, 6.68, 10, 15.87, 25, 50, 75, and 90 percentiles for age-, sex-, and education-specific subgroups. Multiple regression analyses revealed that younger age was significantly associated with better cognitive performance in 15 CERAD-NAB measures and higher education with better cognitive performance in all 17 measures. Women performed significantly better than men in 12 measures and men than women in four measures. The determined norms indicate ceiling effects for the cognitive performances in the Boston Naming, Word List Recognition, Constructional Praxis Copying, and Constructional Praxis Recall tests. The new norms for the extended CERAD-NAB will be useful for evaluating dementia-free German-speaking adults in a broad variety of relevant cognitive domains. The extended CERAD-NAB follows more closely the criteria for the new DSM-5 Mild and Major Neurocognitive Disorder. Additionally, it could be further developed to include a test for social cognition. (PsycINFO Database Record

The Extension of the German CERAD Neuropsychological Assessment Battery with Tests Assessing Subcortical, Executive and Frontal Functions Improves Accuracy in Dementia Diagnosis

Background/Aims: Alzheimer's disease (AD) is the most common form of dementia. Neuropsychological assessment of individuals with AD primarily focuses on tests of cortical functioning. However, in clinical practice, the underlying pathologies of dementia are unknown, and a focus on cortical functioning may neglect other domains of cognition, including subcortical and executive functioning. The current study aimed to improve the diagnostic discrimination ability of the Consortium to Establish a Registry for Alzheimer's Disease - Neuropsychological Assessment Battery (CERAD-NAB) by adding three tests of executive functioning and mental speed (Trail Making Tests A and B, S-Words). Methods: Logistic regression analyses of 594 normal controls (NC), 326 patients with mild AD and 224 patients with other types of dementia (OD) were carried out, and the area under the curve values were compared to those of CERAD-NAB alone. Results: All comparisons except AD-OD (65.5%) showed excellent classification rates (NC-AD: 92.7%; NC-OD: 89.0%; NC-all patients: 91.0%) and a superior diagnostic accuracy of the extended version. Conclusion: Our findings suggest that these three tests provide a sensible addition to the CERAD-NAB and can improve neuropsychological diagnosis of dementia.

A normative study of total scores of the CERAD neuropsychological assessment battery in an educationally diverse elderly population.

This study aimed to investigate the influences of age, education, and gender on the two total scores (TS-I and TS-II) of the Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological assessment battery (CERAD-NP) and to provide normative information based on an analysis for a large number of elderly persons with a wide range of educational levels. In the study, 1,987 community-dwelling healthy volunteers (620 males and 1,367 females; 50-90 years of age; and zero to 25 years of education) were included. People with serious neurological, medical, and psychiatric disorders (including dementia) were excluded. All participants underwent the CERAD-NP assessment. TS-I was generated by summing raw scores from the CERAD-NP subtests, excluding Mini-Mental State Examination and Constructional Praxis (CP) recall subtests. TS-II was calculated by adding CP recall score to TS-I. Both TS-I and TS-II were significantly influenced by demographic variables. Education accounted for the greatest proportion of score variance. Interaction effect between age and gender was found. Based on the results obtained, normative data of the CERAD-NP total scores were stratified by age (six overlapping tables), education (four strata), and gender. The normative information will be very useful for better interpretation of the CERAD-NP total scores in various clinical and research settings and for comparing individuals' performance of the battery across countries.

Norms for total scores on the CERAD Neuropsychological Assessment Battery in an educationally diverse elderly population

Norms for total scores on the CERAD Neuropsychological Assessment Battery in an educationally diverse elderly population

The emergence of infections with methicillin-resistant Staphylococcus aureus

25 older peoples who were not performed BVET. Cognitive function was assessed using the CERAD neuropsychological assessment battery and balance was assessed using Berg Balance scale. The quality of life was assessed according instrument WHOQOL-BREF which focusing on four domains; physical health, psychological well-being, social relationships and environment as well as the overall Quality of Life and Health. The results showed significant improvements in the overall health based on the quality of life measurement, cognitive function in several it items in CERAD (MMSE, CDT, Verbal Fluency and Visuoconstruction), and balance after oneyear intervention BVET (P < 0.05). Conclusion.– One year BVET program improved the overall health, cognitive function and the balance of older people. Disclosure.– No significant relationships.

Relationship between occupation attributes and brain metabolism in frontotemporal dementia

Occupation has been associated with cognitive reserve in healthy aging and Alzheimer's disease. Here we assess the relationship between cerebral metabolic deficits in behavioral variant frontotemporal dementia (bvFTD) and occupation characteristics. Using factor analysis, we derived verbal, physical and visuospatial occupation scores from the US Department of Labor, Occupational Information Network and related these scores to regional cerebral metabolic rate of glucose utilization in 31 patients diagnosed with behavioral variant bvFTD, controlling for cognitive status (CERAD neuropsychological assessment battery), gender and education. Regression analyses showed a marked inverse association between glucose metabolism and (a) verbal occupation scores in left prefrontal cortex and, (b) physical occupation characteristics in right supplementary motor area. We concluded that, consistent with the cognitive reserve hypothesis, lifelong occupation characteristics are related to focal cerebral metabolic deficits in bvFTD. Specific occupation demands spanning decades may strengthen cognitive resistance to pathology.

Prevalence of Mild Cognitive Impairment and Its Subtypes Are Influenced by the Application of Diagnostic Criteria: Results from the Korean Longitudinal Study on Health and Aging (KLoSHA)

Aims: We investigated the influence of varying applications of diagnostic criteria on the prevalence of mild cognitive impairment (MCI) in community-dwelling Korean elders. Methods: A study population of 1,118 Korean elders was randomly sampled from the residents aged 65 years or older living in Seongnam, Korea. Standardized face-to-face interviews, with neurological and physical examinations, were conducted with 714 respondents. Cognitive function was evaluated using the Korean version of the CERAD Neuropsychological Assessment Battery, digit span test, and lexical fluency test. Activities of daily living were evaluated using the Blessed Dementia Scale in the CERAD Clinical Assessment Battery (Korean version). Using variable sets of operational diagnostic criteria, the prevalence of MCI was estimated. Results: Age- and gender-standardized prevalence estimates according to the Petersen criteria were 28.6% (95% CI = 25.3–31.9) for overall MCI, 17.0% (95% CI = 14.3–19.8) for amnestic MCI, and 11.5% (95% CI = 9.2–13.9) for non-amnestic MCI. However, the estimated prevalence of MCI varied widely (8.3–27.6%) according to the applied operational diagnostic criteria. The proportion of MCI subtypes also varied considerably according to the number and types of applied neuropsychological tests. Conclusions: Variable implementation of MCI diagnostic criteria may significantly complicate the homogeneity of this condition.

P4-138: The influence Of TSH level on cognitive function in euthyroid elders

The objective of this study was to analyse the relationship of the thyroid stimulating hormone(TSH) to cognitive function in normal elderly individuals in Korea. All the subjects were cognitively normal elderly individuals selected from a district(Chungbuk-do) in Korea. They were free of a history of cerebrovascular disease and got less than 3 in modified Hachinski ischemic score(MHIS). They also were not diagnosed with major depressive disorder and below 20 in Korean version of Geriatric Depression Rating scale(GDS-K) score. TSH level was measured in cognitively normal elderly individuals. Among the subjects, we selected 150 individuals who were all euthyroid. The nine neuropsychological test domains from the Korean version of CERAD neuropsychological assessment battery were done to them. The relation between cognitive performance and the TSH level was evaluated using correlation analysis. The impact of the level of TSH was significant in the verbal fluency test(VFT, r=0.296, p=0.028) and the trail making test-A(TMT-A, r=0.191, p=0.032), but other test domains in CERAD-K neuropsychological assessment battery scored not significantly. This analysis revealed that cognitive decline was associated with decreasing level of TSH especially in VFT and TMT-A.

P3-124: Early detection of Alzheimer's disease with composite scores of German CERAD neuropsychological assessment battery performance

P3-124: Early detection of Alzheimer's disease with composite scores of German CERAD neuropsychological assessment battery performance

A normative study of the CERAD neuropsychological assessment battery in the Korean elderly.

This study aimed to explore the effects of age, education and gender on the performance of eight tests in the Korean version of the CERAD neuropsychological assessment battery and to provide normative information on the tests in the Korean elderly. The battery was administered to 618 healthy volunteers aged from 60 to 90. People with serious neurological, medical and psychiatric disorders, including dementia, were excluded. Multiple linear regression analyses were performed to assess the relative contribution of the demographic factors on the score of each cognitive test. Age, education, and gender were found to have significant effects on the performance of many tests in the battery. Based on these results, 4 overlapping age normative tables (60 to 74, 65 to 79, 70 to 84, and 75 to 90 years of age) with 3 educational strata (0 to 3 years, 4 to 6 years, and 7 years and more) for both genders are presented. The normative information will be useful for a clinical interpretation of the CERAD neuropsychological battery in Korean elderly as well as for comparing the performance of the battery across countries.

The cerad neuropsychological assessment battery (Cerad-NAB)—A minimal data set as a common tool for German-speaking Europe

The cerad neuropsychological assessment battery (Cerad-NAB)—A minimal data set as a common tool for German-speaking Europe