Neuropsychological Assessment Of Dementia Research Articles

Applications of Artificial Intelligence in the Neuropsychological Assessment of Dementia: A Systematic Review.

In the context of advancing healthcare, the diagnosis and treatment of cognitive disorders, particularly Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD), pose significant challenges. This review explores Artificial Intelligence (AI) and Machine Learning (ML) in neuropsychological assessment for the early detection and personalized treatment of MCI and AD. The review includes 37 articles that demonstrate that AI could be an useful instrument for optimizing diagnostic procedures, predicting cognitive decline, and outperforming traditional tests. Three main categories of applications are identified: (1) combining neuropsychological assessment with clinical data, (2) optimizing existing test batteries using ML techniques, and (3) employing virtual reality and games to overcome the limitations of traditional tests. Despite advancements, the review highlights a gap in developing tools that simplify the clinician's workflow and underscores the need for explainable AI in healthcare decision making. Future studies should bridge the gap between technical performance measures and practical clinical utility to yield accurate results and facilitate clinicians' roles. The successful integration of AI/ML in predicting dementia onset could reduce global healthcare costs and benefit aging societies.

Suitability of Neuropsychological Tests for Assessments of Dementia in Africa

AbstractBackgroundNeuropsychological assessment is a centerpiece element for detecting, diagnosing, and following‐up the evolution of a dementia syndrome. It should be based on valid, reliable, standardized, and culturally suitable tests. However, the majority of the available tests were developed in western countries, and little is known about how these tests were translated and adapted in Africa in concordance with the international guidelines of psychological measurement. The aim of this review is to inspect closely the available neuropsychological tests used in Africa during the last three decades, examine their psychometric qualities, and analyze their cultural appropriateness to the local populations.MethodWe performed a systematic review on published articles dealing with the neuropsychological assessment of dementia in the 54 African countries during the latest 30 years on main scientific search databases (Web of Science, Academic Search Ultimate (Ebsco), ScienceDirect, Scopus, PubMed, APA PsycArticles, Embase, Cochran). The search keywords were: dement* and (neuropsych* or *cognit*) and (assessment or evaluation or test*) and country, without restrictions about the language of publication. Our approach is fourfold: i) papers' extraction, ii) tests identification, iii) concordance analysis, and iv) appropriateness evaluation.ResultWe identified a list of different tests used in each country and estimated the level of their concordance with the international guidelines of psychological measurement regarding the translation and adaptation procedures as well as the type of validity, reliability, and the availability of local standardized data. More than the two‐thirds of the identified tests did not respect the international guidelines of psychological measurement in developing, translating and adapting neuropsychological tests for the screening and assessment of dementia in Africa.ConclusionWe focused on the importance to fix measurement’s issues in the neuropsychological assessment of dementia in Africa. A suggested list of recommendations was provided to improve it especially that Africa is the second most populous continent after Asia and its elderly population is showing the most rapid increase in the world.

Clinical and Neuropsychological Assessment of Dementia and Geriatric Depression in Patients of Sir T Hospital, Bhavnagar

Three-hundred-and-thirty-four cognitive profiles from neuropsychological examinations assessed during a 2-yearperiod (2020 to 2022) from geriatric patients of a day clinic in the bhavnagar were analyzed. For this purpose, theprofiles were divided into the following subgroups:(1) Mild Cognitive Impairment, no depression (2) Onset or mild dementia, no depression (3) No cognitivedeficit, depression (4) cognitively impaired (MCI, dementia) and depression. Subgroups were be comparedusing analysis of variance (independent variable IV: diagnostic groups, dependent variable DV: cognitivefunctions) to reveal specific differences that will allow a differential diagnosis. Post-hoc comparisons and agraphical representation of the cognitive profiles were also investigated. All cognitive profiles with a Mini-Mental-State-Examination (MMSE) score of 25 or more points were selected for analysis if they had completedata from the following testing procedures: MMSE, clock drawing test, Geriatric Depression Scale (GDS),Syndrom-Kurztest (SKT), Nuremberg Aging Inventory (NAI) maze test, Wechsler Adult Intelligence Scale(WAIS) similarities, Rivermead Be- havioral Memory Test (RBMT) story immediate and delayed. The resultswill help to improve the differential diagnostic examination of older depressed people with and without cognitiveimpairment: Depressed patients usually have no objectifiable memory impairment and inconspicuous scoresin the logical structure of thought processes, while attention was usually impaired in both depressed anddemented patients.

Acquired mild cognitive impairment in adults with Down syndrome: Age-related prevalence derived from single point assessment data normed by degree of intellectual disability.

BackgroundIndividuals with Down syndrome (DS) are at significant risk for early onset Alzheimer's disease (AD), likely due to the triplication of genes on chromosome 21 that facilitate AD neuropathology. To aid the effective early diagnosis of dementia in DS, we demonstrate the strategy of using single point assessment of cognitive performance with scoring normed for degree of intellectual disability to generate age related prevalence data for acquired mild cognitive impairment (AMCI).MethodsFour hundred and twelve adults with DS were assessed using the Neuropsychological Assessment of dementia in adults with Intellectual Disability. Normative data, banded by degree of intellectual disability, allowed identification of AMCI by atypical deviation from expected performance.ResultsAMCI was evident in approximately 20% of adults with DS aged 40 and under, 40% aged 41–50 and 45% aged 51 and over. Relative risk increased significantly in those aged 46 and over. Analysis of prevalence by 5‐year age bands revealed two peaks for higher prevalence of AMCI.ConclusionsPsychometric data indicate single point assessment of AMCI is possible for the majority of adults with DS. Two peaks for age‐related prevalence of AMCI suggest the risk for onset of AD conferred by trisomy of chromosome 21 is moderated by another factor, possibly ApoE status.

Economic evaluations of diagnostic process and neuropsychological assessment of dementia: a systematic review

Alzheimer disease will have a strong growth rate among the adult population. Today, for healthcare managers, it would be extremely important to consider: the prevalence of the disease, and the demands for healthcare services. Adequate models have not yet been developed for estimating the evaluations of diagnostic tests useful for the decision-making process of healthcare managers. A systematic literature review was performed following the PRISMA checklist. The search retrieved 1,831 references. The highest impact of neuropsychological assessment was in France and Sweden. The lowest was in Spain and Netherlands. As for the total indirect costs, values varied from 630 international dollars (IntD$) in the USA, to IntD$956.25 in France for mild ALD patients. As for the moderate ALD, the lower value was in the USA (IntD$825), the medium in the UK (IntD$972.86), and the higher in Spain (IntD$1,123.33). Future research to better manage healthcare resources is recommended.

Economic evaluations of diagnostic process and neuropsychological assessment of Dementia: a systematic review.

Alzheimer disease will have a strong growth rate among the adult population. Today, for healthcare managers, it would be extremely important to consider: the prevalence of the disease, and the demands for healthcare services. Adequate models have not yet been developed for estimating the evaluations of diagnostic tests useful for the decision-making process of healthcare managers. A systematic literature review was performed following the PRISMA checklist. The search retrieved 1,831 references. The highest impact of neuropsychological assessment was in France and Sweden. The lowest was in Spain and Netherlands. As for the total indirect costs, values varied from 630 international dollars (IntD$) in the USA, to IntD$956.25 in France for mild ALD patients. As for the moderate ALD, the lower value was in the USA (IntD$825), the medium in the UK (IntD$972.86), and the higher in Spain (IntD$1,123.33). Future research to better manage healthcare resources is recommended.

Neuropsychological Assessment of Dementia and Cognitive Disorders

Neuropsychological Assessment of Dementia and Cognitive Disorders

Relationship between smell identification testing and the neuropsychological assessment of dementia in community-dwelling adults

ABSTRACTThe objective of this research was to investigate the relationship of the University of Pennsylvania Smell Identification Test (UPSIT) with neuropsychological tests and identify the utility of the UPSIT in detecting cognitive impairment. This research was an archival study of neuropsychological test results obtained from 70 clients (30 male/40 female) of a community-based memory clinic. The sample had an average age of 69.7 (SD = 9.7) and education of 14.6 (SD = 2.8) years. Hypotheses were tested using correlations, receiver operating characteristic (ROC) curves, and logistic regression. The UPSIT showed significant, weak to moderate correlations with neuropsychological tests. The UPSIT raw score correlated significantly with all but one cognitive ability domain. The UPSIT T-score was significantly correlated with all cognitive domains. Obtained areas under the ROC curve (AUC) for the UPSIT ranged from .60 to .87. The AUCs of the UPSIT did not differ significantly from verbal semantic fluency tests, but the Repeatable Battery for the Assessment of Neuropsychological Status Total Scale and Delayed Memory index tended to produce larger AUCs than the UPSIT. Results from step-wise logistic regressions suggest that the UPSIT raw score provides unique information beyond its relationship to age. Olfaction relates broadly to cognitive ability and may be sensitive to early symptoms of cognitive decline. Further research is needed to explore the relationships between smell identification tests and neuropsychological assessment.

Towards onset prevention of cognition decline in adults with Down syndrome (The TOP-COG study): A pilot randomised controlled trial.

BackgroundDementia is very common in Down syndrome (trisomy 21) adults. Statins may slow brain amyloid β (Aβ, coded on chromosome 21) deposition and, therefore, delay Alzheimer disease onset. One prospective cohort study with Down syndrome adults found participants on statins had reduced risk of incident dementia, but there are no randomised controlled trials (RCTs) on this issue. Evidence is sparse on the best instruments to detect longitudinal cognitive decline in older Down syndrome adults.MethodsTOP-COG was a feasibility/pilot, double-blind RCT of 12 months simvastatin 40 mg versus placebo for the primary prevention of dementia in Alzheimer disease in Down syndrome adults aged 50 years or older. Group allocation was stratified by age, apolipoprotein E (APOE) ε4 allele status, and cholesterol level. Recruitment was from multiple general community sources over 12 months. Adults with dementia, or simvastatin contraindications, were excluded. Main outcomes were recruitment and retention rates. Cognitive decline was measured with a battery of tests; secondary measures were adaptive behaviour skills, general health, and quality of life. Assessments were conducted pre randomisation and at 12 months post randomisation. Blood Aβ40/Aβ42 levels were investigated as a putative biomarker. Results were analysed on an intention-to-treat basis. A qualitative sub-study was conducted and analysed using the Framework Approach to determine recruitment motivators/barriers, and participation experience.ResultsWe identified 181 (78 %) of the likely eligible Down syndrome population, and recruited 21 (11.6 %), from an area with a general population size of 3,135,974. Recruitment was highly labour-intensive. Thirteen (62 %) participants completed the full year. Results favoured the simvastatin group. The most appropriate cognitive instrument (regarding ease of completion and detecting change over time) was the Memory for Objects test from the Neuropsychological Assessment of Dementia in Individuals with Intellectual Disabilities battery. Cognitive testing appeared more sensitive than proxy-rated adaptive behaviour, quality of life, or general health scores. Aβ40 levels changed less for the simvastatin group (not statistically significant). People mostly declined to participate because of not wanting to take medication, and not knowing if they would receive simvastatin or placebo. Participants reported enjoying taking part.ConclusionA full-scale RCT is feasible. It will need 37 % UK population coverage to recruit the required 160 participants. Information/education about the importance of RCT participation is needed for this population.Trial registrationISRCTN67338640.Electronic supplementary materialThe online version of this article (doi:10.1186/s13063-016-1370-9) contains supplementary material, which is available to authorized users.

Diagnosis of Alzheimer's disease using Naive Bayesian Classifier

In the world of modern medicine, though there is lot of medical achievements, some diseases still continue to pest the human race. Unfortunately, dementia is one such disease. All over the world, a large number of people are suffering from dementia. Dementia is a brain-related disease. Diagnosis of the disease at the earlier stage is the requirement of the day. Alzheimer's disease (AD) is one of the types of the dementia, and around 60 % of demented are affected from Alzheimer’s disease (Salmon and Bondi in Neuro psychological assessment of dementia. National Institutes of Health, 2010). All over the world, there are around 35 million people suffering from AD and this number is expected to double by 2030 and more than triple by 2050, that is to 115 million (Prince et al. in World Alzheimer report 2013: journey of caringan analysis of long-term care for dementia. Kings College, London, 2013). Diagnosis of this disease at an early stage will help the patients to lead a quality life for the remaining tenure of their life. In this paper, the authors have collected data of 466 subjects by conducting neuropsychological tests. The authors focus on diagnosis of AD for neuropsychological tests using Naive Bayes.

Neuropsychological assessment of dementia with lewy bodies: Focus on the influence of white matter hyperintensity

Neuropsychological assessment of dementia with lewy bodies: Focus on the influence of white matter hyperintensity

Is the MWT-A Suitable for the Estimation of Premorbid Intelligence Level?

Vocabulary tests have long been used for estimating premorbid intelligence level in the neuropsychological assessment of dementia. However, doubts exist about the validity of such intelligence tests. The present study examines whether the Multiple-Choice Vocabulary Test – Version A (Mehrfachwahl-Wortschatz-Test – Version A, MWT-A) is valid for assessing premorbid intelligence level. Data from a total of 821 patients in a specialized outpatient clinic for dementia (memory clinic), covering the whole spectrum of cognitive impairment, were evaluated using analysis of variance with the dependent variable premorbid intelligence level (MWT-A) and the independent variable extent of global cognitive impairment (Mini-Mental-State Examination, MMSE: mean = 25.2, SD = 3.9). The latter was divided into six MMSE ranges or groups, respectively (29–30, 28–28, 27–27, 25–26, 22–24, 05–21). In the case of a pathologically relevant global cognitive impairment (24–26 MMSE points), the MWT-A underestimates the premorbid intelligence level. This effect is moderated neither by age nor education. Results indicate that the MWT-A is unsuitable for estimating premorbid intelligence level in neuropsychological assessments of cognitively impaired patients or demented patients.

O Teste de Aprendizagem Auditivo-Verbal de Rey (RAVLT) no diagnóstico diferencial do envelhecimento cognitivo normal e patológico

This paper aims at reviewing the literature on the use of Rey’s Verbal Auditory Learning Test (RAVLT) with respect to its potential contribution to the differential diagnosis between normal aging and Alzheimer’s disease. We researched articles published in the last ten years, indexed in the databases of PubMed and Lilacs, which were designed to evaluate the use of the RAVLT in the diagnosis of dementia, particularly Alzheimer’s disease. Thirty-seven studies were selected according to the methodology outlined. Seventeen items assessed the utility of the RAVLT test in neuropsychological assessment of dementia is usefulness to differentiate AD and normal development and twenty studies investigated the performance of normal elderly on RAVLT or how the factors age, education and gender may influence the performance in the test. We conclude that the RAVLT is an effective tool to assist in the differential diagnosis between normal and pathological aging. It is necessary, however, further studies on regulation of it to evaluate the different dementia syndromes. Key words: RAVL, normal and pathological aging, Alzheimer’s disease.

P-442 - Educational level in the diagnostic of dementias: A research with eldery patients

A major problem in the early diagnosis of dementia is the absence, in most cases, the lack of previous objective information before the current expression of the symptoms. The analysis of the discrepancies is the only reference that can guide the diagnosis. Based on neuropsychological assessment of dementia in elderly patients, the present study analyzed the relationship between gender and educational level in the verbal and performance dimension results in dementia neuropsychological assessment among elderly patients. Twenty patients (10 males and 10 females), with more that 60 year old, participated in the study. The WAIS-III, the Rey auditory verbal learning, the Folstein and the Zulliger tests were employed. Results indicated that male subjects with higher education presented lower scores in the WAIS performance subtest when compared to verbal subtest. Although the educational status and the intellectual activity had a tendency to mask the lost of performance in the beginning of dementia disorder, the objective evaluation of the discrepancies indicated the presence of a reduction in efficiency. The female sample, with lower level of scholarship, although the results indicated a general tendency to cognitive impairment, no differences between verbal and performance subtests were detected. Without objective and reliable information regarding the antecedent performance, the mnemonic test resources were crucial to reach a diagnosis in this group. The male sample presented higher scores in the verbal subtest as compared to the female sample. A covariance analyses indicated that education level and not gender was the responsible variable for this difference.

The relationship between acquired impairments of executive function and behaviour change in adults with Down syndrome

The latter stages of dementia in individuals with Down syndrome are well documented; however, earlier cognitive and behavioural changes have only recently been described. Holland et al. suggested such early signs of dementia in this population are behavioural and are similar to those seen in frontotemporal dementia, but there is, as yet, no evidence to determine whether such behavioural changes are associated with a declines in specific cognitive functions, including those associated with the frontal lobes. A longitudinal design of three time points across 16 months was used across 30 adults with Down syndrome aged 30 years and over. Measures of cognition (Neuropsychological Assessment of Dementia in Individuals with Intellectual Disabilities), receptive language (British Picture Vocabulary Scales), adaptive behaviour (Vineland Adaptive Behavior Scales), behavioural excesses and behavioural deficits (Assessment for Adults with Developmental Disabilities) and measures of executive functioning were completed at each time point. Using a data-driven method, cognitive deterioration was determined using the Reliable Change Index on performance on the Neuropsychological Assessment of Dementia in Individuals with Intellectual Disabilities across the duration of the study. Performance on the remaining measures were then compared between those with (n = 10) and those without (n = 20) cognitive deterioration. Only individuals with cognitive deterioration showed decreases on measures of executive function and significant changes in behaviour across the duration of the study, which was not solely due to declines in memory. There were no changes between the groups on levels of adaptive behaviour. Even in the early stages of cognitive deterioration, specific behavioural changes can be identified that are not present in those without cognitive deterioration. The differing effects of cognitive deterioration on behavioural excesses and deficits are discussed in relation to potentially differing underlying neuropathological causes.

Neuropsychological assessment of dementia: state of the art.

A comprehensive neuropsychological examination includes an assessment of both cognitive functions and personality characteristics. In order to evaluate dementia, the patient's present as well as the premorbid functioning has to be assessed, which is performed by means of tests, behavioral observations, rating scales, and inquiries. These methods are used for diagnostic purposes, for differential diagnostics, follow-up studies, and for evaluation of treatment effects. Recent research has shown that neuropsychological methods have a high sensitivity and specificity in detection of dementia, utilizing measures of episodic memory. For staging of dementia, episodic memory as well as other cognitive functions are necessary. The effectiveness of dementia differentiation by means of neuropsychological methods varies from quite good regarding frontal lobe degeneration to less good regarding cerebrovascular dementias, probably due to the variation in site, extent, number, and temporal characteristics of the lesion. Future development is required regarding methods for evaluation of premorbid functioning, instruments for assessment of executive functions, and personality characteristics in dementia. Furthermore, brain-behavior studies are needed to learn more about the relation between neuropsychological measures vs neuropathology, neurochemistry, and neuroimaging.

Assessment of intellectual function in dementing disorders: validity of WAIS-R short forms for patients with Alzheimer's, Huntington's, and Parkinson's disease.

While commonly administered in the neuropsychological assessment of dementia, the Wechsler Adult Intelligence Scale-Revised (WAIS-R) is excessively long (70-90 min) and difficult for many patients. The present study examined WAIS-R data from patients with clinically distinct dementing disorders, including those with Alzheimer's, Huntington's, and Parkinson's disease (N = 148). The profiles of performance of these three patient groups across subtests were remarkably similar, suggesting that the use of a short form would not result in the loss of clinically significant information. The validity of several published short forms was reviewed. Although all of these systematically over- or underestimated Full Scale IQ for these patients, after a scaling table revision the Kaufman (1990) form appears to provide an accurate estimate of IQ. The use of this short form is therefore recommended to minimize frustration and fatigue on the part of the patient, and to allow the inclusion of other tests critical to the evaluation of dementia within a single assessment session.