Browsing by Subject "Neuropsychological Tests"
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Item Characterization and Differences Between Possible and Probable Mild Cognitive Impairment(2009-06-15) Denney, David Austin; Lacritz, LauraMild Cognitive Impairment (MCI) is the period of subtle cognitive decline that occurs between normal aging and clinical Alzheimer's Disease (AD). Patients' subjective memory complaints (SMCs) are essential to the diagnosis of MCI. In cases where memory complaints are not verifiable by objective measures, patients are left without a formal diagnosis of cognitive impairment. The current proposal describes a study designed to compare the cognitive features and risk factors of AD in subgroups of patients with SMCs with (Probable MCI) and without (Possible MCI) objective memory deficits in relation to controls. It is predicted that the Probable MCI group will demonstrate lower performance and have a greater decline on neuropsychological measures than patients diagnosed with Possible MCI, who will demonstrate lower performance and have a greater decline on those measures than controls. Also, it is predicted that Probable MCI patients will have greater incidence of vascular risk factors and presence of the apolipoprotein element 4 (APOE-4) allele than the Possible MCI patients, who will have higher incidence of these variables than controls. There is also a demographic analysis designed to identify any differences in age, education, and gender between the groups. Implications of possible outcomes of the study are then discussed.Item Performance on the Texas Functional Living Scale (TFLS) In Mild Cognitive Impairment(2007-08-08) Binegar, Dani Lyn; Cullum, C. MunroMild cognitive impairment (MCI) describes the transitional state between normal aging and dementia for many individuals, although debate continues over whether MCI represents an initial, separate condition, or if it is, in fact, the earliest presentation of dementia. One criterion for the diagnosis of MCI is an absence of impairment in activities of daily living; however, there is growing evidence that many individuals with MCI have difficulties with some instrumental activities of daily living (IADLs), such as managing finances and medications. The current study examined the performance of individuals diagnosed with MCI and normal control subjects (NC) on a brief, quantifiable measure of IADLs, the Texas Functional Living Scale (TFLS). Additional goals of this study were to examine how the TFLS relates to standard neuropsychological measures of global cognitive function, memory, language, executive functioning, and attention, and to determine whether performance on the TFLS declines over time in MCI. As predicted, the MCI sample (n = 30) scored significantly lower than the NC group (n = 30) on the TFLS total score (t (58) = 2.34, p = .011) and on the TFLS Memory subscale (t (58) = 3.29, p = .002). Performance on the TFLS was significantly correlated with performance on the MMSE (ρ = .26) and The Consortium to Establish a Registry for Alzheimer's Disease neuropsychological battery (CERAD; r = .37). Scores on the TFLS Memory and Communication subscales were also correlated with the CERAD total score (r = .45 and .22, respectively). Across all subjects, the TFLS was associated with standard measures of memory and language (ρ's = .22 to .31). Although the difference did not reach statistical significance, subgroups of MCI and NC were followed over time, and 50% of individuals with MCI declined on the TFLS, compared with 29% of NC sample. These findings suggest that subtle changes in cognitive-related IADLs may be present in individuals with MCI, and that the TFLS is sensitive to such changes.Item Utility of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Neuropsychological Battery Total Score in the Progression of Alzheimer's Disease(2007-08-08) Rossetti, Heidi Christine; Lacritz, LauraThe Consortium to Establish a Registry for Alzheimer's Disease (CERAD) created a neuropsychological battery that is both brief and sensitive to dementia (Morris et al., 1989). Chandler et al. (2005) put forth a method of calculating a Total Score for the CERAD along with normative data. The objective of this study was to determine the utility of the Total Score as a measure of progression of Alzheimer's disease (AD). Subjects included CERAD registry normal controls (NC; N = 383) and AD subjects (N = 655) with a baseline assessment and at least one follow-up assessment. Change Scores were calculated along with Reliable Change Indexes (RCI). The AD sample declined an average of -7.2 points per year, compared to a 1.0 point annual increase obtained by the NC sample. By the third annual assessment, the majority of AD subjects (65.2%) exceeded the confidence interval established by the RCI. Annualized CERAD Change Scores significantly correlated with change scores on the MMSE (r = .66), CDR Sum of Boxes (r = -.42), and BDRS (r = -.38). The impact of race, gender, education, and age-at-baseline on AD progression was examined with analysis of covariance and multiple regression. Demographic variables accounted for only 4% of the variance in annualized change in CERAD performance, with greater annualized decline in Total Score observed in Caucasians (M = -7.64, SD = 6.82) versus African- Americans (M = -4.60, SD = 7.03); males (M = -8.22, SD = 6.70) versus females (M = 6-.44, SD = 7.04); and younger age-at-baseline (M = -8.72, SD = 6.44) versus older age-at-baseline (M = -6.85, SD = 7.01). Neither education nor dementia severity significantly impacted annualized Change Scores. The current study provides support for the validity of the CERAD Total Score as a measure of progression in AD.Item Validation of a Neuropsychological Wada Procedure(2005-08-11) Eisenman, Daniel David; Lacritz, LauraThe Intracarotid amobarbital procedure (IAP) is considered an essential part of the presurgical neurodiagnostic evaluation in most epilepsy centers throughout the country. Despite the IAP's mainstream use, there is great variability in how the test is being performed across centers. The main purpose of this study was to validate a standardized IAP memory measure and explore its value in predicting lateralization as well as treatment outcome. The IAP memory measure had good overall reliability for all three Forms (Cronbach's Alpha = .85 for Form I, .83 for Form II, and .69 for Form III). The majority of items on Form I and II had acceptable item difficulty values, item discrimination values, and item-total correlations. There were a few items on Forms I and II that may be candidates for revision, but most items were only slightly below predicted ranges for what defines a "good" measure, and the majority of items contributed to the reliability of the test. In terms of construct validity, correlations with other memory tests provided some evidence of convergent validity for the IAP memory measure, but were generally low. In terms of divergent validity, both Forms I and II had low or no correlations with the executive functioning measures, providing preliminary support for the construct validity of the measure. When utilizing a discrepancy score to predict lateralization in subjects with temporal lobe epilepsy, asymmetry scores from the IAP memory measure were able to classify 92% of subjects with either left or right TLE after applying a correction factor for left injection scores. There was limited data regarding post-operative seizure outcome. However, seizure-free subjects had a higher percentage of DS greater than 20% than those subjects who reported at least one seizure postoperatively. In addition, there was a significant difference on Form I of the IAP memory measure between subjects who reported they were seizure free following temporal resection as compared to subjects who continued to report symptoms. Overall, the IAP memory measure demonstrated good psychometric properties and this study represents one of the most thorough analyses of the IAP memory test to date.