CERAD neuropsychological compound scores are accurate in detecting prodromal alzheimer's disease: a prospective AddNeuroMed study.
The Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Battery (CERAD-NB) is a widely used tool in screening for Alzheimer's disease (AD), however, it does not include a validated total score for delayed memory. Our aim was to develop clinically applicable memory compound scores for CERAD-NB and examine whether they and global cognitive total scores could detect prodromal AD and cognitive progression in MCI. One year follow-up data of 201 subjects with a baseline diagnosis of MCI (46 progressed to AD; 155 remained stable) and 212 controls in the European multicenter AddNeuroMed study were analyzed. Two previously described cognitive total scores and two memory compound scores were tabulated for CERAD-NB. Receiver Operating Characteristic analysis was applied in the group discrimination at baseline and the annual change for different compound scores was examined. Normative cut-offs for CERAD compound scores were tabulated in the Finnish CERAD sample of 306 controls. Country adjusted CERAD compound scores (AUC 0.95-0.96) were more accurate than Word List Recall (AUC 0.93) and Mini-Mental State Examination (AUC 0.90) in discriminating progressive mild cognitive impairment (MCI) subjects from controls. With normative cut-off values CERAD total scores yielded to 87-89% sensitivity and 84-86% specificity in screening for prodromal AD in a separate multinational population. The annual deterioration in all CERAD compound scores was significant in the progressive (p ≤ 0.001) but not in the stable MCI group (p > 0.08). CERAD total scores are a practical way of screening for prodromal AD and assessing cognitive progression in MCI. The new memory compound scores were more accurate than CERAD subtests in predicting AD conversion.
Cognition and Work Team, Finnish Institute of Occupational Health, Helsinki, Finland Department of Neurology, University of Eastern Finland, Kuopio University Hospital, Kuopio, Finland.
Teemu
T
Paajanen
Department of Neurology, University of Eastern Finland, Kuopio University Hospital, Kuopio, Finland.
Tuomo
T
Hänninen
Institute of Psychiatry, King's College London, London, UK.
Catherine
C
Tunnard
Department of Neurology, University of Eastern Finland, Kuopio University Hospital, Kuopio, Finland.
Merja
M
Hallikainen
Institute of Gerontology and Geriatrics, University of Perugia, Perugia, Italy.
Patrizia
P
Mecocci
Department of Medical Psychology, Medical University of Lodz, Lodz, Poland.
Tomasz
T
Sobow
Department of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Magda
M
Tsolaki
Toulouse Gerontopole University Hospital, Paul Sabatier University, Toulouse, France.
Bruno
B
Vellas
Institute of Psychiatry, King's College London, London, UK NIHR Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and King's College London, London, UK.
Simon
S
Lovestone
Department of Neurology, University of Eastern Finland, Kuopio University Hospital, Kuopio, Finland.
Hilkka
H
Soininen
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications*; D000704:Analysis of Variance; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D009483:Neuropsychological Tests; D062706:Prodromal Symptoms; D011446:Prospective Studies; D012372:ROC Curve; D014706:Verbal Learning
Alzheimer's disease; CERAD; cognition; memory; mild cognitive impairment; neuropsychology; prodromal Alzheimer's disease; screening dementia