Screening Utility of the King-Devick Test in Mild Cognitive Impairment and Alzheimer Disease Dementia.
The King-Devick (K-D) test is a 1 to 2 minute, rapid number naming test, often used to assist with detection of concussion, but also has clinical utility in other neurological conditions (eg, Parkinson disease). The K-D involves saccadic eye and other eye movements, and abnormalities thereof may be an early indicator of Alzheimer disease (AD)-associated cognitive impairment. No study has tested the utility of the K-D in AD and we sought to do so. The sample included 206 [135 controls, 39 mild cognitive impairment (MCI), and 32 AD dementia] consecutive subjects from the Boston University Alzheimer's Disease Center registry undergoing their initial annual evaluation between March 2013 and July 2015. The K-D was administered during this period. Areas under the receiver operating characteristic curves generated from logistic regression models revealed the K-D test distinguished controls from subjects with cognitive impairment (MCI and AD dementia) [area under the curve (AUC)=0.72], MCI (AUC=0.71) and AD dementia (AUC=0.74). K-D time scores between 48 and 52 seconds were associated with high sensitivity (>90.0%) and negative predictive values (>85.0%) for each diagnostic group. The K-D correlated strongly with validated attention, processing speed, and visual scanning tests. The K-D test may be a rapid and simple effective screening tool to detect cognitive impairment associated with AD.
*Department of Neurology, Brigham and Women's Hospital †Department of Neurology, Massachusetts General Hospital, Harvard Medical School ‡Boston University Alzheimer's Disease and CTE Center Departments of ∥Neurology ¶Pathology and Laboratory Medicine ‡‡Neurosurgery and Anatomy & Neurobiology, Boston University School of Medicine §Data Coordinating Center **Department of Biostatistics, Boston University School of Public Health #VA Boston Healthcare System, Boston, MA ††Departments of Neurology, Population Health and Ophthalmology, New York University School of Medicine, New York, NY.
Kristin M
KM
Galetta
Kimberly R
KR
Chapman
Maritza D
MD
Essis
Michael L
ML
Alosco
Danielle
D
Gillard
Eric
E
Steinberg
Diane
D
Dixon
Brett
B
Martin
Christine E
CE
Chaisson
Neil W
NW
Kowall
Yorghos
Y
Tripodis
Laura J
LJ
Balcer
Robert A
RA
Stern
D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis*; D060825:Cognitive Dysfunction / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D012438:Saccades / Q000502:physiology