Assessment of cognition in early dementia

Silverberg, Nina; Ryan, Laurie; Carrillo, María C.; Sperling, Reisa A.; Petersen, Ronald C.; Posner, Holly; Snyder, Peter J.; Hilsabeck, Robin C.; Gallagher, Michela; Raber, Jacob; Rizzo, Albert; Possin, Katherine L.; King, J. W.; Kaye, Jeffrey; Ott, Brian R.; Albert, Marilyn; Wagster, Molly V.; Schinka, John A.; Cullum, C. Munro; Farias, Sarah Tomaszewski; Balota, David A.; Rao, Stephen M.; Loewenstein, David; Budson, Andrew E.; Brandt, Jason; Manly, Jennifer J.; Barnes, Lisa L.; Strutt, Adriana M.; Gollan, Tamar H.; Ganguli, Mary; Babcock, Debra; Litvan, Irene; Kramer, Joel H.; Ferman, Tanis J.

doi:10.1016/j.jalz.2011.05.001

Cited by 81 publications

(82 citation statements)

References 117 publications

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“…[38] Moreover, computer-based virtual reality tests may be difficult for older adults to perform, especially those with cognitive impairment. [8, 39] Logistical considerations limited the size of the maze and inclusion of walls in the design. However, it may not be practical in many clinical and research settings to erect large scale mazes with walls.…”

Section: Discussionmentioning

confidence: 99%

Spatial navigation and risk of cognitive impairment: A prospective cohort study

Verghese

Lipton

Ayers

2017

Alzheimer's & Dementia

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INTRODUCTION Spatial navigation deficits are reported in dementia, but their temporal relationship to cognitive decline is not established. METHODS Prospective cohort study in 442 non-demented adults (mean age 79.9 years). Spatial navigation measured with the Floor Maze Test, and reported as immediate maze time (IMT) and delayed maze time (DMT). Pre-dementia syndromes, Mild Cognitive Impairment (MCI) and Motoric Cognitive Risk (MCR) syndromes, were primary outcomes. RESULTS Over a mean follow-up of 16.5 ± 13.7 months, 41 participants developed MCI and 30 MCR. In Cox models adjusted for age, sex, education, cognitive status, comorbid illnesses, and maze errors, a 10-second increment on IMT predicted incident MCI (adjusted hazard ratio [aHR] 1.25; 95% CI 1.06 to 1.48) and MCR (aHR 1.53; 95% CI 1.23 to 1.90). DMT predicted MCR but not MCI. DISCUSSION Spatial navigation performance predicted pre-dementia syndromes in aging, and implicates navigational impairments as an early feature in dementias.

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Section: Discussionmentioning

confidence: 99%

Spatial navigation and risk of cognitive impairment: A prospective cohort study

Verghese

Lipton

Ayers

2017

Alzheimer's & Dementia

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“…It is not clear, however, that biological markers alone will be able to effectively identify these at-risk individuals given the presence of AD pathology in a large number of cognitively healthy elderly [4,5]. Furthermore, while cognitive probes could provide a more widely applicable and cost effective method of identification, traditional cognitive assessment instruments may not be effective at detecting subtle cognitive changes associated with the earliest stages of the disease [6]. A novel and potentially more fruitful approach would be to exploit recent advances in cognitive neuroscience to develop cognitive measures that more directly reflect the pathology present in the earliest stages of AD.…”

Section: Introductionmentioning

confidence: 99%

Dissociable Effects of Aging and Mild Cognitive Impairment on Bottom-Up Audiovisual Integration

Festa

Katz

Ott

et al. 2017

JAD

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Abstract. Effective audiovisual sensory integration involves dynamic changes in functional connectivity between superior temporal sulcus and primary sensory areas. This study examined whether disrupted connectivity in early Alzheimer's disease (AD) produces impaired audiovisual integration under conditions requiring greater corticocortical interactions. Audiovisual speech integration was examined in healthy young adult controls (YC), healthy elderly controls (EC), and patients with amnestic mild cognitive impairment (MCI) using McGurk-type stimuli (providing either congruent or incongruent audiovisual speech information) under conditions differing in the strength of bottom-up support and the degree of top-down lexical asymmetry. All groups accurately identified auditory speech under congruent audiovisual conditions, and displayed high levels of visual bias under strong bottom-up incongruent conditions. Under weak bottom-up incongruent conditions, however, EC and amnestic MCI groups displayed opposite patterns of performance, with enhanced visual bias in the EC group and reduced visual bias in the MCI group relative to the YC group. Moreover, there was no overlap between the EC and MCI groups in individual visual bias scores reflecting the change in audiovisual integration from the strong to the weak stimulus conditions. Top-down lexicality influences on visual biasing were observed only in the MCI patients under weaker bottom-up conditions. Results support a deficit in bottom-up audiovisual integration in early AD attributable to disruptions in corticocortical connectivity. Given that this deficit is not simply an exacerbation of changes associated with healthy aging, tests of audiovisual speech integration may serve as sensitive and specific markers of the earliest cognitive change associated with AD.

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“…In recent years, many researchers studying Alzheimer's disease (AD) have concluded that intervention and assessment of cognitive impairment in the early stage of AD likely need to be started before neurodegeneration has destroyed substantial regions of the brain (Silverberg et al, 2011). Mild cognitive impairment (MCI) has emerged as a classification that defines the transitional state from normal cognitive function to dementia, with an elevated risk of progression to AD (i.e., conversion; Matthews et al, 2008;Roberts & Knopman, 2013), In addition, MCI has been investigated in clinical trials (Cabral, Morgado, Campos Costa, Silveira, & Alzheimers Disease Neuroimaging Initiative, 2015;Gauthier et al, 2006).…”

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confidence: 99%