Assessment of cognition in mild cognitive impairment: A comparative study

Abstract

The demand for rapidly administered, sensitive, and reliable cognitive assessments that are specifically designed for identifying individuals in the earliest stages of cognitive decline (and to measure subtle change over time) has escalated as the emphasis in Alzheimer’s disease clinical research has shifted from clinical diagnosis and treatment toward the goal of developing presymptomatic neuroprotective therapies. To meet these changing clinical requirements, cognitive measures or tailored batteries of tests must be validated and determined to be fit-for-use for the discrimination between cognitively healthy individuals and persons who are experiencing very subtle cognitive changes that likely signal the emergence of early mild cognitive impairment. We sought to collect and review data systematically from a wide variety of (mostly computer-administered) cognitive measures, all of which are currently marketed or distributed with the claims that these instruments are sensitive and reliable for the early identification of disease or, if untested for this purpose, are promising tools based on other variables. The survey responses for 16 measures/batteries are presented in brief in this review; full survey responses and summary tables are archived and publicly available on the Campaign to Prevent Alzheimer’s Disease by 2020 Web site (http://pad2020.org). A decision tree diagram highlighting critical decision points for selecting measures to meet varying clinical trials requirements has also been provided. Ultimately, the survey questionnaire, framework, and decision guidelines provided in this review should remain as useful aids for the evaluation of any new or updated sets of instruments in the years to come.

Performance of the CogState computerized battery in the Mayo Clinic Study on Aging

“…Brief computerized cognitive batteries may be a better option for this purpose, particularly if they are easy to understand and designed for repeated administration (i.e., minimal practice effects and lack of ceiling effects). Several computerized tests have been developed including CogState, CANTAB, CNS Vital Signs, and NIH Toolbox (see [3], [5], and [6] for a more in-depth comparison of computerized tests). In the present study, we characterized the feasibility of the computerized CogState battery in the population-based MCSA, identified factors associated with test completion, compared performance to a standard neuropsychological battery, and compared performance on different platforms.…”

“…A computerized battery may have advantage over standard neuropsychological tests or other cognitive screening measures (e.g., Mini-Mental State Examination) by being more sensitive and efficient, removing ceiling and floor effects, providing real-time data entry and precise recording of accuracy and speed of response, minimizing practice effects, and suitability for off-site or long-distance use [3–6]. However, studies of computerized cognitive batteries have mainly been conducted in the clinical research setting using selected volunteers.…”

Association of Fatigue Intensification with Cognitive Impairment during Radiation Therapy for Prostate Cancer

“…CAMCI® has good test-retest reliability and has demonstrated good sensitivity (86%) as well as specificity (94%) for the identification of mild forms of cognitive impairment [26, 48]. The sensitivity of CAMCI® was 0.72 relative to the Global Impairment Rating, with good positive and negative predictive values of 0.93 and 0.89, respectively [49].…”

Independent comparison of CogState computerized testing and a standard cognitive battery with neuroimaging

“…For example, the card tasks have relatively low face validity as they are game-like and remote from traditional neuropsychological tests [17]). Further, the four card tasks primarily load on only two factors – “learning efficiency” and “problem solving” [18,19]. …”