Neuropsychological detection of dementia: An overview of the neuropsychological component of the canadian study of health and aging

Abstract

As part of the Canadian Study of Health and Aging (CSHA), a battery of neuropsychological measures was administered to 1879 participants. Participants who received neuropsychological evaluations were selected from an age-stratified random sample on the basis of scores on a cognitive screening tool, the Modified Mini-Mental State Examination (3MS). Seventy-five percent of the sample seen for neuropsychological evaluation scored between 50 and 77 on the 3MS and 25% of the sample scored 78 or over. This paper provides a descriptive summary of the methodological basis of the neuropsychological component of the CSHA. The findings indicated that differences existed between participants administered the battery in English or French in terms of refusal rates and diagnoses of dementia. Cursory examination of the utility of the battery indicated that the battery was tolerated well by both the participants and the psychologists involved with the study and that measures of memory functioning were central to diagnostic decision-making. The relations between neuropsychological, preliminary medical and consensus diagnoses were examined and indicated that neuropsychological information influenced diagnostic decision-making. The neuropsychology component of the CSHA is a rich source of information on persons aged 65 years and older in Canada.

A novel language-neutral Visual Cognitive Assessment Test (VCAT): validation in four Southeast Asian countries

“…Thus a participant scoring 21 on the English MoCA might not necessarily be experiencing the same level of cognitive impairment as a participant who scored 21 on the Malay or Tagalog MoCA. Previous studies investigating the modified MMSE also showed such differences in performance between English and French speakers and observed that the rates of diagnosis for dementia were different between the two language groups [30,31]. This could be attributable to the translation and adaptation process of the original test version, which gave rise to test items that varied in difficulty, discrimination, and psychometric properties across different language groups [32].…”

Outcomes of incident mild cognitive impairment in relation to case definition

“…Conceptually, the consensus criteria incorporate clinical judgment and are not derived just from test cut points. In that context, we note that the CSHA criteria for MCI, CIND, and ''dementia'' each incorporated clinical judgment that was based on extensive clinical 12 and neuropsychological 13 evaluations. An additional issue in population studies of MCI is the impact of screening which is particularly relevant in considering the role of a subjective memory complaint.…”

Memory impairment, executive dysfunction, and intellectual decline in preclinical Alzheimer's disease

“…It is used in five major longitudinal aging studies besides the BLSA: (1) Einstein Aging Study (EAS; Grober et al, 1988); (2) Mayo Older Adults Normative Study (Petersen et al, 1995); (3) Berlin Aging Study (Lindenberger & Reischies, 1999); (4) Canadian Study of Health and Aging (Tuokko et al, 1995); and (5) Personnes Agees QUID (Sarazin et al, 2007). FCSR is also used in the Alzheimer's Disease Cooperative Study Instrumentation Protocol to identify persons with prevalent dementia and trigger clinical evaluations for incident dementia (Ferris et al, 2006).…”

“…Scoring is quick, easy, and unambiguous and test-retest reliability is high (.93;Lindenberger & Reischies, 1999). FCSR is well tolerated by patients and provides clinicians with useful diagnostic information (Tuokko et al, 1995).…”