Reliable change and minimum clinically important difference (MCID) of the Repeatable Battery for the Assessment of Neuropsychology Status (RBANS) in a heterogeneous dementia sample: Support for reliable change methods but not the MCID

O’Connell, Megan E; Gould, Benjamin; Ursenbach, Jake; Enright, Joe; Morgan, Debra

doi:10.1080/23279095.2017.1413575

Cited by 13 publications

(8 citation statements)

References 23 publications

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“…MCIDs for clinical decline have been identified as a 3 point decrease on the MMSE [38,39], a 1 point increase on the CDR-SB [40], or a 3 point increase on the ADAS-Cog [41]. While an MCID has been proposed for the RBANS Total Index [42], it was not included in these analyses, as subsequent work has questioned its utility [43]. Receiver operating characteristic (ROC) analyses with Youden's Index were used to determine [ 18 F]GTP1 SUVR thresholds that optimally discriminated between participants whose decline did or did not meet MCID criteria on the MMSE, CDR-SB, or ADAS-Cog13.…”

Section: Methodsmentioning

confidence: 99%

Baseline [18F]GTP1 tau PET imaging is associated with subsequent cognitive decline in Alzheimer’s disease

Teng¹,

Manser²,

Bohórquez³

et al. 2021

Alz Res Therapy

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Background The role and implementation of tau PET imaging for predicting subsequent cognitive decline in Alzheimer’s disease (AD) remains uncertain. This study was designed to evaluate the relationship between baseline [18F]GTP1 tau PET and subsequent longitudinal change across multiple cognitive measures over 18 months. Methods Our analyses incorporated data from 67 participants, including cognitively normal controls (n = 10) and β-amyloid (Aβ)-positive individuals ([18F] florbetapir Aβ PET) with prodromal (n = 26), mild (n = 16), or moderate (n = 15) AD. Baseline measurements included cortical volume (MRI), tau burden ([18F]GTP1 tau PET), and cognitive assessments [Mini-Mental State Examination (MMSE), Clinical Dementia Rating (CDR), 13-item version of the Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog13), and Repeatable Battery for the Assessment of Neuropsychological Status (RBANS)]. Cognitive assessments were repeated at 6-month intervals over an 18-month period. Associations between baseline [18F]GTP1 tau PET indices and longitudinal cognitive performance were assessed via univariate (Spearman correlations) and multivariate (linear mixed effects models) approaches. The utility of potential prognostic tau PET cut points was assessed with ROC curves. Results Univariate analyses indicated that greater baseline [18F]GTP1 tau PET signal was associated with faster rates of subsequent decline on the MMSE, CDR, and ADAS-Cog13 across regions of interest (ROIs). In multivariate analyses adjusted for baseline age, cognitive performance, cortical volume, and Aβ PET SUVR, the prognostic performance of [18F]GTP1 SUVR was most robust in the whole cortical gray ROI. When AD participants were dichotomized into low versus high tau subgroups based on baseline [18F]GTP1 PET standardized uptake value ratios (SUVR) in the temporal (cutoff = 1.325) or whole cortical gray (cutoff = 1.245) ROIs, high tau subgroups demonstrated significantly more decline on the MMSE, CDR, and ADAS-Cog13. Conclusions Our results suggest that [18F]GTP1 tau PET represents a prognostic biomarker in AD and are consistent with data from other tau PET tracers. Tau PET imaging may have utility for identifying AD patients at risk for more rapid cognitive decline and for stratification and/or enrichment of participant selection in AD clinical trials. Trial registration ClinicalTrials.gov NCT02640092. Registered on December 28, 2015

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Section: Methodsmentioning

confidence: 99%

Baseline [18F]GTP1 tau PET imaging is associated with subsequent cognitive decline in Alzheimer’s disease

Teng¹,

Manser²,

Bohórquez³

et al. 2021

Alz Res Therapy

View full text Add to dashboard Cite

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“…To our knowledge, no minimal clinically important differences have been suggested for longitudinal RBANS data, though attempts have been made. 35 Most likely the difference needed for an individual to sense improvement or decline in cognitive function differs depending on baseline score, cognitive domain investigated, time between tests and more participant-specific factors. 35 , 42 Hence, we are not able to verify if the improvements seen in our participants are clinically meaningful.…”

Section: Discussionmentioning

confidence: 99%

“…Attempts have been made to establish a minimal clinically important difference using an anchor-based approach, but with no solid results. 35 Therefore, we chose not to use a specific cut-off value for clinical relevance.…”

Section: Methodsmentioning

confidence: 99%

<p>Cognitive Function During Opioid Tapering in Patients with Chronic Pain: A Prospective Cohort Study</p>

Laigaard

Bache

Stottmeier

et al. 2020

JPR

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Purpose Evidence for efficacy and safety lacks for long-term opioid therapy in patients with chronic non-cancer pain and adverse effects, including affection of cognitive function and quality of life, is of concern. We aimed to investigate cognitive function and health-related quality of life in patients with chronic non-cancer pain during opioid reduction. Patients and Methods At two multidisciplinary pain centers, all patients with planned opioid reduction were screened for eligibility. Cognitive function was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) and Trail Making Test A and B. Health-related quality of life was assessed using Short Form-36 (SF36) and Hospital Anxiety and Depression Scale (HADS). Results We included 51 participants and 40 participants attended follow-up of median 254 (IQR 106–357) days. Baseline RBANS score was 82 (IQR 65–93) with reference population norm value of 100 (SD±15). Daily opioid consumption was reduced from median 80 (IQR 45–161) oral morphine milligram equivalents to 19 (IQR 0–60) mg. RBANS score estimate increased by 6.2 (95% CI 3.1–9.3, p=0.0004) points after tapering. No differences were observed for Trail Making Test times, HADS or SF36 scores. Conclusion Generally, cognitive function showed minor improvement after opioid tapering with stationary health-related quality of life, depression and anxiety scores. The clinical significance is unclear, as no minimal clinically important difference in RBANS score is available.

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“…RCIs can provide complementary information to external criteria of clinically important change. 44 Ascertaining change from CR entry to discharge strongly depends upon the criteria applied, as RCI distributions differed significantly from those of other change criteria we tested. Our data suggest improvement by 0.5 MET in exercise capacity, a CCS-QI, 11 is too liberal to ascertain individual patients' true changes over and above error and practice effects, when indirect measurement is used.…”

Section: Conclusion and Summarymentioning

confidence: 92%

Measuring True Change in Individual Patients: Reliable Change Indices of Cardiac Rehabilitation Outcomes, and Implications for Quality Indicators

2021

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Reliable change and minimum clinically important difference (MCID) of the Repeatable Battery for the Assessment of Neuropsychology Status (RBANS) in a heterogeneous dementia sample: Support for reliable change methods but not the MCID

Cited by 13 publications

References 23 publications

Baseline [18F]GTP1 tau PET imaging is associated with subsequent cognitive decline in Alzheimer’s disease

Baseline [18F]GTP1 tau PET imaging is associated with subsequent cognitive decline in Alzheimer’s disease

<p>Cognitive Function During Opioid Tapering in Patients with Chronic Pain: A Prospective Cohort Study</p>

Measuring True Change in Individual Patients: Reliable Change Indices of Cardiac Rehabilitation Outcomes, and Implications for Quality Indicators

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