Role of neuropsychological assessment in the differential diagnosis of Alzheimer's disease and vascular dementia

Pimentel, Érica Maria Lima

doi:10.1590/s1980-57642009dn30300007

Cited by 16 publications

(13 citation statements)

References 49 publications

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“…The ability of neuropsychological measures to help in discriminating between different degrees of cognitive impairment has been widely recognized (e.g., [ 37 , 38 ]). Despite the existence of clinical measures that are used to classify patients and diagnose clinical disorders showing cognitive impairment, as AD, a large amount of subjectivity affects the diagnostic process.…”

Section: Discussionmentioning

confidence: 99%

Optimizing Neuropsychological Assessments for Cognitive, Behavioral, and Functional Impairment Classification: A Machine Learning Study

Battista

Salvatore

Castiglioni

2017

Behavioural Neurology

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Subjects with Alzheimer's disease (AD) show loss of cognitive functions and change in behavioral and functional state affecting the quality of their daily life and that of their families and caregivers. A neuropsychological assessment plays a crucial role in detecting such changes from normal conditions. However, despite the existence of clinical measures that are used to classify and diagnose AD, a large amount of subjectivity continues to exist. Our aim was to assess the potential of machine learning in quantifying this process and optimizing or even reducing the amount of neuropsychological tests used to classify AD patients, also at an early stage of impairment. We investigated the role of twelve state-of-the-art neuropsychological tests in the automatic classification of subjects with none, mild, or severe impairment as measured by the clinical dementia rating (CDR). Data were obtained from the ADNI database. In the groups of measures used as features, we included measures of both cognitive domains and subdomains. Our findings show that some tests are more frequently best predictors for the automatic classification, namely, LM, ADAS-Cog, AVLT, and FAQ, with a major role of the ADAS-Cog measures of delayed and immediate memory and the FAQ measure of financial competency.

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Section: Discussionmentioning

confidence: 99%

Optimizing Neuropsychological Assessments for Cognitive, Behavioral, and Functional Impairment Classification: A Machine Learning Study

Battista

Salvatore

Castiglioni

2017

Behavioural Neurology

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“…However, the clinical diagnosis is often confused with other forms of dementia like Lewy body dementia, HIV dementia, Huntington's disease, frontotemporal dementia, dementia due to Parkinson's disease and hydrocephalus, Cruetzfeldt-Jacob disease and other conditions [12,14]. Vascular dementia poses a special problem because of overlapping clinical features and etiopathogenesis [15,16]. Thus, in a significant Aging and Disease • Volume 6, Number 4, August 2015 284…”

Section: Clinical Diagnosismentioning

confidence: 99%

Metabolic Risk Factors of Sporadic Alzheimer's Disease: Implications in the Pathology, Pathogenesis and Treatment

Chakrabarti¹,

Khemka²,

Banerjee³

et al. 2015

Aging and disease

111

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Alzheimer's disease (AD), the major cause of dementia among the elderly world-wide, manifests in familial and sporadic forms, and the latter variety accounts for the majority of the patients affected by this disease. The etiopathogenesis of sporadic AD is complex and uncertain. The autopsy studies of AD brain have provided limited understanding of the antemortem pathogenesis of the disease. Experimental AD research with transgenic animal or various cell based models has so far failed to explain the complex and varied spectrum of AD dementia. The review, therefore, emphasizes the importance of AD related risk factors, especially those with metabolic implications, identified from various epidemiological studies, in providing clues to the pathogenesis of this complex disorder. Several metabolic risk factors of AD like hypercholesterolemia, hyperhomocysteinemia and type 2 diabetes have been studied extensively both in epidemiology and experimental research, while much less is known about the role of adipokines, proinflammatory cytokines and vitamin D in this context. Moreover, the results from many of these studies have shown a degree of variability which has hindered our understanding of the role of AD related risk factors in the disease progression. The review also encompasses the recent recommendations regarding clinical and neuropathological diagnosis of AD and brings out the inherent uncertainty and ambiguity in this area which may have a distinct impact on the outcome of various population-based studies on AD-related risk factors.

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“… 10 It is an integral part of the strategies used to diagnose cognitive decline, being clinically relevant and helpful in distinguishing among the various types of dementia evolution. 11 , 12 Although the diagnosis of a dementia condition should be established according to clinical criteria adopted internationally, 13 the evaluation of an individual with suspected dementia requires confirmation and assessment of cognition by means of neuropsychological evaluation. This evaluation should take into consideration factors that may interfere in the performance of individuals on these tests, such as the typical educational heterogeneity observed in the Brazilian population.…”

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confidence: 99%

Longitudinal cognitive screening study in community-dwelling individuals

Pereira

Stella

Hernández

et al. 2010

Dement. neuropsychol.

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Cognitive changes in normal aging can be similar to the alterations that take place in the initial stages of a dementia process. Longitudinal studies can provide a better understanding of this progression.ObjectivesTo evaluate the cognitive and functional evolution of community-dwelling individuals without dementia through a three-year longitudinal study.Methods168 individuals were evaluated in 2006. Three years later in 2009, 73 of these subjects were reevaluated as regards cognition and functionality using the Mini Mental State Examination (MMSE), Brief Cognitive Battery (BCB) and the Pfeffer Functional Activities Questionnaire. The statistical analysis included descriptive measurements, the Wilcoxon’s test for intra-group comparison, and the Spearman’s correlation coefficient test for comparing cognitive and functionality scores.ResultsAfter three years, the Wilcoxon’s test showed a discreet yet significant cognitive decline (MMSE: –0.7 points; p=0.02; Z= –2.29; and global score on the BCB: +3.6 points; p=0.02; Z= –2.29), in addition to functional decline (Pfeffer: +0.7 points; p= 0.001; Z= –3.38).ConclusionsAfter three years of follow-up we observed a discreet yet significant functional and cognitive decline in the subjects. Longitudinal cognitive screening represents an important strategy in the early identification of changes from normal conditions to a dementia process.

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Role of neuropsychological assessment in the differential diagnosis of Alzheimer's disease and vascular dementia

Cited by 16 publications

References 49 publications

Optimizing Neuropsychological Assessments for Cognitive, Behavioral, and Functional Impairment Classification: A Machine Learning Study

Optimizing Neuropsychological Assessments for Cognitive, Behavioral, and Functional Impairment Classification: A Machine Learning Study

Metabolic Risk Factors of Sporadic Alzheimer's Disease: Implications in the Pathology, Pathogenesis and Treatment

Longitudinal cognitive screening study in community-dwelling individuals

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