The need for harmonisation and innovation of neuropsychological assessment in neurodegenerative dementias in Europe: consensus document of the Joint Program for Neurodegenerative Diseases Working Group

Abstract

Cognitive, behavioural, and functional assessment is crucial in longitudinal studies of neurodegenerative dementias (NDD). Central issues, such as the definition of the study population (asymptomatic, at risk, or individuals with dementia), the detection of change/decline, and the assessment of relevant outcomes depend on quantitative measures of cognitive, behavioural, and functional status.Currently, we are far from having available reliable protocols and tools for the assessment of dementias in Europe. The main problems are the heterogeneity of the tools used across different European countries, the lack of standardisation of administration and scoring methods across centres, and the limited information available about the psychometric properties of many tests currently in widespread use. This situation makes it hard to compare results across studies carried out in different centres, thus hampering research progress, in particular towards the contribution to a “big data” common data set.We present here the results of a project funded by the Joint Program for Neurodegenerative Diseases (JPND) and by the Italian Ministry of Health. The project aimed at providing a consensus framework for the harmonisation of assessment tools to be applied to research in neurodegenerative disorders affecting cognition across Europe. A panel of European experts reviewed the current methods of neuropsychological assessment, identified pending issues, and made recommendations for the harmonisation of neuropsychological assessment of neurodegenerative dementias in Europe.A consensus was achieved on the general recommendations to be followed in developing procedures and tools for neuropsychological assessment, with the aim of harmonising tools and procedures to achieve more reliable data on the cognitive-behavioural examination. The results of this study should be considered as a first step to enhancing a common view and practise on NDD assessment across European countries.

Fully Automatic Speech-Based Analysis of the Semantic Verbal Fluency Task

“…Costa et al [30] state that we are far from having available reliable tools for the assessment of dementias, since one of the main problems is the heterogeneity of the tools used across different countries. Therefore, a working group of experts recently published recommendations for the harmonisation of neuropsychological assessment of neurodegenerative dementias with the aim to achieve more reliable data on the cognitive-behavioural examination.…”

“…It is relatively short and part of standard dementia screens such as the Addenbrookes Cognitive Examination-Revised (ACE-R) [21] and often used in assessing cognitive function in older people [22-24]. SVF performance can distinguish people with dementia from healthy controls (HC) and people with mild cognitive impairment (MCI) [25-29], and additionally can be sensitive to early phases of neurodegenerative disease [30]. …”

Longitudinal Speech Biomarkers for Automated Alzheimer's Detection

“…Clinical evidence supports the importance of sentiments in AD early-diagnosis [22,31], and different clinical settings emphasize different sentiments, such as doubt [32] or frustration [32]. We train a Sentiment Speech classifier model to learn intonation features on the RAVDESS -an emotional speech dataset by [33] of actors speaking in 8 different emotional states.…”

“…Neuropsychological tests are a common screening tool for AD [32]. These tests, among others, evaluate a patient's ability to remember uncommon words, contextualize, infer actions and detect saliency [32,31]. In the case of this AD dataset, all patients are asked to describe the Cookie Theft picture created by [38], where a set of words such as 'kitchen' (context), 'tipping' (unique), 'jar' (inferred) and 'overflow' (salient), are used to capture four cognitive biomarkers.…”

Neuropsychologische Diagnostik in der Praxis. Was ist leitliniengerecht, was ist sinnvoll, was ist machbar?

“…Ein weiteres Problem bei der Bildung von Hypothesen über Art und Ursache neuropsychologischer Störungen besteht in der Vielzahl unterschiedlicher Möglichkeiten, solche Störungen funktional einzuteilen und zu operationalisieren, was zu teils verwirrender Nomenklatur und uneinheitlicher Befundung führen kann [45][46][47][48]. Hier ist innerhalb der klinischen Neuropsychologie eine weitere Harmonisierung nötig.…”