Utility of the NIH Toolbox for assessment of prodromal Alzheimer's disease and dementia

Hackett, Katherine; Krikorian, Robert; Giovannetti, Tania; Meléndez-Cabrero, Josefina; Rahman, Aneela; Caesar, Emily; Chen, Jaclyn L.; Hristov, Hollie; Seifan, Alon; Mosconi, Lisa; Isaacson, Richard S.

doi:10.1016/j.dadm.2018.10.002

Cited by 39 publications

(48 citation statements)

References 43 publications

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“…As such, assessment scales cannot be easily repeated from prior treatment trials, and novel composite measures sensitive to pre-dementia decline may hold promise. 24,48 Because the study was conducted in the real-world clinical setting and one of the treating clinicians left the practice due to geographical relocation, 24 participants (58.6%) were lost to follow-up for this reason. Future studies should consider safeguards to account for similar factors that can substantially influence discontinuation rate.…”

Section: Discussionmentioning

confidence: 99%

“…31,32 Similar to other trials, 33,34 we refined the APCC based on the selection of tests administered (Table S2 and prior publication of neuropsychological measures used in our clinic). 24 Tests comprising the m-APCC were selected to represent the same cognitive domains as those used in the APCC. 24…”

Section: Methodsmentioning

confidence: 99%

“…24 Tests comprising the m-APCC were selected to represent the same cognitive domains as those used in the APCC. 24…”

Section: Methodsmentioning

confidence: 99%

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Individualized clinical management of patients at risk for Alzheimer's dementia

Isaacson

Hristov

Saif

et al. 2019

Alzheimer's & Dementia

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Summary INTRODUCTION: Multi-domain intervention for Alzheimer’s disease (AD) risk reduction is an emerging therapeutic paradigm. METHODS: Patients were prescribed individually-tailored interventions (education/pharmacologic/non-pharmacologic) and rated on compliance. Normal cognition/subjective cognitive decline/preclinical-AD were classified as Prevention. Mild cognitive impairment due to AD/mild-AD were classified as Early Treatment. Change from baseline to 18-months on the modified-Alzheimer’s Prevention Cognitive Composite (primary outcome) was compared against matched historical control cohorts. Cognitive aging composite (CogAging), AD/cardiovascular risk-scales, and serum biomarkers were secondary outcomes. RESULTS: 174 were assigned interventions (age 25–86). Higher-compliance Prevention improved more than both historical cohorts (P=.0012,P<.0001). Lower-compliance Prevention also improved more than both historical cohorts (P=.0088,P<.0055). Higher-compliance Early Treatment improved more than lower-compliance (P=.0007). Higher-compliance Early Treatment improved more than historical cohorts (P<.0001,P=.0428). Lower-compliance Early Treatment did not differ (P=.9820,P=.1115). Similar effects occurred for CogAging. AD/cardiovascular risk-scales and serum biomarkers improved. DISCUSSION: Individualized multi-domain interventions may improve cognition and reduce AD/cardiovascular risk scores in patients at-risk for AD-dementia.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Individualized clinical management of patients at risk for Alzheimer's dementia

Isaacson

Hristov

Saif

et al. 2019

Alzheimer's & Dementia

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“…Uncorrected standard scores compare the performance of the test takers to those in the entire NIH toolbox nationally representative normative sample (100 ± 15), regardless of age or any other variable. Although the NIHTB-CB was not designed to substitute comprehensive neuropsychological assessment, data indicate it is a valid tool for broad assessment of cognition in dementia and predementia conditions [ 81 ].…”

Section: Methodsmentioning

confidence: 99%

Light in the Senior Home: Effects of Dynamic and Individual Light Exposure on Sleep, Cognition, and Well-Being

et al. 2020

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Disrupted sleep is common among nursing home patients and is associated with cognitive decline and reduced well-being. Sleep disruptions may in part be a result of insufficient daytime light exposure. This pilot study examined the effects of dynamic “circadian” lighting and individual light exposure on sleep, cognitive performance, and well-being in a sample of 14 senior home residents. The study was conducted as a within-subject study design over five weeks of circadian lighting and five weeks of conventional lighting, in a counterbalanced order. Participants wore wrist accelerometers to track rest–activity and light profiles and completed cognitive batteries (National Institute of Health (NIH) toolbox) and questionnaires (depression, fatigue, sleep quality, lighting appraisal) in each condition. We found no significant differences in outcome variables between the two lighting conditions. Individual differences in overall (indoors and outdoors) light exposure levels varied greatly between participants but did not differ between lighting conditions, except at night (22:00–6:00), with maximum light exposure being greater in the conventional lighting condition. Pooled data from both conditions showed that participants with higher overall morning light exposure (6:00–12:00) had less fragmented and more stable rest–activity rhythms with higher relative amplitude. Rest–activity rhythm fragmentation and long sleep duration both uniquely predicted lower cognitive performance.

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“…Moderate associations with neuropsychological tests of preclinical Alzheimer’s disease (Buckley et al, 2017) and hippocampal volumes (O’Shea, Cohen, Porges, Nissim, & Woods, 2016) have been reported and interpreted as preliminary support for its clinical utility with older adults. In a recent investigation of the NIHTB-CB in a memory clinic setting, Hackett and colleagues (2018) found that the NIHTB-CB could differentiate cognitively normal adults from those with Alzheimer’s disease dementia, but not from individuals with mild cognitive impairment. Although the authors acknowledge that the NIHTB-CB was not designed to replace comprehensive neuropsychological evaluations, they concluded that it may represent a “key part of the clinical diagnostic evaluation” in memory clinics.…”

Section: Introductionmentioning

confidence: 99%

Psychometric Properties of the NIH Toolbox Cognition Battery in Healthy Older Adults: Reliability, Validity, and Agreement with Standard Neuropsychological Tests

Scott

Sorrell

Benitez

2019

J Int Neuropsychol Soc

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Objective: Few independent studies have examined the psychometric properties of the NIH Toolbox Cognition Battery (NIHTB-CB) in older adults, despite growing interest its use for clinical purposes. In this paper we report the test-retest reliability and construct validity of the NIHTB-CB, as well as its agreement or concordance with traditional neuropsychological tests of the same construct to determine whether tests could be used interchangeably. Methods: Sixty-one cognitively healthy adults ages 60-80 completed “gold standard” (GS) neuropsychological tests, NIHTB-CB, and brain MRI. Test-retest reliability, convergent/discriminant validity and agreement statistics were calculated using Pearson’s correlations, concordance correlation coefficients (CCC), and root mean square deviations. Results: Test-retest reliability was acceptable (CCC = .73 Fluid; CCC = .85 Crystallized). The NIHTB-CB Fluid Composite correlated significantly with cerebral volumes (r’s = ∣.35-.41∣), and both composites correlated highly with their respective GS composites (r’s = .58-.84), although this was more variable for individual tests. Absolute agreement was generally lower (CCC = .55 Fluid; CCC = .70 Crystallized) due to lower precision in Fluid scores and systematic overestimation of Crystallized Composite scores on the NIHTB-CB. Conclusions: These results support the reliability and validity of the NIHTB-CB in healthy older adults and suggest that the Fluid Composite tests are at least as sensitive as standard neuropsychological tests to medial temporal atrophy and ventricular expansion. However, the NIHTB-CB may generate different estimates of performance and should not be treated as interchangeable with established neuropsychological tests.

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Utility of the NIH Toolbox for assessment of prodromal Alzheimer's disease and dementia

Cited by 39 publications

References 43 publications

Individualized clinical management of patients at risk for Alzheimer's dementia

Individualized clinical management of patients at risk for Alzheimer's dementia

Light in the Senior Home: Effects of Dynamic and Individual Light Exposure on Sleep, Cognition, and Well-Being

Psychometric Properties of the NIH Toolbox Cognition Battery in Healthy Older Adults: Reliability, Validity, and Agreement with Standard Neuropsychological Tests

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