Clinical Utility of Select Neuropsychological Assessment Battery Tests in Predicting Functional Abilities in Dementia
Clinical Utility of Select Neuropsychological Assessment Battery Tests in Predicting Functional Abilities in Dementia
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DOI：
10.1093/arclin/acx100
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发表时间：
2018-08-01
影响因子：
2.6
通讯作者：
Stern, Robert A.
中科院分区：
文献类型：
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作者：
Ashendorf, Lee;Alosco, Michael L.;Stern, Robert A.
目的：神经心理学测试的表现可以为痴呆症患者的功能能力提供洞察，特别是在缺乏信息提供者的情况下。由于认知领域评估和神经心理学测试的异质性，神经心理学测量和日常生活工具活动（IADLs）之间的关系尚不清楚。实用的和生态上有效的基于性能的iadl措施也很有限。神经心理学评估组（NAB）的独特定位是提供认知和IADL功能的双重目的评估，因为它包括模拟现实世界功能任务的日常生活测试。我们研究了选择NAB测试在预测轻度认知障碍和痴呆患者报告的iadl中的效用。方法：327名参与者的样本包括128名正常对照，97名轻度认知障碍患者和102名来自波士顿大学阿尔茨海默病中心研究登记处的阿尔茨海默病痴呆症患者。被调查者完成了劳顿·布罗迪日常生活工具活动量表，研究参与者接受了选择性的NAB测试，这些测试是对现有方案的补充。结果：ROC曲线显示，记忆测量（列表学习延迟回忆和日常生活记忆延迟回忆）和日常生活驾驶场景对IADL的预测最强（AUC为0.90）。在预先确定的特异性水平上（95%），列表学习延迟回忆（71%）和日常生活记忆延迟回忆（88%）是最敏感的。日常生活记忆和驾驶场景测试强烈预测IADL状态，其他日常生活测试贡献独特的方差。结论：NAB记忆测量和日常生活测试可能在检测痴呆患者的信息评价功能损害方面具有临床应用价值。
Objective: Neuropsychological test performance can provide insight into functional abilities in patients with dementia, particularly in the absence of an informant. The relationship between neuropsychological measures and instrumental activities of daily living (IADLs) is unclear due to hetereogeneity in cognitive domains assessed and neuropsychological tests administered. Practical and ecologically valid performance-based measures of IADLs are also limited. The Neuropsychological Assessment Battery (NAB) is uniquely positioned to provide a dual-purpose assessment of cognitive and IADL function, as it includes Daily Living tests that simulate real-world functional tasks. We examined the utility of select NAB tests in predicting informant-reported IADLs in mild cognitive impairment and dementia.Methods: The sample of 327 participants included 128 normal controls, 97 individuals with mild cognitive impairment, and 102 individuals with Alzheimer's disease dementia from the Boston University Alzheimer's Disease Center research registry. Informants completed the Lawton Brody Instrumental Activities of Daily Living Scale, and study participants were administered selected NAB tests that were complementary to the existing protocol.Results: ROC curves showed strongest prediction of IADL (AUC > 0.90) for memory measures (List Learning delayed recall and Daily Living Memory delayed recall) and Daily Living Driving Scenes. At a predetermined level of specificity (95%), List Learning delayed recall (71%) and Daily Living Memory delayed recall (88%) were the most sensitive. The Daily Living Memory and Driving Scenes tests strongly predicted IADL status, and the other Daily Living tests contributed unique variance.Conclusions: NAB memory measures and Daily Living Tests may have clinical utility in detecting informant-rated functional impairment in dementia.