Utility of learning ratio scores from the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) Word List Memory Test in distinguishing patterns of cognitive decline in veterans referred for neuropsychological evaluation.
Joseph J Boscarino, Daniel S Weitzner, Erin K Bailey, Joel E Kamper, Emily N Vanderbleek
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引用次数: 0
Abstract
Background: The Learning Ratio (LR) is a novel learning score that has shown improved utility over other learning metrics in detecting Alzheimer's disease (AD) across multiple memory tasks. However, its utility on the Consortium to Establish a Registry for Alzheimer's Disease Word List Memory Test (CERAD WLMT), a widely used list learning measure sensitive to decline in neurodegenerative disease, is unknown. The goal of the current study was to determine the utility of LR on the CERAD WLMT in differentiating between diagnostic (MiNCD vs MaNCD) and etiologic groups (VaD vs AD) in a veteran sample. Methods: Raw learning slope (RLS) and LR scores were examined in 168 veterans diagnosed with major neurocognitive disorder (MaNCD), mild neurocognitive disorder (MiNCD), or normal aging following neuropsychological evaluation. Patients with MaNCD were further classified by suspected etiology (i.e. microvascular disease vs AD). Results: Whereas RLS scores were not significantly different between MiNCD and MaNCD, LR scores were significantly different between all diagnostic groups (p's < .05). Those with AD had lower LR scores and RLS scores compared to those with VaD (p's < .05). LR classification accuracy was acceptable for MiNCD (AUC = .76), excellent for MaNCD (AUC = .86) and VaD (AUC = .81), and outstanding for AD (AUC = .91). Optimal cutoff scores for WLMT LR were derived from Youden's index. Conclusion: Results support the use of LR scores over RLS when interpreting the CERAD WLMT and highlight the clinical utility of LR in differentiating between diagnostic groups and identifying suspected etiology.
背景:学习比率(LR)是一种新颖的学习评分方法,与其他学习指标相比,它在多种记忆任务中检测阿尔茨海默病(AD)的效用有所提高。然而,它在阿尔茨海默病单词表记忆测试(CERAD WLMT)中的效用尚不清楚,该测试是一种广泛使用的列表学习测量方法,对神经退行性疾病的衰退很敏感。本研究的目的是确定 LR 在 CERAD WLMT 中的作用,以区分退伍军人样本中的诊断组(MiNCD vs MaNCD)和病因组(VaD vs AD)。方法:对 168 名退伍军人的原始学习坡度(RLS)和 LR 分数进行了研究,这些退伍军人在接受神经心理学评估后被诊断为重度神经认知障碍(MaNCD)、轻度神经认知障碍(MiNCD)或正常衰老。根据疑似病因(即微血管疾病与注意力缺失症)对 MaNCD 患者进行了进一步分类。研究结果MiNCD和MaNCD患者的RLS评分无明显差异,但所有诊断组的LR评分均有明显差异(P<0.05)。与 VaD 患者相比,AD 患者的 LR 评分和 RLS 评分均较低(P<0.05)。MiNCD患者的LR分类准确性可接受(AUC = .76),MaNCD患者(AUC = .86)和VaD患者(AUC = .81)的LR分类准确性极佳,而AD患者(AUC = .91)的LR分类准确性出色。根据尤登指数得出了 WLMT LR 的最佳截断分数。结论结果支持在解释 CERAD WLMT 时使用 LR 评分而非 RLS,并强调了 LR 在区分诊断组别和确定可疑病因方面的临床实用性。
期刊介绍:
The Clinical Neuropsychologist (TCN) serves as the premier forum for (1) state-of-the-art clinically-relevant scientific research, (2) in-depth professional discussions of matters germane to evidence-based practice, and (3) clinical case studies in neuropsychology. Of particular interest are papers that can make definitive statements about a given topic (thereby having implications for the standards of clinical practice) and those with the potential to expand today’s clinical frontiers. Research on all age groups, and on both clinical and normal populations, is considered.