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Comparison of the ‘word’ vs. ‘picture’ versions of the free and cued selective reminding test (FCSRT) in older adults
Poster Presentations: P2 among screen passes and screen failures. Results: Administration of the MC was readily learned by nursing staff and did not disrupt work flow. A total of 230 patients were screened over 6 months. The average patient age was 78.4 years with 42.7% male subjects. The rate of screen failure was 38.7%. Data relating to clinical outcomes and medication compliance are pending. Conclusions: The MC is an easily administered screen for early detection of AD within the primary care setting and may identify patients at risk for suboptimal management of chronic conditions. Preliminary results demonstrate a higher failure rate among patients compared to standard prevalence rates for dementia within the 70 population. We hope this study will provide support for standardized cognitive screening within the geriatric population. Further investigations in primary care are necessary to address the clinical and cost benefits of early dementia screening in the elderly.
P2-295
PROTOTYPICAL EMOTIONAL STROOP EFFECT IN THE ONSET OF ALZHEIMER’S DISEASE
Molka Snoussi1, Mohamed Reba^ı2, Didier Hannequin3, Thibault Simon4, Heidi Charvin5, 1University of Rouen, Rouen, France; 2Universite de Rouen, U.F.R. de Psychologie, Rouen, France; 3Faculte de Medicine, Rouen, France; 4CHI Elbeuf, France; 5Universite de Rouen, U.F.R. de Psychologie, Rouen, France. Background: Alzheimer’s disease is associated with some cognitive decline and emotional changes. Various researchers have focused their studies although separately on the evaluation of these changes. Our research proposes to evaluate both of these changes “cognition-emotion interaction”, based on Damasio’s (1996) hypothesis of somatic marking of information with emotional valence and emotional disturbances, noted in AD. We hypothesize that: if the loss of affect severely decreases the somatic marking of information, the inhibitory capacity of AD should not be affected by the combination of emotional valence to information on the Emotional Stroop(ES). Our previous research (Snoussi et al., 2011), have showed no difference between the Standard Stroop (SS) (color vs. words) and ES (color vs. emotional words), but we notice that the RT and errors number in medium and high inhibition load, increased with infrequent colors (10 colors). In this study, we want to control the infrequency bias of colors. We used in this experiment only five frequent colors, in order to be sure that the lack of difference between Stroop tasks is really due to a loss of somatic-markers. Methods: To test this hypothesis, three groups of participants were included: 15 young healthy adults (23 yrs), 15 normal aged individuals (77, 67 yrs) and 15 AD patients (81 yrs; MMSE ¼ 22, 7). All groups were matched on socio-educational level and gender, and were tested on the ES and SS (5 colors): which include 5 conditions with increase of inhibition load. The performance is measured by adding (RT (neperian logarithm) + number of errors). Results: Statistic analysis indicates, no difference between the two Stroop for AD patients, but we find a significant group effect in RT and Errors numbers: AD>OLD>Young (P ¼ 0.020). Moreover, we find that there’s significant difference in RT and errors numbers, between the two version of Stroop (Stroop version 1 > Stroop version 2). Conclusions: The results on ES may suggest that, the “dysaffectation” deletes the influence on the inhibition ability of the emotional valence of the information for AD patients. These findings support the inhibitory-emotional interaction hypothesis. We can conclude that the lack of somatic-marking of information may be prototypical of AD in early stage.
P2-296
COMPARISON OF THE ‘WORD’ VS. ‘PICTURE’ VERSIONS OF THE FREE AND CUED SELECTIVE REMINDING TEST (FCSRT) IN OLDER ADULTS
Molly Zimmerman1, Mindy Katz1, Cuiling Wang1, Leah Burns2, Robert Berman2, Carol Derby1, Gilbert L’Italien2, David Budd3, Richard Lipton1, 1Albert Einstein College of Medicine, Bronx, New York,
P367
United States; 2Bristol-Myers Squibb, Wallingford, Connecticut, United States; 3Bristol-Myers Squibb, Lawrenceville, Connecticut, United States. Background: The Free and Cued Selective Reminding Test (FCSRT) is a verbal memory task that utilizes control of attention and strategy to maximize performance. FCSRT performance has high discriminative validity for diagnosis of dementia. There are two versions of the FCSRT; one uses pictorial stimuli (“Picture” version) and another uses printed words (“Word” version). The goal of this study was to determine the psychometric relationship between the Word and Picture versions of the FCSRT among cognitively normal older adults and to develop an algorithm for score conversions. Development of an algorithm will facilitate comparisons of findings and pooling of data across different studies. Methods: Participants were 122 cognitively normal older adults from the Einstein Aging Study (EAS), a community-based sample of individuals aged 70 years and older residing in the Bronx, New York. Participants were administered both versions of the FCSRT on two separate clinic visits (median ¼ 4 months) using a randomized counterbalanced design. Primary variables of interest were scores on the free recall conditions of each version (score range: 0-48). Linear regression models were used to evaluate the association of the Word and Picture versions of the FCSRT. Estimates of the parameters were used to develop a model to predict Word score from Picture score. Results: The Pearson correlation between the Word and Picture FCSRT versions was r ¼ 0.52 (95% CI: 0.38-0.64). The mean Picture score was 7.67 points higher than the Word score. The formula for predicting Word from Picture score was W ¼ 2.86 + 0.69P, where W denotes estimate of mean Word Score and P denotes Picture score. Conclusions: The Word and Picture versions of the FCSRT were moderately associated in a sample of cognitively normal older adults. The strength of this relationship would likely improve with inclusion of subjects with memory impairment. A regression equation facilitates conversion of scores between the two versions among non-demented older adults. On average, scores were higher on the Picture version, perhaps because this version facilitates dual encoding. Ongoing analyses will broaden the sample to include older adults at-risk for the development of Alzheimertype dementia. P2-297
NEUROPSYCHIATRIC SYMPTOMS IN MILD ALZHEIMER’S DISEASE AND MILD COGNITIVE IMPAIRMENT
So Yeong Kim, Mun Seong Choi, Maryknoll Hospital, Busan, South Korea. Background: Neuropsychiatric symptoms affect than a third of dementia patients, and are associated with institualization and caregiver stress or care burden in patients with Alzheimer’ s disease (AD). They are also commom in mild cognitive impairment (MCI). The early identification of neuropsychiatric symptoms in MCI could improve further the prediction of the complex clinical course of the dementia illness, possibly helping improve treatment approaches, and ultimately the prognosis. Methods: We included 101 outpatients of a memory clinic in Maryknoll Hospital (48 AD; 53 amnestic-MCI-multidomain) and 25 controls. Categorical disorders of depression and apathy were diagnosed with structured interviews. Symptoms were evaluated with the neuropsychiatric inventory (NPI). The odds ratios (OR) of patients having neuropsychiatric symptoms compared to controls were calculated with logistic regression, adjusted for sociodemographic and clinical variables. Results: A large proportion of AD (62.5%), amnestic-MCImultidomain (39.6%) patients had depressed disorder. Apathy disorder was common in AD (68.7%), less frequent in amnestic MCI-multidomain (9.4%). AD patients were five times more likely to have depression disorders (OR ¼ 5.1, CI ¼ 1.1-23.1) compared to amnestic-MCI-multidomain. After apathy and depression, the most prevalent neuropsychiatric symptoms in AD and MCI were anxiety, agitation, irritability, night-time behaviors, and appetite disturbances. Conclusions: Clinicians should consider the relevance of neuropsychiatric symptoms in patients with cognitive disturbances, and incorporate a thorough psychiatric examination in the evaluation of patients.
P2-295
PROTOTYPICAL EMOTIONAL STROOP EFFECT IN THE ONSET OF ALZHEIMER’S DISEASE
Molka Snoussi1, Mohamed Reba^ı2, Didier Hannequin3, Thibault Simon4, Heidi Charvin5, 1University of Rouen, Rouen, France; 2Universite de Rouen, U.F.R. de Psychologie, Rouen, France; 3Faculte de Medicine, Rouen, France; 4CHI Elbeuf, France; 5Universite de Rouen, U.F.R. de Psychologie, Rouen, France. Background: Alzheimer’s disease is associated with some cognitive decline and emotional changes. Various researchers have focused their studies although separately on the evaluation of these changes. Our research proposes to evaluate both of these changes “cognition-emotion interaction”, based on Damasio’s (1996) hypothesis of somatic marking of information with emotional valence and emotional disturbances, noted in AD. We hypothesize that: if the loss of affect severely decreases the somatic marking of information, the inhibitory capacity of AD should not be affected by the combination of emotional valence to information on the Emotional Stroop(ES). Our previous research (Snoussi et al., 2011), have showed no difference between the Standard Stroop (SS) (color vs. words) and ES (color vs. emotional words), but we notice that the RT and errors number in medium and high inhibition load, increased with infrequent colors (10 colors). In this study, we want to control the infrequency bias of colors. We used in this experiment only five frequent colors, in order to be sure that the lack of difference between Stroop tasks is really due to a loss of somatic-markers. Methods: To test this hypothesis, three groups of participants were included: 15 young healthy adults (23 yrs), 15 normal aged individuals (77, 67 yrs) and 15 AD patients (81 yrs; MMSE ¼ 22, 7). All groups were matched on socio-educational level and gender, and were tested on the ES and SS (5 colors): which include 5 conditions with increase of inhibition load. The performance is measured by adding (RT (neperian logarithm) + number of errors). Results: Statistic analysis indicates, no difference between the two Stroop for AD patients, but we find a significant group effect in RT and Errors numbers: AD>OLD>Young (P ¼ 0.020). Moreover, we find that there’s significant difference in RT and errors numbers, between the two version of Stroop (Stroop version 1 > Stroop version 2). Conclusions: The results on ES may suggest that, the “dysaffectation” deletes the influence on the inhibition ability of the emotional valence of the information for AD patients. These findings support the inhibitory-emotional interaction hypothesis. We can conclude that the lack of somatic-marking of information may be prototypical of AD in early stage.
P2-296
COMPARISON OF THE ‘WORD’ VS. ‘PICTURE’ VERSIONS OF THE FREE AND CUED SELECTIVE REMINDING TEST (FCSRT) IN OLDER ADULTS
Molly Zimmerman1, Mindy Katz1, Cuiling Wang1, Leah Burns2, Robert Berman2, Carol Derby1, Gilbert L’Italien2, David Budd3, Richard Lipton1, 1Albert Einstein College of Medicine, Bronx, New York,
P367
United States; 2Bristol-Myers Squibb, Wallingford, Connecticut, United States; 3Bristol-Myers Squibb, Lawrenceville, Connecticut, United States. Background: The Free and Cued Selective Reminding Test (FCSRT) is a verbal memory task that utilizes control of attention and strategy to maximize performance. FCSRT performance has high discriminative validity for diagnosis of dementia. There are two versions of the FCSRT; one uses pictorial stimuli (“Picture” version) and another uses printed words (“Word” version). The goal of this study was to determine the psychometric relationship between the Word and Picture versions of the FCSRT among cognitively normal older adults and to develop an algorithm for score conversions. Development of an algorithm will facilitate comparisons of findings and pooling of data across different studies. Methods: Participants were 122 cognitively normal older adults from the Einstein Aging Study (EAS), a community-based sample of individuals aged 70 years and older residing in the Bronx, New York. Participants were administered both versions of the FCSRT on two separate clinic visits (median ¼ 4 months) using a randomized counterbalanced design. Primary variables of interest were scores on the free recall conditions of each version (score range: 0-48). Linear regression models were used to evaluate the association of the Word and Picture versions of the FCSRT. Estimates of the parameters were used to develop a model to predict Word score from Picture score. Results: The Pearson correlation between the Word and Picture FCSRT versions was r ¼ 0.52 (95% CI: 0.38-0.64). The mean Picture score was 7.67 points higher than the Word score. The formula for predicting Word from Picture score was W ¼ 2.86 + 0.69P, where W denotes estimate of mean Word Score and P denotes Picture score. Conclusions: The Word and Picture versions of the FCSRT were moderately associated in a sample of cognitively normal older adults. The strength of this relationship would likely improve with inclusion of subjects with memory impairment. A regression equation facilitates conversion of scores between the two versions among non-demented older adults. On average, scores were higher on the Picture version, perhaps because this version facilitates dual encoding. Ongoing analyses will broaden the sample to include older adults at-risk for the development of Alzheimertype dementia. P2-297
NEUROPSYCHIATRIC SYMPTOMS IN MILD ALZHEIMER’S DISEASE AND MILD COGNITIVE IMPAIRMENT
So Yeong Kim, Mun Seong Choi, Maryknoll Hospital, Busan, South Korea. Background: Neuropsychiatric symptoms affect than a third of dementia patients, and are associated with institualization and caregiver stress or care burden in patients with Alzheimer’ s disease (AD). They are also commom in mild cognitive impairment (MCI). The early identification of neuropsychiatric symptoms in MCI could improve further the prediction of the complex clinical course of the dementia illness, possibly helping improve treatment approaches, and ultimately the prognosis. Methods: We included 101 outpatients of a memory clinic in Maryknoll Hospital (48 AD; 53 amnestic-MCI-multidomain) and 25 controls. Categorical disorders of depression and apathy were diagnosed with structured interviews. Symptoms were evaluated with the neuropsychiatric inventory (NPI). The odds ratios (OR) of patients having neuropsychiatric symptoms compared to controls were calculated with logistic regression, adjusted for sociodemographic and clinical variables. Results: A large proportion of AD (62.5%), amnestic-MCImultidomain (39.6%) patients had depressed disorder. Apathy disorder was common in AD (68.7%), less frequent in amnestic MCI-multidomain (9.4%). AD patients were five times more likely to have depression disorders (OR ¼ 5.1, CI ¼ 1.1-23.1) compared to amnestic-MCI-multidomain. After apathy and depression, the most prevalent neuropsychiatric symptoms in AD and MCI were anxiety, agitation, irritability, night-time behaviors, and appetite disturbances. Conclusions: Clinicians should consider the relevance of neuropsychiatric symptoms in patients with cognitive disturbances, and incorporate a thorough psychiatric examination in the evaluation of patients.