- Email: [email protected]
THE RELATIONSHIP BETWEEN THE GERIATRIC DEPRESSION SCALE AND COGNITIVE-BEHAVIORAL ASPECTS IN ALZHEIMER’S DEMENTIA
Poster Presentations: Tuesday, July 18, 2017 Background: Previous studies have characterized pathways linking frontal control systems with temporal regions involved in semantic memory storage that are critically involved in retrieval under effortful conditions. Recent findings also suggest that disruption within frontotemporal pathways are present in preclinical AD and may predict conversion to prodromal/clinical AD. Cognitive tasks placing high demands on controlled semantic retrieval may therefore be particularly sensitive markers of AD pathology in presymptomatic individuals. Methods: Cognitively normal older adults (mean age: 64.3 years) with a family history of AD and subjective memory complaints performed a semantic control task in which participants were asked to determine which word from a set of possible targets was most related to a cue word. Retrieval demands were manipulated by varying the associative strength (Strong or Weak) between cue and correct target, and semantic load was manipulated by varying the number (2 or 4) of potential targets. Two summary scores were derived from participants’ response times across conditions: 1) Controlled Retrieval (Weak 2 vs. Strong 2) and 2) Semantic Load (Strong 4 vs. Strong 2). All participants underwent Florbetapir PET beta-amyloid (Ab) imaging at time of cognitive testing and 27 months prior to testing. Results: Using an SUVr threshold of 1.1 in the anterior cingulate cortex, participants were classified as either Ab+ (n¼15) or Ab- (n¼23), and the two groups did not differ for age or education. The Ab+ group performed significantly worse on Controlled Retrieval despite comparable performance on Semantic Load across groups. Twenty participants had increased SUVr levels (D+) from their scan 27 months earlier, whereas 18 did not. A two-way ANOVA revealed a significant interaction between change status and summary score, with the D+ group performing worse on Controlled Retrieval despite comparable performance on Semantic Load across groups. Conclusions: Results suggest that tests of controlled semantic retrieval dependent on the integrity of frontotemporal pathways are sensitive both to current Ab status and to changes in Ab load in preclinical AD. Impaired controlled retrieval may reflect subtle disruptions of frontotemporal pathways in preclinical AD, and may serve as a potential cognitive stress test for the detection of subtle change in presymptomatic AD.
P3-443
THE RELATIONSHIP BETWEEN THE GERIATRIC DEPRESSION SCALE AND COGNITIVE-BEHAVIORAL ASPECTS IN ALZHEIMER’S DEMENTIA
Youngsoon Yang, VHS Medical Center, Seoul, Republic of South Korea. Contact e-mail: [email protected]
P1139
lated with calculation, SVLT(Seoul Verbal Learning Test) immediate recall, RCFT(Rey-Osterrieth Complex Figure Test) copy, RCFT delayed recall, contrasting, COWAT, CWST word, and delusion. Our study identified three factors and revealed that the GDS15 may be comprised of a heterogeneous scale. Conclusions: These results suggest that the GDS15 may be comprised of a heterogeneous scale and suggested multi-dimensional properties of GDS15 in AD.
P3-444
THE STICK DESIGN TEST (SDT): CAN A VISUOCONSTRUCTION TEST HELP DISCRIMINATE HEALTHY CONTROLS (HC), MILD COGNITIVE IMPAIRMENT (MCI) AND ALZHEIMER’S DISEASE (AD)?
Eduardo Sturzeneker Tres1, Diane da costa Miranda1, Sonia Maria Dozzi Brucki1, Maira O. Oliveira1, Mario Amore Cecchini Sr1, Monica Sanches Yassuda1, Ricardo Nitrini2,3,4 GNCC - Grupo de Neurologia Cognitiva e do Comportamento, 1University of S~ao Paulo, S~ao Paulo, Brazil; 2Brazilian Brain Bank of the Aging Brain Study Group; University of S~ao Paulo, S~ao Paulo, Brazil; 3Medical School of University of S~ao Paulo, S~ao Paulo, Brazil; 4University of S~ao Paulo Medical School, S~ao Paulo, Brazil. Contact e-mail: [email protected] Background: Cognitive assessment is essential for an accurate diag-
nosis of HC, MCI and AD. Many brief tests exploring visuoconstructional abilities have been proposed as practical alternatives to otherwise extensive neuropsychological (NPS) testing1,2,3. The SDT is proposed to be a simple, nongraphomotor, visuoconstructional test, with little dependence from educational levels4. The present study aims to analyze the discriminative power of the SDT in a sample of HC, MCI and AD. Methods: Sixty-eight individuals, aged 60 years and older, selected from University of S~ao Paulo’s dementia center were evaluated through a NPS composite constituted by MMSE, Brief Cognitive Screening Battery (BCSB), phonemic fluency (PF) and visuospatial parameters (VSP) - the clock drawing test (CDT), the cube and intersecting infinity loops (IIL) copies. NPS assessment was performed to determine the diagnosis of MCI and AD according to international criteria5,6, while HC were classified if screening tests and clinical characteristics were normal. Results: AD patients were older than HC and MCI participants and less educated than the HC group (table 1). In the NPS tests, AD group showed poorer performance than the HC and MCI groups, as expected (table 2). The scores obtained in the construction step of the SDT appeared to show a ceiling effect, especially if we take into consideration the cut-off values (11.5), too close to maximum points possibly acquired (12) at this phase (table
Background: Although 15-item on the Geriatric Depression Scale
(GDS15) is a widely used depression screening questionnaire, the implications of GDS15 in AD may be questioned. We designed this study to explore the factor structure of GDS15 and the relation between these factors and cognitive-behavioral aspects. Methods: GDS15, cognitive function tests, Korean-Neuropsychiatry Inventory (K-NPI) were administered to 310 patients with probable AD, who were not medicated before visiting the hospital. Using Principal component analysis (PCA), three factors were identified. To determine the relationship between factors and neurocognitive, behavior symptoms, bivariate correlation was used. Results: The factor 2 was correlated with K-BNT (Korean Boston Naming Test), calculation, Go-no-go test, COWAT(Controlled Oral Word Association Test), CWST(Color Word Stroop Test; word and color), aggression, depression, and apathy. The factor 3 was corre-
Figure 1. ROC Curves. Note. HC ¼ Healthy controls; MCI ¼ Mild cognitive impairment; AD ¼ Alzheimer’s disease.
P3-443
THE RELATIONSHIP BETWEEN THE GERIATRIC DEPRESSION SCALE AND COGNITIVE-BEHAVIORAL ASPECTS IN ALZHEIMER’S DEMENTIA
Youngsoon Yang, VHS Medical Center, Seoul, Republic of South Korea. Contact e-mail: [email protected]
P1139
lated with calculation, SVLT(Seoul Verbal Learning Test) immediate recall, RCFT(Rey-Osterrieth Complex Figure Test) copy, RCFT delayed recall, contrasting, COWAT, CWST word, and delusion. Our study identified three factors and revealed that the GDS15 may be comprised of a heterogeneous scale. Conclusions: These results suggest that the GDS15 may be comprised of a heterogeneous scale and suggested multi-dimensional properties of GDS15 in AD.
P3-444
THE STICK DESIGN TEST (SDT): CAN A VISUOCONSTRUCTION TEST HELP DISCRIMINATE HEALTHY CONTROLS (HC), MILD COGNITIVE IMPAIRMENT (MCI) AND ALZHEIMER’S DISEASE (AD)?
Eduardo Sturzeneker Tres1, Diane da costa Miranda1, Sonia Maria Dozzi Brucki1, Maira O. Oliveira1, Mario Amore Cecchini Sr1, Monica Sanches Yassuda1, Ricardo Nitrini2,3,4 GNCC - Grupo de Neurologia Cognitiva e do Comportamento, 1University of S~ao Paulo, S~ao Paulo, Brazil; 2Brazilian Brain Bank of the Aging Brain Study Group; University of S~ao Paulo, S~ao Paulo, Brazil; 3Medical School of University of S~ao Paulo, S~ao Paulo, Brazil; 4University of S~ao Paulo Medical School, S~ao Paulo, Brazil. Contact e-mail: [email protected] Background: Cognitive assessment is essential for an accurate diag-
nosis of HC, MCI and AD. Many brief tests exploring visuoconstructional abilities have been proposed as practical alternatives to otherwise extensive neuropsychological (NPS) testing1,2,3. The SDT is proposed to be a simple, nongraphomotor, visuoconstructional test, with little dependence from educational levels4. The present study aims to analyze the discriminative power of the SDT in a sample of HC, MCI and AD. Methods: Sixty-eight individuals, aged 60 years and older, selected from University of S~ao Paulo’s dementia center were evaluated through a NPS composite constituted by MMSE, Brief Cognitive Screening Battery (BCSB), phonemic fluency (PF) and visuospatial parameters (VSP) - the clock drawing test (CDT), the cube and intersecting infinity loops (IIL) copies. NPS assessment was performed to determine the diagnosis of MCI and AD according to international criteria5,6, while HC were classified if screening tests and clinical characteristics were normal. Results: AD patients were older than HC and MCI participants and less educated than the HC group (table 1). In the NPS tests, AD group showed poorer performance than the HC and MCI groups, as expected (table 2). The scores obtained in the construction step of the SDT appeared to show a ceiling effect, especially if we take into consideration the cut-off values (11.5), too close to maximum points possibly acquired (12) at this phase (table
Background: Although 15-item on the Geriatric Depression Scale
(GDS15) is a widely used depression screening questionnaire, the implications of GDS15 in AD may be questioned. We designed this study to explore the factor structure of GDS15 and the relation between these factors and cognitive-behavioral aspects. Methods: GDS15, cognitive function tests, Korean-Neuropsychiatry Inventory (K-NPI) were administered to 310 patients with probable AD, who were not medicated before visiting the hospital. Using Principal component analysis (PCA), three factors were identified. To determine the relationship between factors and neurocognitive, behavior symptoms, bivariate correlation was used. Results: The factor 2 was correlated with K-BNT (Korean Boston Naming Test), calculation, Go-no-go test, COWAT(Controlled Oral Word Association Test), CWST(Color Word Stroop Test; word and color), aggression, depression, and apathy. The factor 3 was corre-
Figure 1. ROC Curves. Note. HC ¼ Healthy controls; MCI ¼ Mild cognitive impairment; AD ¼ Alzheimer’s disease.