Value of Neuropsychological Tests to Identify Patients with Depressive Symptoms on the Alzheimer's Disease Continuum.
Alzheimer’s disease
cerebrospinal fluid
depression
executive function
memory
neuropsychology
Journal
Journal of Alzheimer's disease : JAD
ISSN: 1875-8908
Titre abrégé: J Alzheimers Dis
Pays: Netherlands
ID NLM: 9814863
Informations de publication
Date de publication:
2020
2020
Historique:
pubmed:
20
10
2020
medline:
8
5
2021
entrez:
19
10
2020
Statut:
ppublish
Résumé
Depressive symptoms often co-occur with Alzheimer's disease (AD) and can impact neuropsychological test results. In early stages of AD, disentangling cognitive impairments due to depression from those due to neurodegeneration often poses a challenge. We aimed to identify neuropsychological tests able to detect AD-typical pathology while taking into account varying degrees of depressive symptoms. A battery of neuropsychological tests (CERAD-NP) and the Geriatric Depression Scale (GDS) were assessed, and cerebrospinal fluid (CSF) biomarkers were obtained. After stratifying patients into CSF positive or negative and into low, moderate, or high GDS score groups, sensitivity and specificity and area under the curve (AUC) were calculated for each subtest. 497 participants were included in the analyses. In patients with low GDS scores (≤10), the highest AUC (0.72) was achieved by Mini-Mental State Examination, followed by Constructional Praxis Recall and Wordlist Total Recall (AUC = 0.714, both). In patients with moderate (11-20) and high (≥21) GDS scores, Trail Making Test-B (TMT-B) revealed the highest AUCs with 0.77 and 0.82, respectively. Neuropsychological tests showing AD-typical pathology in participants with low GDS scores are in-line with previous results. In patients with higher GDS scores, TMT-B showed the best discrimination. This indicates the need to focus on executive function rather than on memory task results in depressed patients to explore a risk for AD.
Sections du résumé
BACKGROUND
Depressive symptoms often co-occur with Alzheimer's disease (AD) and can impact neuropsychological test results. In early stages of AD, disentangling cognitive impairments due to depression from those due to neurodegeneration often poses a challenge.
OBJECTIVE
We aimed to identify neuropsychological tests able to detect AD-typical pathology while taking into account varying degrees of depressive symptoms.
METHODS
A battery of neuropsychological tests (CERAD-NP) and the Geriatric Depression Scale (GDS) were assessed, and cerebrospinal fluid (CSF) biomarkers were obtained. After stratifying patients into CSF positive or negative and into low, moderate, or high GDS score groups, sensitivity and specificity and area under the curve (AUC) were calculated for each subtest.
RESULTS
497 participants were included in the analyses. In patients with low GDS scores (≤10), the highest AUC (0.72) was achieved by Mini-Mental State Examination, followed by Constructional Praxis Recall and Wordlist Total Recall (AUC = 0.714, both). In patients with moderate (11-20) and high (≥21) GDS scores, Trail Making Test-B (TMT-B) revealed the highest AUCs with 0.77 and 0.82, respectively.
CONCLUSION
Neuropsychological tests showing AD-typical pathology in participants with low GDS scores are in-line with previous results. In patients with higher GDS scores, TMT-B showed the best discrimination. This indicates the need to focus on executive function rather than on memory task results in depressed patients to explore a risk for AD.
Identifiants
pubmed: 33074230
pii: JAD200710
doi: 10.3233/JAD-200710
pmc: PMC7739969
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
819-826Références
Psychol Med. 2014 Jul;44(10):2029-40
pubmed: 24168753
Neurology. 1989 Sep;39(9):1159-65
pubmed: 2771064
J Geriatr Psychiatry Neurol. 2007 Dec;20(4):189-98
pubmed: 18004006
Front Aging Neurosci. 2018 Feb 23;10:38
pubmed: 29527163
Neuropsychologia. 2007 Apr 8;45(7):1408-19
pubmed: 17178419
Int J Geriatr Psychiatry. 2006 Oct;21(10):911-6
pubmed: 16927401
Dement Geriatr Cogn Disord. 1997 Jul-Aug;8(4):244-7
pubmed: 9213070
J Psychiatr Res. 2009 Jan;43(4):411-31
pubmed: 18579155
J Am Geriatr Soc. 1992 Sep;40(9):922-35
pubmed: 1512391
Int J Geriatr Psychiatry. 2001 Jan;16(1):18-26
pubmed: 11180481
JAMA Psychiatry. 2017 Jul 1;74(7):712-718
pubmed: 28514478
Alzheimers Dement. 2018 Apr;14(4):535-562
pubmed: 29653606
Lancet Neurol. 2006 Mar;5(3):228-34
pubmed: 16488378
J Psychiatr Res. 1975 Nov;12(3):189-98
pubmed: 1202204
Int J Psychiatry Med. 1998;28(4):437-47
pubmed: 10207742
Psychol Med. 1997 Jul;27(4):967-71
pubmed: 9234474
Cold Spring Harb Perspect Med. 2012 Apr;2(4):a006213
pubmed: 22474610
Int Psychogeriatr. 2015 Oct;27(10):1649-60
pubmed: 26138809
Neurology. 2000 Dec 26;55(12):1847-53
pubmed: 11134384
J Consult Psychol. 1955 Oct;19(5):393-4
pubmed: 13263471
Int Psychogeriatr. 1996 Fall;8(3):469-76
pubmed: 9116182
Dement Geriatr Cogn Disord. 2011;31(2):139-45
pubmed: 21304219
Alzheimers Res Ther. 2017 Oct 10;9(1):84
pubmed: 29017593
Curr Alzheimer Res. 2015;12(2):189-98
pubmed: 25654505
J Psychiatr Res. 1982-1983;17(1):37-49
pubmed: 7183759
Alzheimer Dis Assoc Disord. 2019 Jan-Mar;33(1):15-20
pubmed: 30489279
Int Psychogeriatr. 1997;9 Suppl 1:173-6; discussion 177-8
pubmed: 9447441
Clin Chem Lab Med. 2010 May;48(5):603-7
pubmed: 20201744
Dement Geriatr Cogn Disord. 2007;23(4):231-40
pubmed: 17308387
Neurology. 2012 Feb 7;78(6):379-86
pubmed: 22238414
Arch Gen Psychiatry. 2006 May;63(5):530-8
pubmed: 16651510
Lancet Psychiatry. 2016 Jul;3(7):628-35
pubmed: 27138970
PLoS One. 2014 Jun 24;9(6):e100784
pubmed: 24959687