Measuring cognitive function by the SDMT across functional domains: Useful but not sufficient.
Cognitive function
Cognitive impairment
Computerized cognitive assessment
Multiple sclerosis
Screening
Symbol digit modalities test
Journal
Multiple sclerosis and related disorders
ISSN: 2211-0356
Titre abrégé: Mult Scler Relat Disord
Pays: Netherlands
ID NLM: 101580247
Informations de publication
Date de publication:
Apr 2022
Apr 2022
Historique:
received:
18
11
2021
revised:
21
01
2022
accepted:
19
02
2022
pubmed:
9
3
2022
medline:
18
5
2022
entrez:
8
3
2022
Statut:
ppublish
Résumé
The Symbol Digit Modalities Test (SDMT) is a common screen of cognitive function for people with Multiple Sclerosis (pwMS) but growing acknowledgement that people with cognitive impairment are a heterogeneous population suggests that a single screen may provide limited information. To assess the adequacy of the SDMT in capturing impairment across specific cognitive domains as measured by a multi-domain cognitive assessment battery (CAB, NeuroTrax). 113 pwMS were assessed with SDMT and the CAB. Cognitive impairment in each CAB domain was defined as ≥1.5 SD below the normalized mean. Logistic regression models were fit for each CAB domain with domain-specific cognitive impairment as the outcome and SDMT as the predictor, and a classifier created by selecting cutpoints using the Youden Index. Model performance was assessed by predicting domain-specific cognitive impairment in an independent data set consisting of 81 pwMS. SDMT was a significant predictor of cognitive impairment in all outcomes considered (Odds Ratio: 0.885-0.950), but prediction metrics such as area under the receiver operating curve (AUC) were modest (0.623-0.778), and the alignment between observed/predicted impairment was less than optimal. The SDMT is not sufficient to differentiate between impaired and non-impaired pwMS across several cognitive domains.
Sections du résumé
BACKGROUND
BACKGROUND
The Symbol Digit Modalities Test (SDMT) is a common screen of cognitive function for people with Multiple Sclerosis (pwMS) but growing acknowledgement that people with cognitive impairment are a heterogeneous population suggests that a single screen may provide limited information.
OBJECTIVE
OBJECTIVE
To assess the adequacy of the SDMT in capturing impairment across specific cognitive domains as measured by a multi-domain cognitive assessment battery (CAB, NeuroTrax).
METHODS
METHODS
113 pwMS were assessed with SDMT and the CAB. Cognitive impairment in each CAB domain was defined as ≥1.5 SD below the normalized mean. Logistic regression models were fit for each CAB domain with domain-specific cognitive impairment as the outcome and SDMT as the predictor, and a classifier created by selecting cutpoints using the Youden Index. Model performance was assessed by predicting domain-specific cognitive impairment in an independent data set consisting of 81 pwMS.
RESULTS
RESULTS
SDMT was a significant predictor of cognitive impairment in all outcomes considered (Odds Ratio: 0.885-0.950), but prediction metrics such as area under the receiver operating curve (AUC) were modest (0.623-0.778), and the alignment between observed/predicted impairment was less than optimal.
CONCLUSION
CONCLUSIONS
The SDMT is not sufficient to differentiate between impaired and non-impaired pwMS across several cognitive domains.
Identifiants
pubmed: 35259683
pii: S2211-0348(22)00219-X
doi: 10.1016/j.msard.2022.103704
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
103704Informations de copyright
Copyright © 2022. Published by Elsevier B.V.