Diagnostic Precision in the Detection of Mild Cognitive Impairment: A Comparison of Two Approaches
| Autor: | Christopher R. Bowie, Swathi Gujral, Benoit H. Mulsant, Andrea M. Weinstein, Alastair J. Flint, Tarek K. Rajji, Corinne E. Fischer, James L. Kennedy, Nathan Herrmann, Bruce G. Pollock, Meryl A. Butters, Shima Ovaysikia, Linda Mah |
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| Rok vydání: | 2020 |
| Předmět: |
Neuropsychological Tests
Transcranial Direct Current Stimulation Article 03 medical and health sciences 0302 clinical medicine Alzheimer Disease mental disorders medicine Dementia Humans Cognitive Dysfunction Aged Depressive Disorder Major 030214 geriatrics business.industry Neuropsychology Montreal Cognitive Assessment Cognition medicine.disease Psychiatry and Mental health Cross-Sectional Studies Disease Progression Major depressive disorder Geriatrics and Gerontology business Psychosocial Neurocognitive Geriatric psychiatry Clinical psychology |
| Zdroj: | Am J Geriatr Psychiatry |
| ISSN: | 1545-7214 |
| Popis: | OBJECTIVE This study compared diagnostic rates and clinical predictors of discrepancies between diagnoses conferred via: 1) a comprehensive neuropsychological evaluation and National Institute on Aging–Alzheimer's Association (NIA-AA) criteria versus 2) a cognitive screener and Diagnostic Statistical Manual of Mental Disorders (DSM-5) criteria. DESIGN Cross-sectional examination of baseline data from the P revention of Al zheimer's dementia (AD) using C ognitive remediation and t ranscranial direct current stimulation in Mild Cognitive Impairment (MCI) and D epression (PACt-MD; ClinicalTrials.gov Identifier: NCT02386670) trial. SETTING Five geriatric psychiatry and memory clinics located at academic hospitals affiliated with the Department of Psychiatry, University of Toronto. PARTICIPANTS Older adults (N = 431) with a history of major depressive disorder (MDD) in remission, MCI, or both. MEASUREMENTS Main outcome was a comparison of NIA-AA diagnostic rates of MCI or dementia versus DSM-5 rates of mild or major neurocognitive disorder. Secondary analyses examined demographic, race, gender, premorbid intellectual ability, psychosocial, health-related, and genetic predictors of discrepancy between DSM-5 and NIA-AA diagnoses. RESULTS There were 103 (23.8%) discrepant cases, with most (91; 88.3%) of these discrepant cases reflecting more impairment with the detailed neuropsychological testing and NIA-AA criteria. Discrepancies were more likely in individuals with a history of MDD or who had at least one ApoE4 allele. CONCLUSION The NIA-AA criteria, in conjunction with comprehensive neuropsychological testing, identified a greater prevalence of cognitive impairment than DSM-5 criteria, in conjunction with the Montreal Cognitive Assessment. Detailed neuropsychological evaluations are recommended for older adults who have a history of MDD or a genetic vulnerability to dementia. |
| Databáze: | OpenAIRE |
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