INS NYC 2024 Program

Poster	Poster Session 02 Program Schedule 02/15/2024 08:00 am - 09:15 am Room: Shubert Complex (Posters 1-60) Poster Session 02: Aging \| MCI \| Neurodegenerative Disease - PART 1 Final Abstract #28 Comparing the Clinical Dementia Rating (CDR) to Neuropsychological Assessments in Persons with Mild Cognitive Impairment Emma Flynn, University of Michigan, Ann Arbor, United States Subhamoy Pal, University of Michigan, Ann Arbor, United States Jon Reader, University of Michigan, Ann Arbor, United States Jordan Bross, University of Michigan, Ann Arbor, United States Allyson Gregoire, University of Michigan, Ann Arbor, United States Arijit Bhaumik, University of Michigan, Ann Arbor, United States Judith Heidebrink, University of Michigan, Ann Arbor, United States Benjamin Hampstead, University of Michigan, Ann Arbor, United States Bruno Giordani, University of Michigan, Ann Arbor, United States Category: MCI (Mild Cognitive Impairment) Keyword 1: neuropsychological assessment Keyword 2: aging disorders Keyword 3: mild cognitive impairment Objective: In research and clinic, early, accurate identification of persons at risk for developing Mild Cognitive Impairment (MCI) and Alzheimer’s Disease (AD) is vital. The Clinical Dementia Rating (CDR) is a tool used to clinically assess the severity of these disorders, including ratings of memory, language, and problem-solving. Similarly, neuropsychological tests use objective measures of cognitive performance in contrast to clinician judgment. This study investigates the relationship between CDR ratings and neuropsychological tests. Participants and Methods: Retrospective data analysis was conducted on 231 MCI participants from the Michigan Alzheimer’s Disease Research Center (MADRC), with mean age of 73 (SD=8) years, 63% female, who completed the National Alzheimer’s Disease Coordinating Center (NACC) Uniform Data Set Version 3 (UDSv3), which includes the CDR and basic neuropsychological measures along with additional tasks (e.g., Hopkins Verbal Learning Test Delayed Recall (HVLT), Benson Judgment of Line Orientation (JoLO), Wisconsin Card Sorting Test Emory Short Form (WCST) and Weschler Test of Adult Reading (WTAR)). The CDR consists of a global score and eight domains, three of which were used in this analysis (Memory, Judgment/Problem-Solving, and Language) since not enough participants fell into all eight. Within each domain, each participant was either given a score of 0 (no loss in ability), 0.5 (consistent slight problems), or 1.0 (moderate loss). Given that few MCI individuals score a 1 on CDR domains, scores of 0.5 and 1 were combined. Chi-square tests were used for categorical variable comparison, Wilcoxon rank sum for variables treated as continuous, and when missing data, Fisher’s exact was employed. Results: For the Memory Domain of the CDR significant group (no loss vs. loss) differences were observed for memory-related neuropsychological tasks, including Immediate Craft Story Recall (p=.001, p=.003), Animals Naming (p=.013), Vegetables Naming (p=.009), Delayed Craft Story (p<.001), HVLT (p=.023), and the global measure of the Montreal Cognitive Assessment (MoCA, p=.02). There also were differences for non-memory scores JoLO (p=.01) and WCST set loss errors (p=.048). CDR Judgment and Problem-Solving domain scores significantly showed no loss/loss group differences for executive Trails B (p=.032), but also with non-judgment related tasks, including MoCA (p=.02), Delayed Craft Story (p=.02), and JoLO (p=.035). The CDR Language domain score did not show impairment/no impairment differences on any language-related tasks, but with a working memory task, Digit Span Backward (p=.025). The CDR Global Score demonstrated no loss/loss significant differences for MoCA (p=.009), Immediate Craft Story Recall (p=.003), Animals (p=.002), Vegetables (p=.003), Trails A (p=.007), Delayed Craft Story (p<.001), HVLT Delayed Recall (p=.013), and JoLO (p=.003). All non-impaired group means were higher than impaired for observed differences. Conclusions: CDR Memory and Judgement/Problem-Solving domains were related to expected objective neuropsychological tests for individuals with MCI, however, CDR language scores did not correlate with the expected language tasks. This may be due to MCI patients showing less significant issues in everyday language during clinician interview in comparison to objective testing. Better understanding of CDR cognitive domains will assist in diagnostic accuracy and increase trust in clinician judgment.

Poster

02/15/2024
08:00 am - 09:15 am
Room: Shubert Complex (Posters 1-60)

Poster Session 02: Aging | MCI | Neurodegenerative Disease - PART 1

Final Abstract #28

Comparing the Clinical Dementia Rating (CDR) to Neuropsychological Assessments in Persons with Mild Cognitive Impairment

Emma Flynn, University of Michigan, Ann Arbor, United States
Subhamoy Pal, University of Michigan, Ann Arbor, United States
Jon Reader, University of Michigan, Ann Arbor, United States
Jordan Bross, University of Michigan, Ann Arbor, United States
Allyson Gregoire, University of Michigan, Ann Arbor, United States
Arijit Bhaumik, University of Michigan, Ann Arbor, United States
Judith Heidebrink, University of Michigan, Ann Arbor, United States
Benjamin Hampstead, University of Michigan, Ann Arbor, United States
Bruno Giordani, University of Michigan, Ann Arbor, United States

Category: MCI (Mild Cognitive Impairment)

Keyword 1: neuropsychological assessment
Keyword 2: aging disorders
Keyword 3: mild cognitive impairment

Objective:

In research and clinic, early, accurate identification of persons at risk for developing Mild Cognitive Impairment (MCI) and Alzheimer’s Disease (AD) is vital. The Clinical Dementia Rating (CDR) is a tool used to clinically assess the severity of these disorders, including ratings of memory, language, and problem-solving. Similarly, neuropsychological tests use objective measures of cognitive performance in contrast to clinician judgment. This study investigates the relationship between CDR ratings and neuropsychological tests.

Participants and Methods:

Retrospective data analysis was conducted on 231 MCI participants from the Michigan Alzheimer’s Disease Research Center (MADRC), with mean age of 73 (SD=8) years, 63% female, who completed the National Alzheimer’s Disease Coordinating Center (NACC) Uniform Data Set Version 3 (UDSv3), which includes the CDR and basic neuropsychological measures along with additional tasks (e.g., Hopkins Verbal Learning Test Delayed Recall (HVLT), Benson Judgment of Line Orientation (JoLO), Wisconsin Card Sorting Test Emory Short Form (WCST) and Weschler Test of Adult Reading (WTAR)). The CDR consists of a global score and eight domains, three of which were used in this analysis (Memory, Judgment/Problem-Solving, and Language) since not enough participants fell into all eight. Within each domain, each participant was either given a score of 0 (no loss in ability), 0.5 (consistent slight problems), or 1.0 (moderate loss). Given that few MCI individuals score a 1 on CDR domains, scores of 0.5 and 1 were combined. Chi-square tests were used for categorical variable comparison, Wilcoxon rank sum for variables treated as continuous, and when missing data, Fisher’s exact was employed.

Results:

For the Memory Domain of the CDR significant group (no loss vs. loss) differences were observed for memory-related neuropsychological tasks, including Immediate Craft Story Recall (p=.001, p=.003), Animals Naming (p=.013), Vegetables Naming (p=.009), Delayed Craft Story (p<.001), HVLT (p=.023), and the global measure of the Montreal Cognitive Assessment (MoCA, p=.02). There also were differences for non-memory scores JoLO (p=.01) and WCST set loss errors (p=.048). CDR Judgment and Problem-Solving domain scores significantly showed no loss/loss group differences for executive Trails B (p=.032), but also with non-judgment related tasks, including MoCA (p=.02), Delayed Craft Story (p=.02), and JoLO (p=.035). The CDR Language domain score did not show impairment/no impairment differences on any language-related tasks, but with a working memory task, Digit Span Backward (p=.025). The CDR Global Score demonstrated no loss/loss significant differences for MoCA (p=.009), Immediate Craft Story Recall (p=.003), Animals (p=.002), Vegetables (p=.003), Trails A (p=.007), Delayed Craft Story (p<.001), HVLT Delayed Recall (p=.013), and JoLO (p=.003). All non-impaired group means were higher than impaired for observed differences.

Conclusions:

CDR Memory and Judgement/Problem-Solving domains were related to expected objective neuropsychological tests for individuals with MCI, however, CDR language scores did not correlate with the expected language tasks. This may be due to MCI patients showing less significant issues in everyday language during clinician interview in comparison to objective testing. Better understanding of CDR cognitive domains will assist in diagnostic accuracy and increase trust in clinician judgment.