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Poster Presentations P2
Participants (n ¼ 300) included cognitively normal community volunteers and patients with mild cognitive complaints, all of whom were not demented at baseline, had been clinically evaluated, and were followed annually as part of a longitudinal study of Mild Cognitive Impairment (MCI) at the Joseph and Kathleen Bryan ADRC at Duke (18% African American; mean age ¼ 75 [8.8sd]). Diagnoses for prAD, functional MCI (CDR ¼ 0.5) and revised prAD were algorithmically applied retrospectively, as was done in previous work. Diagnostic stability, assessed by positive and negative predictive values (PPV, NPV) and reversion rates over three years of follow-up, was examined in the AfAm and Caucasian subgroups. Results: At baseline, approximately half of the participants met criteria for prAD and fMCI, while only 9% met criteria for revised prAD. The reversion rate to cognitively normal status in each impaired group was low (1016%), though substantially higher in AfAms (30%). Prediction of later dementia at one year was highest for the revised prAD criteria (ppv ¼ 0.32) compared to fMCI (ppv ¼ .09) and the original formulation of prAD (ppv ¼ 0.08). NPVs were consistently high across all diagnostic entities (.961.0). Conclusions: Current results suggest that diagnosing early AD in its prodromal stage across diverse groups is facilitated by clinical criteria which require objective evidence of both memory disorder and either executive dysfunction or functional decline. However, there is a higher degree of diagnostic instability in AfAm using this approach, possibly due to cultural differences in psychometric test performance or due to other variables that may be changing with time (e.g. disease co-morbidities). The findings require further investigation in a larger sample before applied as a screening method. P2-145
SPATIAL NAVIGATION COMPUTER TEST CAN DISCRIMINATE TWO TYPES OF AMNESTIC MILD COGNITIVE IMPAIRMENT
Jan Laczo´1, Ross Andel2, Kamil Vlcek3, Martin Vyhna´lek1, Hana Magerova´1, Alexandra Varjassyova´1, Zuzana Nedelska´1, Jakub Linka1, Manfred Windish4, Martin Tolar5, Martin Bojar1, Jakub Hort1, 1 Charles University, 2nd Medical School, Prague, Czech Republic; 2University of South Florida, School of Aging Studies, Tampa, FL, USA; 3Czech Academy of Sciences, Institute of Physiology, Prague, Czech Republic; 4JSW Lifesciences GmbH, Grambach, Austria; 5Yale University School of Medicine, New Haven, CT, USA. Contact e-mail:
[email protected] Background: Our previous published results indicated that spatial navigation testing in the real-space human analogue of the Morris Water Maze (MWM) can distinguish amnestic mild cognitive impairment (aMCI) patients with (versus without) hippocampus-related memory impairment, hence offering a tool to identify cases susceptible for conversion to Alzheimer’s disease (AD). We contrasted results from a computer version of the human analogue of the MWM with the test itself and tested whether it can also discriminate two different aMCI groups. Methods: A total of 42 aMCI patients were stratified according to memory impairment using the Free and Cued Selective Reminding Test (FCSRT) into two groups: 1) memory impairment of hippocampal type - the hippocampal aMCI (HaMCI; n ¼ 10) (potential preclinical AD) and 2) isolated retrieval impairment - the non-hippocampal aMCI (NHaMCI; n ¼ 32). Results were compared to the control (n ¼ 28) and Alzheimer’s disease (AD; n ¼ 21) groups. As with the human analogue of MWM we examined spatial navigation either dependent (egocentric) or independent (allocentric) of the individual’s position. Results: The results in the computer and real-space versions strongly correlated with each other (egocentric: p < 0.001, r ¼ 0.815; allocentric: p < 0.001, r ¼ 0.824). Overall, the HaMCI group performed poorer on spatial navigation than the NHaMCI group (p < 0.01), especially in the latter trials (when the HaMCI group did not exhibit any learning effect (p > 0.576)). Finally, the HaMCI group performed similarly as the AD group (p > 0.383). Conclusions: The computer version of the human analogue of MWM yielded findings similar to those found with the real-world version and it reliably distinguished an aMCI group with a pronounced hippocampus-based memory impairment, a known indicator of incipient AD, from an
aMCI group without such impairment. This test may be a useful, relatively inexpensive screening tool for evaluation of pre-symptomatic individuals at risk of AD. P2-146
EARLY DETECTION OF ALZHEIMER’S DISEASE USING SPATIAL SOURCE MONITORING TASKS
Reiko Koide1, Kazuhiro Ishii1, Hikari Kinjo2, Yasushi Tomidokoro1, Akira Tamaoka1, 1University of Tsukuba, Tsukuba-Schi, Ibaraki-Ken, Japan; 2Otsuma Women’s University, Tama, Tokyo, Japan. Contact e-mail:
[email protected] Background: Much research is currently focused on the qualities of memory decline in Alzheimer’s disease (AD), but source monitoring disruption, conventionally defined as the inability to identify the conditions under which a memory is acquired, has been rather neglected. We examined the effectiveness of source monitoring tasks, particularly with regard to spatial memory, to detect early AD. Methods: Patients with AD (N ¼ 39) or amnestic mild cognitive impairment (aMCI, N ¼ 36), and normal age-matched individuals (N ¼ 51) were asked to (a) arrange, (b) imagine arranging, or (c) watch an experimenter arrange figures (line drawings of furniture on small pieces of paper) in a virtual room and then were given a source memory test. Errors on the actor (i.e., I did vs. the experimenter did) and performance of the action (i.e., I did vs. I imagined) were scored. Scores of the three groups were compared using ANOVA. Receiver operating characteristic (ROC) curves were generated to examine the ability of the scores of AD and aMCI patients to discriminate them from normal controls. Results: The patients with AD or MCI had higher error scores than normal control subjects on both source monitoring scores (p < .001). The area under the ROC plots verified the ability to discriminate between AD patients and normal control subjects, (0.919, p < .001 for error on actor; 0.953 p < .001 for error on action), as well as between aMCI patients and normal control subjects, (0.858, p < .001 for error on actor; 0.820, p < .001 for error on action). Conclusions: Spatial source monitoring tasks appear to be useful for early diagnosis of AD. P2-147
SMELL IDENTIFICATION IN NONAMNESTIC MILD COGNITIVE IMPAIRMENT AND FRONTOTEMPORAL LOBAR DEGENERATION
Hana Magerova1, Martin Vyhnalek1, Alexandra Varjassyova1, Irena Rektorova2, Zuzana Nedelska1, Jan Laczo1, Daniel Horinek3, Jiri Brabec4, Ross Andel5, Martin Bojar1, Jakub Hort1, 1Department of Neurology, Charles University, 2nd Medical School and Motol Hospital, Prague, Czech Republic; 21st Department of Neurology, Masaryk University, St Anne’s Teaching Hospital, Brno, Czech Republic; 3Department of Neurosurgery, Charles University, 1st Medical School and Central Military Hospital, Prague, Czech Republic; 4Department of Neurology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA; 5School of Aging Studies and Florida Alzheimer’s Disease Research Center, University of South Florida, Tampa, FL, USA. Contact e-mail: hana.magerova@email. cz Background: Olfactory deficit is a constant finding in early Alzheimer’s disease (AD). Frontotemporal lobar degeneration (FTLD) is heterogenic entity and was less studied; however the neuropathological basis of this disease suggests that the olfactory impairment could be present in this disorder. The aim of our study was to determine the smell identification impairment in FTLD and in non-amnestic mild cognitive impairment (naMCI) which is considered to be a prodromal stage of mainly non-Alzheimer’s (non-AD) dementias. Methods: 27 FTLD patients were stratified into following subgroups: frontotemporal dementia-behavior variant (FTDbv, n ¼ 10), primary progressive aphasia (PPA, n ¼ 5) semantic dementia (SD, n ¼ 3), progressive supranuclear palsy (PSP, n ¼ 7) and corticobasal degeneration (CBD, n ¼ 2). All these subjects together with the naMCI (n ¼ 27) and the control (n ¼ 41) groups underwent a smell identification assessment using the University of Pennsylvania Smell Identification
