[P3.199] Computerized Cognitive Testing of Individuals with Down Syndrome and Alzheimer Disease
Michael J. Gutman,1Ethan Moskovic,2,1Joseph Jeret1
1Rockville Centre, NY, USA, 2
BACKGROUND: Alzheimer disease (AD) neuropathology typically begins at age 35-40 years in Down syndrome (DS), with lifetime risk approaching 100%. Cognitive evaluation of these individuals is challenging and time consuming.
OBJECTIVE: The National Task Force on Intellectual Disabilities and Dementia Practices Consensus Guidelines (Mayo Clin Proc 2013; 88:831-840) acknowledged the absence of an accepted standard for cognitive assessment. We evaluated the reliability and reproducibility of an easy-to-use computerized cognitive test to serially quantify function in this population.
METHODS: 14 adults (10 females) with DS and mean age of 52 years were diagnosed with AD using ICD-10 criteria. Baseline MMSE scores were 8 to 26. All subjects were treated with a cholinesterase inhibitor (donepezil, 13, rivastigmine, 1), and 8 also received memantine. Subjects were evaluated with the NeuroTrax Moderate to Severe Impairment Assessment Battery (Mindstreams, Newark, NJ). Memory, executive function, verbal function, and visual spatial were evaluated. The test was administered 4 times at 6 month intervals.
RESULTS: Scaled scores from the first and last tests were compared. Memory (42.3, 45.5), executive function (63.2, 59.5), verbal (69.5, 73.4), visual spatial (80.1, 74.4.), and global scores (59.2, 55.9) did not significantly change. There was no significant depression on the Geriatric Depression Scale or anxiety on the Zung Self-Rating Anxiety Scale.
CONCLUSIONS: The precision, reproducibility, and ease of computerized cognitive testing make it a valuable tool in the evaluation of this particularly difficult-to-assess population. Small case studies have suggested efficacy of treatment with cholinesterase inhibitors and possibly memantine. The stability demonstrated by our cohort during the 18-month testing period could suggest therapeutic response to therapy. Randomized trials addressing this question are required
Category - Aging, Dementia, and Cognitive and Behavioral Neurology: Clinical
Tuesday, April 29, 2014 3:00 PM
P3: Poster Session III: Aging, Dementia, and Cognitive and Behavioral Neurology: Clinical Aspects (3:00 PM-6:30 PM)