REMEDES for Alzheimer-R4Alz Battery: Design and Development of a New Tool of Cognitive Control Assessment for the Diagnosis of Minor and Major Neurocognitive Disorders

J Alzheimers Dis. 2019;72(3):783-801. doi: 10.3233/JAD-190798.

Abstract

Background: Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are acknowledged stages of the clinical spectrum of Alzheimer's disease (AD), and cognitive control seems to be among the first neuropsychological predictors of cognitive decline. Existing tests are usually affected by educational level, linguistic abilities, cultural differences, and social status, constituting them error-prone when differentiating between the aforementioned stages. Creating robust neuropsychological tests is therefore prominent.

Objective: The design of a novel psychometric battery for the cognitive control and attention assessment, free of demographic effects, capable to discriminate cognitively healthy aging, SCD, MCI, and mild Dementia (mD).

Methods: The battery initial hypothesis was tuned using iterations of administration on random sampling healthy older adults and people with SCD, MCI, and mD, from the area of Thessaloniki, Greece. This resulted in the first release of the REflexes MEasurement DEviceS for Alzheimer battery (REMEDES for Alzheimer-R4Alz).

Results: The first release lasts for almost an hour. The battery was design to assess working memory (WM) including WM storage, processing, and updating, enriched by episodic buffer recruitment. It was also designed to assess attention control abilities comprising selective, sustained, and divided attention subtasks. Finally, it comprises an inhibitory control, a task/rule switching or set-shifting, and a cognitive flexibility subtask as a combination of inhibition and task/rule switching abilities.

Conclusion: The R4Alz battery is an easy to use psychometric battery with increasing difficulty levels and assumingly ecological validity, being entertaining for older adults, potentially free of demographic effects, and promising as a more accurate and early diagnosis tool of neurodegeneration.

Keywords: Attentional control; cognitive control; dementia; healthy aging; mild cognitive impairment; psychometric assessment; subjective cognitive decline.

MeSH terms

  • Aged
  • Alzheimer Disease / diagnosis*
  • Alzheimer Disease / psychology
  • Cognitive Dysfunction / diagnosis*
  • Cognitive Dysfunction / psychology
  • Female
  • Healthy Aging / physiology
  • Healthy Aging / psychology
  • Humans
  • Male
  • Memory, Short-Term / physiology*
  • Mental Status and Dementia Tests*
  • Neurocognitive Disorders / diagnosis
  • Neurocognitive Disorders / psychology
  • Neuropsychological Tests
  • Psychometrics / instrumentation
  • Psychometrics / methods*
  • Psychomotor Performance / physiology*