Alzheimer Dementia: Cognitive decline, which scale is the most effective predictor of dementia?

In recent decades, people have realized that Alzheimer's disease (AD) takes a long time to develop, much earlier than the appearance of clinical symptoms and the diagnosis of dementia
.

Pathophysiological manifestations such as amyloid deposits and tau-related lesions can be observed ten to twenty years before the diagnosis of dementia, and the gradual changes in cognitive function can begin 12 to 15 years before the diagnosis

diagnosis

The gradual nature of disease progression emphasizes the importance of early clinical trials before the onset of dementia and irreversible damage
.

For these early-stage clinical trials, the use of dementia diagnosis time is generally considered the most effective primary endpoint

In addition to the high cost, long-term follow-up can also lead to selection bias, which may affect the validity of this standard
.

Long-term follow-up can also lead to selection bias, which may affect the validity of this standard
.

Other outcome measures can be used in early-stage trials
.

The benefit of biomarkers is an objective measure of pathophysiological progress

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Some studies have analyzed the cross-sectional measurements of different neuropsychological tests to predict the development of dementia in subjects
.

Research on the relevance of these tests over time is relatively rare

However, few studies directly compare the effectiveness of various neuropsychological and functional assessment time courses in predicting the onset of mid-term dementia in a preventive trial setting
.

Few studies directly compare the effectiveness of various neuropsychological and functional assessment time courses in predicting the onset of mid-term dementia in a preventive trial setting
.

prevention

In this way, the French University of Toulouse and others compared the effectiveness of several markers of neuropsychology and functional ability over time in 2 years to predict the occurrence of new dementia in subjects in the "GuidAge" prevention trial within 3 years Symptomatic situation
.

They compared the effectiveness of the 2-year changes (Y0-Y2) of 11 neuropsychological and functional abilities markers (Y0-Y2) in predicting the occurrence of dementia in the following 3 years (Y2-Y5).
All of these subjects were 70 Years of age or older, see a doctor due to memory loss, and have been included in the "GuidAge" prevention trial
.

The Free and Cued Selective Reminding Test-Free Recall (FCSR-FR) score showed the most predictive 2-year change (area under the curve=0.
72 95% confidence interval=0.
64; 0.
81)
.

Changes in other sub-scores of FCSRT, verbal fluency tasks, and comprehensive cognitive scores also have obvious predictive effects
.

Changes in other sub-scores of FCSRT, verbal fluency tasks, and comprehensive cognitive scores also have obvious predictive effects
.

In contrast, the 2-year changes in Mini-Mental State Examination, Trail Making test (TMT)-A, TMT-B, Clinical Dementia Rating Sum of Boxes, and Instrumental Activities of Daily Living scores did not significantly predict the occurrence of dementia
.

In the early prevention trials, FCSRT, fluency tasks, and comprehensive cognitive scores appeared to be good cognitive markers for the development of dementia
.

Original source:
Mura T, Coley N, Amieva H, et al.

Cognitive decline as an outcome and marker of progression toward dementia, in early preventive trials.
Alzheimer Dementia .

Cognitive decline as an outcome and marker of progression toward dementia, in early preventive trials.
Alzheimer Dementia

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