Abstract
With an increasing focus on biomarkers in dementia research, illustrating the role of neuropsychological assessment in detecting mild cognitive impairment (MCI) and Alzheimer’s dementia (AD) is important. This systematic review and meta-analysis, conducted in accordance with PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) standards, summarizes the sensitivity and specificity of memory measures in individuals with MCI and AD. Both meta-analytic and qualitative examination of AD versus healthy control (HC) studies (n = 47) revealed generally high sensitivity and specificity (≥ 80% for AD comparisons) for measures of immediate (sensitivity = 87%, specificity = 88%) and delayed memory (sensitivity = 89%, specificity = 89%), especially those involving word-list recall. Examination of MCI versus HC studies (n = 38) revealed generally lower diagnostic accuracy for both immediate (sensitivity = 72%, specificity = 81%) and delayed memory (sensitivity = 75%, specificity = 81%). Measures that differentiated AD from other conditions (n = 10 studies) yielded mixed results, with generally high sensitivity in the context of low or variable specificity. Results confirm that memory measures have high diagnostic accuracy for identification of AD, are promising but require further refinement for identification of MCI, and provide support for ongoing investigation of neuropsychological assessment as a cognitive biomarker of preclinical AD. Emphasizing diagnostic test accuracy statistics over null hypothesis testing in future studies will promote the ongoing use of neuropsychological tests as Alzheimer’s disease research and clinical criteria increasingly rely upon cerebrospinal fluid (CSF) and neuroimaging biomarkers.
Original language | English |
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Pages (from-to) | 354-388 |
Number of pages | 35 |
Journal | Neuropsychology Review |
Volume | 27 |
Issue number | 4 |
DOIs | |
State | Published - 1 Dec 2017 |
Externally published | Yes |
Bibliographical note
Publisher Copyright:© 2017, US Government (outside the USA).
Funding
Acknowledgements This research was partially supported by the Department of Veterans Affairs, Veterans Health Administration, VISN 1 Career Development Award (N.H.S.), as well as National Institutes of Health grants R01 AG049810 (M.W.B.) and K24 AG026431 (M.W.B.). This material is also based upon work supported by the Office of Academic Affiliations, Department of Veterans Affairs. NHS serves as a consultant to Biogen. MWB serves as a consultant to Novartis and Eisai and receives royalties from Oxford University Press. KS was supported in this work by a University of the Sunshine Coast Research Scholarship. MS reports personal fees from Eli Lily (Australia) Pty Ltd and grants from Novotech Pty Ltd, outside the submitted work. The authors report no conflicts of interest. The contents of this article do not represent the views of the U.S. Department of Veterans Affairs of the United States Government.
Funders | Funder number |
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Novotech Pty Ltd | |
Office of Academic Affiliations | |
Pty Ltd | |
University of the Sunshine Coast Research Scholarship | |
National Institutes of Health | R01 AG049810 |
National Institute on Aging | K24AG026431 |
U.S. Department of Veterans Affairs | |
Health Services Research and Development |
Keywords
- Alzheimer’s disease
- Memory
- Meta-analysis
- Mild cognitive impairment
- Neuropsychological testing
- Sensitivity and specificity