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Target Symptoms and Outcome Measures: Cognition

Published online by Cambridge University Press:  02 December 2014

Andrew Kirk
Andrew Kirk*
Affiliation:
The Division of Neurology, University of Saskatchewan, Royal University Hospital, Saskatoon, Saskatchewan, Canada
*
University of Saskatchewan, Royal University Hospital, 103 Hospital Drive, Saskatoon, Saskatchewan S7N 0W8, Canada.
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Abstract

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The Cognitive section of the Alzheimer's Disease Assessment Scale (ADAS-Cog) remains the most widely used cognitive measure in dementia trials although it does not assess attention, executive function, or agnosia. Designed for use in Alzheimer's disease (AD), it may not be ideal in assessing patients with other diagnoses. The ADAS-Cog differentiates between AD patients, patients with Mild Cognitive Impairment, and normal controls. It has been used in trials of drugs for vascular and mixed dementia and dementia with Lewy bodies. It is not clear that the ADAS-Cog is adequate for assessing cognition in frontotemporal dementia. Well-validated aphasia batteries, such as the Western Aphasia Battery, can be used to assess language. Brief tests of frontal function such as the Frontal Assessment Battery or the Executive Interview might be useful additions in frontotemporal dementia trials. The most widely used assessment tool for patients with advanced dementia is the Severe Impairment Battery. The domains tested are analogous to those assessed by the ADAS-Cog. The Mini-Mental State Exam and the Modified Mini-Mental State Examination are useful in stratifying patients for trial entry. Cognitive measures better tailored to the diseases in question are needed for non-Alzheimer dementias.

Résumé:

RÉSUMÉ:

La section sur la cognition de l'Alzheimer's Disease Assessment Scale (ADAS-Cog) demeure la mesure cognitive la plus utilisée dans les essais cliniques sur la démence, même si elle n'évalue pas l'attention, les fonctions exécutives ou l'agnosie. Cette échelle a été conçue pour être utilisée dans la maladie d'Alzheimer et n'est peut-être pas idéale pour évaluer les patients qui sont atteints d'autres pathologies. L'ADAS-Cog différencie les patients atteints de MA des patients ayant une atteinte cognitive légère et des témoins normaux. Elle a été utilisée dans les essais cliniques portant sur les démences vasculaires et mixtes et la démence à corps de Lewy. Il n'est pas certain que l'ADAS-Cog soit adéquat pour évaluer la cognition dans la démence fronto-temporale. Des batteries bien validées pour évaluer l'aphasie comme la Western Aphasia Battery peuvent être utilisées pour évaluer le langage. Des tests brefs de la fonction frontale comme la batterie d'évaluation frontale ou l'Executive Interview peuvent être ajoutés avec profit dans les études sur la démence fronto-temporale. L'outil le plus utilisé chez les patients qui ont une démence sévère est la Severe Impairment Battery. Les domaines évalués sont analogues à ceux qui sont évalués par l'ADAS-Cog. Le Mini-Mental State Exam et le Mini-Mental State Examination sont utiles pour stratifier les patients au début des études. Des mesures cognitives qui sont mieux adaptées aux maladies en question devront être développées pour les démences autres que la MA.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 34 , Issue S1 , March 2007 , pp. S42 - S46
Copyright
Copyright © The Canadian Journal of Neurological 2007

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