David A Loewenstein1, Rosie E Curiel2, Maria T Greig3, Russell M Bauer4, Marian Rosado2, Dawn Bowers4, Meredith Wicklund4, Elizabeth Crocco2, Michael Pontecorvo5, Abhinay D Joshi5, Rosemarie Rodriguez3, Warren W Barker3, Jacqueline Hidalgo3, Ranjan Duara6. 1. Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami and Center of Aging, Miami, FL; Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL; Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Gainesville, FL. Electronic address: DLoewenstein@miami.edu. 2. Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami and Center of Aging, Miami, FL. 3. Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL; Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Gainesville, FL. 4. Department of Clinical and Health Psychology, University of Florida, Gainesville, FL; Department of Neurology, University of Florida, Gainesville, FL. 5. Avid Radiopharmaceuticals, Philadelphia, PA. 6. Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL; Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, Gainesville, FL; Department of Neurology, University of Florida, Gainesville, FL; Department of Neurology, Florida International University, Miami, FL.
Abstract
OBJECTIVE: To examine the utility of a novel "cognitive stress test" to detect subtle cognitive impairments and amyloid load within the brains of neuropsychologically normal community-dwelling elders. METHODS: Participants diagnosed as cognitively normal (CN), subjective memory impairment (SMI), mild cognitive impairment (MCI), and preclinical mild cognitive impairment (PreMCI) were administered the Loewenstein-Acevedo Scale for Semantic Interference and Learning (LASSI-L), a sensitive test of proactive semantic interference (PSI), retroactive semantic interference, and, uniquely, the ability to recover from the effects of PSI. Ninety-three subjects (31 men and 62 women) were recruited from three academic institutions in a research consortium. A subset of these individuals underwent 18F florbetapir positron emission tomography scanning. Relative percentages of impairment for each diagnostic group on the LASSI-L were calculated by χ(2) and Fisher's exact tests. Spearman's rho was used to examine associations between amyloid load and different cognitive measures. RESULTS: LASSI-L deficits were identified among 89% of those with MCI, 47% with PreMCI, 33% with SMI, and 13% classified as CN. CN subjects had no difficulties with recovery from PSI, whereas SMI, preMCI, and MCI participants evidenced deficits in recovery from PSI effects. Among a subgroup of participants with normal scores on traditional neuropsychological tests, the strong associations were between the failure to recover from the effects of PSI and amyloid load in the brain. CONCLUSION: Failure to recover or compensate for the effects of PSI on the LASSI-L distinguishes the LASSI-L from other widely used neuropsychological tests and appears to be sensitive to subtle cognitive impairments and increasing amyloid load.
OBJECTIVE: To examine the utility of a novel "cognitive stress test" to detect subtle cognitive impairments and amyloid load within the brains of neuropsychologically normal community-dwelling elders. METHODS:Participants diagnosed as cognitively normal (CN), subjective memory impairment (SMI), mild cognitive impairment (MCI), and preclinical mild cognitive impairment (PreMCI) were administered the Loewenstein-Acevedo Scale for Semantic Interference and Learning (LASSI-L), a sensitive test of proactive semantic interference (PSI), retroactive semantic interference, and, uniquely, the ability to recover from the effects of PSI. Ninety-three subjects (31 men and 62 women) were recruited from three academic institutions in a research consortium. A subset of these individuals underwent 18Fflorbetapir positron emission tomography scanning. Relative percentages of impairment for each diagnostic group on the LASSI-L were calculated by χ(2) and Fisher's exact tests. Spearman's rho was used to examine associations between amyloid load and different cognitive measures. RESULTS: LASSI-L deficits were identified among 89% of those with MCI, 47% with PreMCI, 33% with SMI, and 13% classified as CN. CN subjects had no difficulties with recovery from PSI, whereas SMI, preMCI, and MCI participants evidenced deficits in recovery from PSI effects. Among a subgroup of participants with normal scores on traditional neuropsychological tests, the strong associations were between the failure to recover from the effects of PSI and amyloid load in the brain. CONCLUSION: Failure to recover or compensate for the effects of PSI on the LASSI-L distinguishes the LASSI-L from other widely used neuropsychological tests and appears to be sensitive to subtle cognitive impairments and increasing amyloid load.
Authors: Reisa A Sperling; Keith A Johnson; P Murali Doraiswamy; Eric M Reiman; Adam S Fleisher; Marwan N Sabbagh; Carl H Sadowsky; Alan Carpenter; Mat D Davis; Ming Lu; Matthew Flitter; Abhinay D Joshi; Christopher M Clark; Michael Grundman; Mark A Mintun; Daniel M Skovronsky; Michael J Pontecorvo Journal: Neurobiol Aging Date: 2012-08-09 Impact factor: 4.673
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