The CERAD Neuropsychologic Battery Total Score and the Progression of Alzheimer Disease

Department of Psychiatry, University of Texas, Southwestern Medical Center at Dallas, Dallas, TX, USA.
Alzheimer disease and associated disorders (Impact Factor: 2.44). 06/2010; 24(2):138-42. DOI: 10.1097/WAD.0b013e3181b76415
Source: PubMed


To establish the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) neuropsychologic battery as a valid measure of cognitive progression in Alzheimer disease (AD) by deriving annualized CERAD Total Change Scores and corresponding confidence intervals in AD and controls from which to define clinically meaningful change.
Subjects included 383 normal control (NC) and 655 AD subjects with serial data from the CERAD registry database. Annualized CERAD Total Change Scores were derived and Reliable Change Indexes (RCIs) calculated to establish statistically reliable change values. CERAD Change Scores were compared with annualized change scores from the Mini-Mental State Examination (MMSE), Clinical Dementia Rating Scale (CDR) Sum of Boxes, and Blessed Dementia Rating Scale (BDRS).
For the CERAD Total Score, the AD sample showed significantly greater decline than the NC sample over the 4-year interval, with AD subjects declining an average of 22.2 points compared with the NCs' improving an average 2.8 points from baseline to last visit [Group x Time interaction [F(4,1031)=246.08, P<0.001)]. By Visit 3, the majority of AD subjects (65.2%) showed a degree of cognitive decline that fell outside the RCI. CERAD Change Scores significantly correlated (P<0.001) with MMSE (r=-0.66), CDR (r=-0.42), and BDRS (r=-0.38) change scores.
Results support the utility of the CERAD Total Score as a measure of AD progression and provide comparative data for annualized change in CERAD Total Score and other summary measures.

Download full-text


Available from: Linda S Hynan,
18 Reads
    • "A significant difference in CERAD total score has been observed across dementia stages (Seo et al., 2010), as well as significantly greater annual changes in CERAD total score for AD patients compared to controls (Rossetti et al., 2010). Annual CERAD change significantly correlates with dementia severity and functional ability (Rossetti et al., 2010). It has recently been suggested that measures of function, dependence on others, or global measures may be better candidates for modeling AD progression (McLaughlin et al., 2010). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: We studied the suitability of The Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Battery (CERAD-NB) total score for monitoring Alzheimer's disease (AD) progression in early-diagnosed medicated patients. We also investigated possible differences in progression between patients with very mild or mild baseline AD. Methods: In this three-year follow-up of 115 ALSOVA study patients with clinical dementia ratings (CDR) of very mild (0.5) or mild (1) AD, we analyzed total CERAD-NB, Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), The Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory, and Clinical Dementia Rating Sum of Boxes scores. Correlations were identified with efficacy parameters. Results: Over three years, total CERAD-NB declined significantly in both groups. Annual change rates of total CERAD-NB were also significant. Total CERAD-NB revealed annual differences in cognition between study groups, while MMSE did not. Total CERAD-NB correlated well with other cognitive and global measures, but not with NPI. For almost two years, the CDR-0.5 group maintained a higher activities of daily living than the CDR-1 group exhibited at baseline. Furthermore, the CDR-0.5 group showed milder neuropsychiatric symptoms at the end of follow-up than the CDR-1 group showed at baseline. Conclusions: The CERAD total score is a suitable and sensitive follow-up tool in longitudinal AD trials. Cognition progression rates did not significantly differ between study groups; however, patients with very mild AD at baseline had milder neuropsychiatric symptoms after long-term follow-up. This emphasizes the importance of early diagnosis and assessment of neuropsychiatric symptoms at the diagnostic visit and during follow-up.
    International Psychogeriatrics 05/2013; 25(8):1-10. DOI:10.1017/S1041610213000653 · 1.93 Impact Factor
  • Source
    • "Other tests including word recall and logical memory (Wechsler 1997) are becoming more widely used in the clinic and are sensitive to the effects of dementia (Der et al. 2010; Lautenschlager et al. 2008; Mikos et al. 2010; Sachdev et al. 2009; Villemagne et al. 2008), and these tests have unequivocal findings regarding age-related changes in absence of dementia in people over 60 years of age (Nyberg et al. 2003). In addition, clinical dementia rating (CDR) scale, CDR sum of boxes, collateral clinical dementia rating scale (CCDR), and CCDR sum of boxes are useful in identifying clinical cognitive decline at a very early stage in the elderly (Cedarbaum et al. 2010; Dreyfus et al. 2010; Lynch et al. 2006; Rossetti et al. 2010). These tests are a crucial component of the quality of life in the elderly and critical for considering initiation of therapeutic options. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Traditional tests used in the clinic to identify dementia, such as the mini-mental state examination (MMSE), are useful to identify severe cognitive impairments but might be less sensitive to detect more subtle age-related cognitive changes. Previously, the novel image-novel location (NINL) object recognition test was shown to be sensitive to detect effects of apolipoprotein E4, a risk factor for developing age-related cognitive decline and Alzheimer's disease, in nondemented elderly. In the present longitudinal study, performance on the MMSE and the NINL tests were compared over a 4-year period. Individual NINL scores over this period were highly correlated. In addition, while MMSE scores did not change over the 4-year period, NINL scores did. In a final testing session of a subset of the participants, NINL scores correlated with logical memory and word recall lists, cognitive tasks used to detect dementia in the clinic, as well as clinical dementia rating scales. These results support that the NINL might be a valuable tool to assess age-related cognitive decline.
    Age 02/2011; 34(1):1-10. DOI:10.1007/s11357-010-9204-2 · 3.45 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Persistent cognitive impairment (PCI) after remission of depressive symptoms is a major adverse outcome of late-life depression (LLD). The purpose of this study was to examine neural substrates associated with PCI in LLD. Longitudinal study. Outpatient depression treatment study at Duke University. Twenty-three patients with LLD completed a 2-year follow-up study, and were in a remitted or partially remitted state at Year 2. At first entry to the study (Year 0), all participants had a functional magnetic resonance imaging scan while performing an emotional oddball task. For the purpose of this report, the primary functional magnetic resonance imaging outcome was brain activation during target detection, which is a measure of executive function. The Consortium to Establish a Registry for Alzheimer's Disease neuropsychological battery was used to assess cognitive status yearly, and the Montgomery-Åsberg Depression Rating Scale was used to assess severity of depression at Year 0 and every 6 months thereafter for 2 years. We investigated changes in brain activation at Year 0 associated with PCI over 2 years. Patients with PCI at the 2-year follow-up date had significantly decreased activation at Year 0 in the dorsal anterior cingulate cortex, hippocampus, inferior frontal cortex, and insula compared to non-PCI patients. Our results suggest individuals who have LLD with PCI have decreased activation in the similar neural networks associated with the development of Alzheimer disease among nondepressed individuals. Measuring neural activity in these regions in individuals with LLD may help identify patients at-risk for cognitive impairment.
    The American journal of geriatric psychiatry: official journal of the American Association for Geriatric Psychiatry 12/2011; 20(8):653-63. DOI:10.1097/JGP.0b013e31823e2cc7 · 4.24 Impact Factor
Show more