Article

Attention: Neuropsychological Predictor of Competency in Alzheimer's Disease

Department of Psychiatry, The Johns Hopkins Medical Institutions, Baltimore, Maryland 21287-5371, USA.
Journal of Geriatric Psychiatry and Neurology (Impact Factor: 2.24). 12/1999; 12(4):200-5. DOI: 10.1177/089198879901200406
Source: PubMed

ABSTRACT

This study was undertaken to examine the relationship between two different competencies, financial and medical decision making, and explore whether neuropsychological testing can identify a common underlying cognitive operation impaired in patients with AD. The objective was to examine the neuropsychological predictors of financial and medical decision-making competencies in patients with Alzheimer's disease (AD). Twenty individuals with mild to moderate AD and 20 control subjects matched for age and education were evaluated at a university medical center. All participants were administered a financial competency questionnaire, a competency test for medical decision making, and a set of standardized neuropsychological tests selected to reflect cognitive processes theoretically related to competency. In addition, an informant provided information regarding banking history for each participant. AD patients performed more poorly on all measures, including both measures of competency, which were highly related (R = .718, P < .001). Two tests, Trails A and Word List Recall, were significantly correlated with both competency measures, with Trails A predicting over 85% of the variance in competency scores. Trails A discriminated competent from not competent participants with an accuracy ranging from 77% to 82%. Measures of financial and medical decision-making competency were significantly correlated among patients with AD. One brief neuropsychological test of attention, Trails A, proved to be highly predictive of performance on both competency measures and useful in the discrimination of competent performance on these measures and by informant report.

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    • "The Alzheimer's disease is the most frequent cause of dementia and is responsible (alone or in association with other diseases) for 50% of the cases in western countries [1][2][3]. "

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    • "Regardless of its high incidence, doctors fail to detect dementia in 21 to 72% of the cases [1]. Much of the disease characteristics and its evolution is still unclear, besides all the progress that has been made. "
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    ABSTRACT: The Alzheimer's disease has become the most frequent cause of dementia in the last few years, and it is responsible, alone or in association with other diseases, for 50% of the cases in western countries. The main focus of this work is to develop a multicriteria model for aiding in decision making on the diagnosis of Alzheimer's disease by using the Aranau Tool, structured on the Verbal Decision Analysis. In this work, the modeling and evaluation processes were conducted with the aid of a medical expert, bibliographic sources and questionnaires. The questionnaires taken into account were based mainly on patients' neuroimaging tests, and we analyzed wheter or not there were problems in the patients' brain that could be relevant to the diagnosis of Alzheimer's disease.
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    • "In at least two minimal risk studies, up to 83% of subjects with mild to moderate dementia had adequate decisional abilities on " appreciation, " " reasoning, " and " choice " (Bassett,1999; Marson, Ingram, Cody et al, 1995). However, a recent pilot study revealed wide variability in how the informed consent process is conducted with persons with dementia (Black, Kass, Fogarty & Rabins, 2007). "
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