1Department of Psychiatry and Psychotherapy A,General Hospital Hall,Hall in Tyrol,Austria.
2Junior Research Group Neuro-cognitive Plasticity,Leibniz Institut für Wissensmedien,Tuebingen,Germany.
J Int Neuropsychol Soc. 2018 Apr;24(4):360-371. doi: 10.1017/S1355617717001072. Epub 2017 Nov 6.
Adverse effects of heavy drinking on cognition have frequently been reported. In the present study, we systematically examined for the first time whether clinical neuropsychological assessments may be sensitive to alcohol abuse in elderly patients with suspected minor neurocognitive disorder.
A total of 144 elderly with and without alcohol abuse (each group n=72; mean age 66.7 years) were selected from a patient pool of n=738 by applying propensity score matching (a statistical method allowing to match participants in experimental and control group by balancing various covariates to reduce selection bias). Accordingly, study groups were almost perfectly matched regarding age, education, gender, and Mini Mental State Examination score. Neuropsychological performance was measured using the CERAD (Consortium to Establish a Registry for Alzheimer's Disease). Classification analyses (i.e., decision tree and boosted trees models) were conducted to examine whether CERAD variables or total score contributed to group classification.
Decision tree models disclosed that groups could be reliably classified based on the CERAD variables "Word List Discriminability" (tapping verbal recognition memory, 64% classification accuracy) and "Trail Making Test A" (measuring visuo-motor speed, 59% classification accuracy). Boosted tree analyses further indicated the sensitivity of "Word List Recall" (measuring free verbal recall) for discriminating elderly with versus without a history of alcohol abuse.
This indicates that specific CERAD variables seem to be sensitive to alcohol-related cognitive dysfunctions in elderly patients with suspected minor neurocognitive disorder. (JINS, 2018, 24, 360-371).
大量研究报告显示,大量饮酒对认知有不良影响。本研究首次系统地检验了临床神经心理学评估是否能对疑似轻度认知障碍的老年酒精滥用患者敏感。
通过应用倾向评分匹配(一种通过平衡各种协变量来减少选择偏差的统计方法),从 738 名患者中选择了 144 名有和没有酒精滥用的老年患者(每组 n=72;平均年龄 66.7 岁)。因此,研究组在年龄、教育、性别和 Mini 精神状态检查评分方面几乎完全匹配。神经心理学表现使用 CERAD(建立阿尔茨海默病登记册联盟)进行测量。分类分析(即决策树和提升树模型)用于检验 CERAD 变量或总分是否有助于组分类。
决策树模型表明,基于 CERAD 变量“单词列表辨别力”(测试语言识别记忆,64%的分类准确性)和“轨迹形成测试 A”(测量视运动速度,59%的分类准确性)可以可靠地对组进行分类。提升树分析进一步表明,“单词列表回忆”(测试自由语言回忆)对区分有和无酒精滥用史的老年人具有敏感性。
这表明特定的 CERAD 变量似乎对疑似轻度认知障碍的老年酒精滥用患者的酒精相关认知功能障碍敏感。(JINS,2018,24,360-371)。