Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
1Florida Alzheimer's Disease Research Center, Miami, FL, USA.
J Alzheimers Dis. 2020;78(2):789-799. doi: 10.3233/JAD-200790.
The Loewenstein-Acevedo Scales for Semantic Interference and Learning (LASSI-L) is an increasingly utilized cognitive stress test designed to identify early cognitive changes associated with incipient neurodegenerative disease.
To examine previously derived cut-points for cognitively unimpaired older adults that were suggestive of performance impairment on multiple subscales of the LASSI-L. These cut-points were applied to a new sample of older adults who were cognitive healthy controls (HC: n = 26) and those on the Alzheimer's disease (AD) continuum from early stage mild cognitive impairment (EMCI: n = 28), late stage MCI (LMCI: n = 18) to mild AD (AD: n = 27).
All participants were administered the LASSI-L. All cognitively impaired participants were PET amyloid positive which likely reflects underlying AD neuropathology, while cognitively normal counterparts were deemed to have amyloid negative scans.
There was a monotonic relationship between the number of deficits on LASSI-L subscales and independent classification of study groups with greater severity of cognitive impairment. Importantly, taken together, impairment on maximum learning ability and measures of proactive semantic interference (both reflected by cued recall and intrusion errors) correctly classified 74.1% of EMCI, 94.4% of LMCI, and 96.3% of AD. Only 7.7% of HC were incorrectly classified as having impairments.
A modest number of LASSI-L subscales taking approximately 8 minutes to administer, had excellent discriminative ability using established cut-offs among individuals with presumptive stages of AD. This has potential implications for both clinical practice and clinical research settings targeting AD during early prodromal stages.
Loewenstein-Acevedo 语义干扰和学习量表(LASSI-L)是一种越来越常用的认知应激测试,旨在识别与早期神经退行性疾病相关的早期认知变化。
检查先前为认知正常的老年人确定的认知障碍切点,这些切点提示 LASSI-L 的多个分量表存在表现障碍。这些切点适用于新的认知健康对照组老年人样本(HC:n=26)和阿尔茨海默病(AD)连续体的早期轻度认知障碍(EMCI:n=28)、晚期轻度认知障碍(LMCI:n=18)到轻度 AD(AD:n=27)。
所有参与者均接受 LASSI-L 测试。所有认知障碍患者均进行 PET 淀粉样蛋白阳性检测,这可能反映了潜在的 AD 神经病理学,而认知正常的患者则被认为是淀粉样蛋白阴性扫描。
LASSI-L 分量表上的缺陷数量与研究组的独立分类之间存在单调关系,认知障碍的严重程度更高。重要的是,综合来看,最大学习能力和主动语义干扰的测量(均由提示回忆和干扰错误反映)的损害可以正确分类 74.1%的 EMCI、94.4%的 LMCI 和 96.3%的 AD。只有 7.7%的 HC 被错误分类为有损伤。
使用既定的 AD 假定阶段的切点,在大约 8 分钟内进行少量的 LASSI-L 分量表测试,具有出色的判别能力。这对 AD 早期前驱阶段的临床实践和临床研究环境都具有潜在意义。