Department of Neurology, Federal University of The State of Rio de Janeiro, Rio de Janeiro, Brazil.
Department of Geriatrics, Fluminense Federal University, Niteroi, Brazil.
J Alzheimers Dis. 2021;81(2):691-697. doi: 10.3233/JAD-210151.
The Clinical Dementia Rating (CDR) scale is commonly used to stage cognitive impairment, despite having educational limitations. In elderly with low education, a previous study has shown that intraindividual variability of reaction time (CV) and commission errors (CE), measured using a culture-free Go/No-Go task, can reliably distinguish early Alzheimer's disease (AD) from mild cognitive impairment (MCI) and healthy controls.
We aimed to extend the clinical utility of this culture-free Go/No-Go task in a sample with high educational disparity.
One hundred and ten participants with a wide range of years of formal education (0-14 years) were randomly selected from a geriatric unit and divided based on their CDR scores into cognitively unimpaired (CDR = 0), MCI (CDR = 0.5), and early AD (CDR = 1). All underwent a 90-s reaction-time test that measured the variables previously found to predict CDR in low educated elderly. Here we added years of formal education (educational level) to the model. Multivariate analyses compared differences in group means using educational level as confounding factor. A confirmatory discriminant analyses was performed, to assess if CDR scores could be predicted by the two Go/No-Go variables in a sample with high educational disparity.
Over all three groups, differences in both CE and CV reached statistical significance (p < 0.05). The discriminant analysis demonstrated that CV and CE discriminated cognitively impaired from cognitively normal elderly. These results remained similar when discriminating MCI from cognitively unimpaired elderly.
The Go/No-Go task reliably discriminates elderly with MCI from elderly without cognitive impairment independent of educational disparity.
尽管存在教育限制，临床痴呆评定量表（CDR）仍常用于对认知障碍进行分期。在受教育程度较低的老年人中，先前的研究表明，使用无文化差异的 Go/No-Go 任务测量的反应时（CV）和误报率（CE）的个体内变异性，可以可靠地区分早期阿尔茨海默病（AD）与轻度认知障碍（MCI）和健康对照组。
我们旨在扩展这种无文化差异的 Go/No-Go 任务在教育程度差异较大的样本中的临床应用。
从老年科病房中随机选择了 110 名具有广泛正规教育年限（0-14 年）的参与者，并根据其 CDR 评分分为认知正常（CDR=0）、MCI（CDR=0.5）和早期 AD（CDR=1）。所有参与者均接受了 90 秒的反应时间测试，该测试测量了先前在受教育程度较低的老年人中预测 CDR 的变量。在这里，我们将正规教育年限（教育水平）添加到模型中。使用多元分析比较了组均值的差异，将教育水平作为混杂因素。进行了验证性判别分析，以评估在教育程度差异较大的样本中，CDR 评分是否可以通过两个 Go/No-Go 变量来预测。
在所有三组中，CE 和 CV 的差异均具有统计学意义（p<0.05）。判别分析表明，CV 和 CE 可以区分认知障碍和认知正常的老年人。当将 MCI 与认知正常的老年人进行区分时，这些结果仍然相似。
无论教育程度差异如何，Go/No-Go 任务都能可靠地区分 MCI 老年人和无认知障碍的老年人。
