Bock Jason R, Russell Julie, Hara Junko, Fortier Dennis
Embic Corporation, Newport Beach, CA, United States.
Front Digit Health. 2021 Nov 3;3:750549. doi: 10.3389/fdgth.2021.750549. eCollection 2021.
Cognitive assessment with wordlist memory tests is a cost-effective and non-invasive method of identifying cognitive changes due to Alzheimer's disease and measuring clinical outcomes. However, with a rising need for more precise and granular measures of cognitive changes, especially in earlier or preclinical stages of Alzheimer's disease, traditional scoring methods have failed to provide adequate accuracy and information. Well-validated and widely adopted wordlist memory tests vary in many ways, including list length, number of learning trials, order of word presentation across trials, and inclusion of semantic categories, and these differences meaningfully impact cognition. While many simple scoring methods fail to account for the information that these features provide, extensive effort has been made to develop scoring methodologies, including the use of latent models that enable capture of this information for preclinical differentiation and prediction of cognitive changes. In this perspective article, we discuss prominent wordlist memory tests in use, their features, how different scoring methods fail or successfully capture the information these features provide, and recommendations for emerging cognitive models that optimally account for wordlist memory test features. Matching the use of such scoring methods to wordlist memory tests with appropriate features is key to obtaining precise measurement of subtle cognitive changes.
使用单词列表记忆测试进行认知评估是一种经济高效且非侵入性的方法,可用于识别由阿尔茨海默病引起的认知变化并衡量临床结果。然而,随着对认知变化进行更精确和细致测量的需求不断增加,尤其是在阿尔茨海默病的早期或临床前阶段,传统的评分方法未能提供足够的准确性和信息。经过充分验证且被广泛采用的单词列表记忆测试在许多方面存在差异,包括列表长度、学习试验次数、各试验中单词呈现的顺序以及语义类别的纳入情况,而这些差异对认知有显著影响。虽然许多简单的评分方法未能考虑这些特征所提供的信息,但人们已付出大量努力来开发评分方法,包括使用潜在模型,以便能够获取这些信息用于临床前鉴别和认知变化预测。在这篇观点文章中,我们讨论了目前使用的主要单词列表记忆测试、它们的特征、不同评分方法如何未能或成功获取这些特征所提供的信息,以及针对能够最佳考虑单词列表记忆测试特征的新兴认知模型的建议。将此类评分方法与具有适当特征的单词列表记忆测试相匹配,是精确测量细微认知变化的关键。