Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado, USA.
Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA.
J Clin Exp Neuropsychol. 2022 Apr;44(3):226-236. doi: 10.1080/13803395.2022.2105820. Epub 2022 Aug 1.
Non-amnestic presentations of neurodegenerative dementias, including posterior- and visual-predominant cognitive forms, are under-recognized. Specific screening measures for posterior cortical symptoms could allow for earlier, more accurate diagnosis and directed treatment.
Based on clinical experience with posterior cortical atrophy evaluations, high-yield screening questions were collected and organized into a 15-item self-report questionnaire, titled the Colorado Posterior Cortical Questionnaire (CPC-Q). The CPC-Q was then piloted within a longitudinal cohort of cognitive aging, including 63 older adults, including healthy older adults (n = 33) and adults with either amnestic Alzheimer's disease (n = 21) or posterior cortical atrophy (PCA, n = 9).
The CPC-Q demonstrated acceptable psychometric properties (internal consistency, α = 0.89; mean item-total correlation = 0.62), correlated strongly with visuospatial measures on cognitive testing (p < 0.001), and could distinguish PCA from non-PCA groups (p < 0.001; AUC 0.95 (95% CI 0.88, 1.0)).
The CPC-Q captured posterior cortical symptoms in older adults, using a gold standard of expert consensus PCA diagnosis. Future studies will validate the CPC-Q in a larger cohort, with recruitment of additional PCA participants, to evaluate its convergent and discriminant validity more thoroughly. As a short, self-report tool, the CPC-Q demonstrates potential to improve detection of non-amnestic neurodegenerative dementias in the clinical setting.
神经退行性痴呆的非遗忘型表现,包括后部和视觉为主的认知形式,尚未得到充分认识。针对后部皮质症状的特定筛查措施可以实现更早、更准确的诊断和针对性治疗。
基于对后部皮质萎缩评估的临床经验,收集了高产量的筛查问题,并将其组织成一个 15 项的自我报告问卷,名为科罗拉多后部皮质问卷(CPC-Q)。然后,在认知老化的纵向队列中对 CPC-Q 进行了试点研究,包括 63 名老年人,包括健康老年人(n=33)和患有遗忘型阿尔茨海默病(n=21)或后部皮质萎缩(PCA,n=9)的成年人。
CPC-Q 表现出可接受的心理测量特性(内部一致性,α=0.89;平均项目总分相关性=0.62),与认知测试中的视觉空间测量密切相关(p<0.001),并且可以区分 PCA 和非 PCA 组(p<0.001;AUC 0.95(95%CI 0.88, 1.0))。
CPC-Q 使用专家共识 PCA 诊断的金标准来捕捉老年人的后部皮质症状。未来的研究将在更大的队列中验证 CPC-Q 的有效性,招募更多的 PCA 参与者,以更全面地评估其收敛和判别效度。作为一种简短的自我报告工具,CPC-Q 具有在临床环境中提高非遗忘性神经退行性痴呆检测能力的潜力。