Clinical Psychology PhD Program, California School of Professional Psychology, San Diego, CA 92131, USA.
Institute of Brain Research and Integrated Neuropsychological Services (iBRAINs.org), San Diego, CA 92105, USA.
Arch Clin Neuropsychol. 2023 Oct 20;38(7):991-1016. doi: 10.1093/arclin/acad036.
Despite decades of research, neuropsychological tests (NPTs) that clearly differentiate between Alzheimer's disease (AD) and late-life depression (LLD) have yet to be agreed upon. Given this gap in knowledge and the rapid deployment of disease-modifying drugs for the two disorders, accurate clinical diagnosis using evidence-based assessment is essential. This study aims to systematically examine the literature to identify NPTs that would be able to differentiate AD and LLD.
Databases and bibliographies were searched to identify articles for analysis. Two major inclusion criteria were that the studies compared neuropsychological functioning of AD versus LLD using normed NPTs and provided data for effect size calculation. Risk of bias was minimized by having independent coders for all steps in the review.
Forty-one studies met inclusion criteria (N = 2,797) and provided effect sizes for tests that were classified as belonging to 15 domains of functioning. The two groups were well differentiated by tasks of delayed contextual verbal memory as compared to immediate or non-contextual memory, recognition cueing, confrontation naming, visuospatial construction, and conceptualization. Specific NPTs that appear to be useful for differential diagnosis include the Rey Auditory Verbal Learning Test-Delayed Recognition; Boston Naming Test; the Dementia Rating Scale's memory, conceptualization, and construction subscales; and the CERAD Constructional Praxis.
The NPTs highlighted in this systematic review could be used as a relatively simple and cost-effective method to differentiate between patients with cognitive dysfunction due to AD versus LLD.
尽管经过了几十年的研究，但仍未达成一致意见，即哪种神经心理学测试（NPT）能明确区分阿尔茨海默病（AD）和老年期抑郁症（LLD）。鉴于这方面知识的空白以及这两种疾病的疾病修饰药物的快速应用，使用基于证据的评估进行准确的临床诊断至关重要。本研究旨在系统地检查文献，以确定能够区分 AD 和 LLD 的 NPT。
搜索数据库和参考文献，以确定进行分析的文章。主要纳入标准有两个，一是使用规范化的 NPT 比较 AD 与 LLD 的神经心理学功能，并提供用于计算效应大小的数据；二是通过对综述的所有步骤都由独立的编码员进行，以最大程度地降低偏倚风险。
41 项研究符合纳入标准（N=2797），并提供了分类为 15 个功能领域的测试的效应大小。与即时或非语境记忆、识别提示、正面命名、视空间构建和概念化相比，延迟语境言语记忆任务能更好地区分两组。似乎对鉴别诊断有用的特定 NPT 包括 Rey 听觉言语学习测试延迟识别、波士顿命名测试、痴呆评定量表的记忆、概念化和构建分量表以及 CERAD 构建实践。
本系统综述中强调的 NPT 可以作为一种相对简单且具有成本效益的方法，用于区分因 AD 还是 LLD 导致认知功能障碍的患者。
