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Cross-validation of a Shortened Battery for the Assessment of Dysexecutive Disorders in Alzheimer Disease

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The frequency of executive disorders in mild-to-moderate Alzheimer disease (AD) has been demonstrated by the application of a comprehensive battery. The present study analyzed data from 2 recent multicenter studies based on the same executive battery. The objective was to derive a shortened battery by using the GREFEX population as a training dataset and by cross-validating the results in the REFLEX population. A total of 102 AD patients of the GREFEX study (MMSE=23.2±2.9) and 72 patients of the REFLEX study (MMSE=20.8±3.5) were included. Tests were selected and receiver operating characteristic curves were generated relative to the performance of 780 controls from the GREFEX study. Stepwise logistic regression identified 3 cognitive tests (Six Elements Task, categorical fluency and Trail Making Test B error) and behavioral disorders globally referred as global hypoactivity (P=0.0001, all). This shortened battery was as accurate as the entire GREFEX battery in diagnosing dysexecutive disorders in both training group and the validation group. Bootstrap procedure confirmed the stability of AUC. A shortened battery based on 3 cognitive tests and 3 behavioral domains provides a high diagnosis accuracy of executive disorders in mild-to-moderate AD.
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Keywords: Alzheimer disease; apathy; attention; executive function; mild cognitive impairment; sensitivity and specificity

Document Type: Research Article

Affiliations: 1: Departments of Neurology, Laboratory of Functional Neurosciences 2: Department of Neurology, Rouen University Hospital, Rouen 3: Geriatric Center, CMRR, Pitié-Salpêtrière University Hospital (AP-HP and UPMC) 4: Department of Neurology, CMRR, University Hospital of Grenoble, Grenoble 5: Department of Gerontology, Research Team EA4468, Broca Hospital 6: Department of Neurology, General Hospital of Cholet, Cholet 7: Biostatistics, University Hospital of Amiens, Amiens 8: Novartis Pharma SAS, Paris 9: Department of Neurology, University Hospital of Reims, Reims 10: Office of Neurology, Bergerac, France

Publication date: April 1, 2016

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