A composite score for executive functioning, validated in Alzheimer’s Disease Neuroimaging Initiative (ADNI) participants with baseline mild cognitive impairment

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• 作者：Laura E. Gibbons (1)
  Adam C. Carle (2)
  R. Scott Mackin (3)
  Danielle Harvey (4)
  Shubhabrata Mukherjee (1)
  Philip Insel (3)
  S. McKay Curtis (1)
  Dan Mungas (5)
  Paul K. Crane (1)
  
• 关键词：Executive function ; Mild cognitive impairment ; Item response theory ; Composite scores
• 刊名：Brain Imaging and Behavior
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：6
• 期：4
• 页码：517-527
• 全文大小：244KB
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• 作者单位：Laura E. Gibbons (1)
  Adam C. Carle (2)
  R. Scott Mackin (3)
  Danielle Harvey (4)
  Shubhabrata Mukherjee (1)
  Philip Insel (3)
  S. McKay Curtis (1)
  Dan Mungas (5)
  Paul K. Crane (1)
  
  1. Harborview Medical Center, University of Washington, Box 359780, 325 Ninth Avenue, Seattle, WA, 98104, USA
  2. Cincinnati Children’s Hospital Medical Center, University of Cincinnati School of Medicine and University of Cincinnati College of Arts and Sciences, 3333 Burnet Avenue, MLC 7014, Cincinnati, OH, 45229, USA
  3. Center for Imaging of Neurodegenerative Diseases (CIND), San Francisco VA Medical Center, 4150 Clement Street, San Francisco, CA, 94121, USA
  4. Division of Biostatistics, Department of Public Health Sciences, University of California, One Shields Avenue, Davis, CA, 95616, USA
  5. Department of Neurology, UC Davis Medical Center, 4860 Y Street, Sacramento, CA, 95817, USA
  

文摘

The Alzheimer’s Disease Neuroimaging Initiative (ADNI) measures abilities broadly related to executive function (EF), including WAIS-R Digit Symbol Substitution, Digit Span Backwards, Trails A and B, Category Fluency, and Clock Drawing. This study investigates whether a composite executive function measure based on these multiple indicators has better psychometric characteristics than the widely used individual components. We applied item response theory methods to 800 ADNI participants to derive an EF composite score (ADNI-EF) from the above measures. We then compared ADNI-EF with component measures in 390 longitudinally-followed participants with mild cognitive impairment (MCI) with respect to: (1) Ability to detect change over time; (2) Ability to predict conversion to dementia; (3) Strength of cross-sectional association with MRI-derived measures of structures involved in frontal systems, and (4) Strength of baseline association with cerebrospinal fluid (CSF) levels of amyloid β1-42, total tau, and phosphorylated tau181P. ADNI-EF showed the greatest change over time, followed closely by Category Fluency. ADNI-EF needed a 40?% smaller sample size to detect change. ADNI-EF was the strongest predictor of AD conversion. ADNI-EF was the only measure significantly associated with all the MRI regions, though other measures were more strongly associated in a few of the regions. ADNI-EF was associated with all the CSF measures. ADNI-EF appears to be a useful composite measure of EF in MCI, as good as or better than any of its composite parts. This study demonstrates an approach to developing a psychometrically sophisticated composite score from commonly-used tests.