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Individualized Summary Assessment of Detailed Neuropsychological Testing for the Etiological Diagnosis of Newly Detected Cognitive Impairment in Hospitalized Geriatric Patients

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Individualized Summary Assessment of Detailed Neuropsychological Testing for the Etiological Diagnosis of Newly Detected Cognitive Impairment in Hospitalized Geriatric Patients. / Mäurer, Anja; Himmel, Gudrun; Lange, Catharina; Mathies, Franziska; Apostolova, Ivayla; Peters, Oliver; Buchert, Ralph.

In: J ALZHEIMERS DIS, Vol. 94, No. 2, 31.07.2023, p. 559-584.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Mäurer, A, Himmel, G, Lange, C, Mathies, F, Apostolova, I, Peters, O & Buchert, R 2023, 'Individualized Summary Assessment of Detailed Neuropsychological Testing for the Etiological Diagnosis of Newly Detected Cognitive Impairment in Hospitalized Geriatric Patients', J ALZHEIMERS DIS, vol. 94, no. 2, pp. 559-584. https://doi.org/10.3233/JAD-221273

APA

Mäurer, A., Himmel, G., Lange, C., Mathies, F., Apostolova, I., Peters, O., & Buchert, R. (2023). Individualized Summary Assessment of Detailed Neuropsychological Testing for the Etiological Diagnosis of Newly Detected Cognitive Impairment in Hospitalized Geriatric Patients. J ALZHEIMERS DIS, 94(2), 559-584. https://doi.org/10.3233/JAD-221273

Vancouver

Mäurer A, Himmel G, Lange C, Mathies F, Apostolova I, Peters O et al. Individualized Summary Assessment of Detailed Neuropsychological Testing for the Etiological Diagnosis of Newly Detected Cognitive Impairment in Hospitalized Geriatric Patients. J ALZHEIMERS DIS. 2023 Jul 31;94(2):559-584. https://doi.org/10.3233/JAD-221273

Bibtex

@article{d22135d47d48470496d2bcda846185b1,
title = "Individualized Summary Assessment of Detailed Neuropsychological Testing for the Etiological Diagnosis of Newly Detected Cognitive Impairment in Hospitalized Geriatric Patients",
abstract = "BACKGROUND: Neuropsychological testing (NPT) of geriatric inpatients can be affected by the acute illness and/or the hospitalization.OBJECTIVE: To test individualized interpretation of detailed NPT for the differentiation between primary 'neurodegenerative' etiologies (predominantly Alzheimer's disease) and 'other' etiologies (including cerebrovascular disease) of newly detected cognitive impairment in geriatric inpatients without and with delirium in remission.METHODS: 96 geriatric inpatients (81.9±5.6 years, 64.6% females) with clinically uncertain cognitive impairment were included. 31.3% had delirium in remission that was not considered the primary cause of the cognitive impairment. Categorization of the most likely etiology as 'neurodegenerative' or 'other' was established retrospectively by a study neuropsychologist based on individualized summary assessment of detailed NPT compiled in a standardized vignette. The etiological diagnosis based on FDG-PET served as gold standard (54.2% 'neurodegenerative', 45.8% 'other').RESULTS: Individualized summary assessment by the study neuropsychologist was correct in 80 patients (83.3%, 8 false positive, 8 false negative). The impact of delirium in remission was not significant (p = 0.237). Individualized summary assessment by an independent neuropsychologist resulted in more false positive cases (n = 22) at the same rate of false negative cases (n = 8). Automatic categorization with a decision tree model based on the most discriminative NPT scores was correct in 68 patients (70.8%, 14 false positive, 14 false negative).CONCLUSION: Individualized summary assessment of detailed NPT in the context of relevant clinical information might be useful for the etiological diagnosis of newly detected cognitive impairment in hospitalized geriatric patients, also in patients with delirium in remission, but requires task-specific expertise.",
keywords = "Female, Humans, Aged, Male, Retrospective Studies, Cognitive Dysfunction/diagnosis, Alzheimer Disease, Delirium/diagnosis, Neuropsychological Tests, Geriatric Assessment",
author = "Anja M{\"a}urer and Gudrun Himmel and Catharina Lange and Franziska Mathies and Ivayla Apostolova and Oliver Peters and Ralph Buchert",
year = "2023",
month = jul,
day = "31",
doi = "10.3233/JAD-221273",
language = "English",
volume = "94",
pages = "559--584",
journal = "J ALZHEIMERS DIS",
issn = "1387-2877",
publisher = "IOS Press",
number = "2",

}

RIS

TY - JOUR

T1 - Individualized Summary Assessment of Detailed Neuropsychological Testing for the Etiological Diagnosis of Newly Detected Cognitive Impairment in Hospitalized Geriatric Patients

AU - Mäurer, Anja

AU - Himmel, Gudrun

AU - Lange, Catharina

AU - Mathies, Franziska

AU - Apostolova, Ivayla

AU - Peters, Oliver

AU - Buchert, Ralph

PY - 2023/7/31

Y1 - 2023/7/31

N2 - BACKGROUND: Neuropsychological testing (NPT) of geriatric inpatients can be affected by the acute illness and/or the hospitalization.OBJECTIVE: To test individualized interpretation of detailed NPT for the differentiation between primary 'neurodegenerative' etiologies (predominantly Alzheimer's disease) and 'other' etiologies (including cerebrovascular disease) of newly detected cognitive impairment in geriatric inpatients without and with delirium in remission.METHODS: 96 geriatric inpatients (81.9±5.6 years, 64.6% females) with clinically uncertain cognitive impairment were included. 31.3% had delirium in remission that was not considered the primary cause of the cognitive impairment. Categorization of the most likely etiology as 'neurodegenerative' or 'other' was established retrospectively by a study neuropsychologist based on individualized summary assessment of detailed NPT compiled in a standardized vignette. The etiological diagnosis based on FDG-PET served as gold standard (54.2% 'neurodegenerative', 45.8% 'other').RESULTS: Individualized summary assessment by the study neuropsychologist was correct in 80 patients (83.3%, 8 false positive, 8 false negative). The impact of delirium in remission was not significant (p = 0.237). Individualized summary assessment by an independent neuropsychologist resulted in more false positive cases (n = 22) at the same rate of false negative cases (n = 8). Automatic categorization with a decision tree model based on the most discriminative NPT scores was correct in 68 patients (70.8%, 14 false positive, 14 false negative).CONCLUSION: Individualized summary assessment of detailed NPT in the context of relevant clinical information might be useful for the etiological diagnosis of newly detected cognitive impairment in hospitalized geriatric patients, also in patients with delirium in remission, but requires task-specific expertise.

AB - BACKGROUND: Neuropsychological testing (NPT) of geriatric inpatients can be affected by the acute illness and/or the hospitalization.OBJECTIVE: To test individualized interpretation of detailed NPT for the differentiation between primary 'neurodegenerative' etiologies (predominantly Alzheimer's disease) and 'other' etiologies (including cerebrovascular disease) of newly detected cognitive impairment in geriatric inpatients without and with delirium in remission.METHODS: 96 geriatric inpatients (81.9±5.6 years, 64.6% females) with clinically uncertain cognitive impairment were included. 31.3% had delirium in remission that was not considered the primary cause of the cognitive impairment. Categorization of the most likely etiology as 'neurodegenerative' or 'other' was established retrospectively by a study neuropsychologist based on individualized summary assessment of detailed NPT compiled in a standardized vignette. The etiological diagnosis based on FDG-PET served as gold standard (54.2% 'neurodegenerative', 45.8% 'other').RESULTS: Individualized summary assessment by the study neuropsychologist was correct in 80 patients (83.3%, 8 false positive, 8 false negative). The impact of delirium in remission was not significant (p = 0.237). Individualized summary assessment by an independent neuropsychologist resulted in more false positive cases (n = 22) at the same rate of false negative cases (n = 8). Automatic categorization with a decision tree model based on the most discriminative NPT scores was correct in 68 patients (70.8%, 14 false positive, 14 false negative).CONCLUSION: Individualized summary assessment of detailed NPT in the context of relevant clinical information might be useful for the etiological diagnosis of newly detected cognitive impairment in hospitalized geriatric patients, also in patients with delirium in remission, but requires task-specific expertise.

KW - Female

KW - Humans

KW - Aged

KW - Male

KW - Retrospective Studies

KW - Cognitive Dysfunction/diagnosis

KW - Alzheimer Disease

KW - Delirium/diagnosis

KW - Neuropsychological Tests

KW - Geriatric Assessment

U2 - 10.3233/JAD-221273

DO - 10.3233/JAD-221273

M3 - SCORING: Journal article

C2 - 37302033

VL - 94

SP - 559

EP - 584

JO - J ALZHEIMERS DIS

JF - J ALZHEIMERS DIS

SN - 1387-2877

IS - 2

ER -