Tests for Cognitive Assessment in Early Alzheimer’s

Scientists are constantly trying to discover a definite treatment for Alzheimer’s, a devastating disease of the elderly. For that purpose, they have been conducting clinical trials for the last two decades with participants having a definitive diagnosis of Alzheimer’s.

The failures of trials regarding late-stage drug development and treatment options can be because they tried to explore the very late stage of the disease. Therefore, the research focus is now shifting to tackle its earliest stages.

Assessing cognition in people with early-stage Alzheimer’s via Automated Neuropsychological Test Battery (CANTAB) can help scientists develop a treatment for this ailment.

Cambridge Neuropsychological Test Automated Battery (CANTAB)

The Cambridge Neuropsychological Test Automated Battery (CANTAB) was developed at the University of Cambridge in the late 1980s to diagnose dementia in older adults. Currently, Cambridge Cognition Limited (CCL) markets it.

CANTAB is a computer-based cognitive evaluation system that includes a battery of neuropsychological tests administered to subjects via a touchscreen computer. It combines the precision and rigor of computerized psychological testing with the wide range of ability measures required of a neuropsychological battery.

This automated test battery consists of twenty-five tests that can investigate several cognitive functions, including typical memory and learning, visual memory, working memory and executive function, attention and reaction time (RT), and decision-making and response control.

Battery of tests for early Alzheimer’s

According to Cambridge Cognition2, the following test battery can sensitively measure cognition and cognitive change in people with early Alzheimer’s.

1.      Motor Screening Task (MOT)

The MOT task can assess a person’s general ability to comprehend and accomplish tasks via iPad technology and identify hearing deficits (if any) that might impede performance. It also allows patients to become acquainted with the use of a touchscreen. Participants in this task must touch the flashing cross on the screen as quickly and accurately as possible.

2.      Paired Associates Learning (PAL)

PAL is a chief component of the dementia test battery. It assesses visual and associative learning and memory and provides information about an individual’s episodic memory abilities, which usually decline in Alzheimer’s. It can also predict late-stage Alzheimer’s in patients with Mild Cognitive Impairment (MCI).

3.      Spatial Working Memory (SWM)

SWM assesses participants’ ability to retain and apply spatial information. It is self-paced, and because participants must devise a strategy, it provides insight into executive function. This task involves touching different boxes to find tokens hidden in them. The work becomes increasingly challenging as the test progresses because the player has to choose from more boxes. The players can not go to a box where they have already discovered a token.

4.      Reaction Time (RTI)

This task assesses the responsiveness and accuracy with which a person reacts in terms of attentiveness and mental and motor response speed. It can also reveal whether the participant is impulsive and if they respond prematurely or defensively.

In this task, participants must hold down a bottom-screen button until a dot appears in a circle at the top of the screen, which they must touch as quickly as possible. This dot may appear in a single (simple RTI) or any of five different circles (five-choice RTI).

5.      Rapid Visual Information Processing (RVP)

RVP assesses participants’ ability to maintain visual attention and cope with a task that requires continuous performance. Single digits appear in the center of the screen at a rate of 100 per minute. The target sequences, which participants must respond to, are displayed in a panel to the right of the central square. When the person detects a sequence, they must press a blue button at the bottom of the screen.

6.      Delayed Matching to Sample (DMS)

DMS measures participants’ visual recognition, memory, and short-term visual memory by assessing how good they are in the simultaneous and delayed matching of diverse visual stimuli to a target. In this task, the participant must match non-verbalizable patterns to the correct one out of four given choices. The sample pattern is either obscured for a delayed response or is still visible along with the options.

7.      Pattern Recognition Memory (PRM)

PRM is a 2-choice forced discrimination test that assesses visual pattern recognition memory. In the first recognition phase, the participant must choose between a previously seen pattern and a novel pattern. The second recognition phase can come immediately or after a delay.

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