The German version of the CERAD - Neuropsychological Assessment Battery (CERAD-NAB) serves as the minimal common assessment instrument for Memory Clinics in German-speaking Europe. Normative data (N=1'100) including demographic (age-gender-education) adjustments are available. We aimed at investigating the German CERAD-NAB's clinical validity to identify early dementia patients. German CERAD-NAB data of 214 early (Mini-Mental State 問 18) dementia patients (150 Alzheimer's disease patients; 25 vascular dementia patients; 25 "mixed" patients (AD+VaD); 9 patients with fronto-temporal lobar degeneration; 5 patients with Lewy-body dementia) from 17 Memory Clinics (2 Austria, 10 Germany, 5 Switzerland) were pooled with our normative sample. All patients had been diagnosed independently of CERAD-NAB results. Utilizing z-scores, ten Receiver Operating Characteristic curves were generated to establish each CERAD-NAB variable's optimal cut-off score, their sensitivity and specificity. A logistic regression analysis aimed to find a combination of variables that best discriminates between patients and controls. The optimal cut-off scores were between 每1.5 (word list-discriminability) and 每0.6 (intrusion errors). Degrees of diagnostic accuracy ranged between 86% (word list每delayed recall) and 62% (intrusions). A stepwise logistic regression selected 'animal fluency', 'word list每total', 'word list每delayed recall', 'word list-discriminability' and 'constructional praxis每delayed recall' and resulted in a sensitivity of 87%, and a specificity of 97%. The current validation study revealed good to excellent discriminatory power of the German CERAD-NAB. Thus, its use as a common minimal assessment instrument in German speaking Memory Clinics is warranted. Future research will need to establish the CERAD-NAB's capacity to distinguish between different dementia etiologies.
The identification of relative strengths and weaknesses of advanced dementia patients in specific areas of cognition could help to: 1) reveal etiology-specific cognitive patterns of impairment, which allow to determine strategies to enhance communication and interactions with patients and therefore improve the care of institutionalized individuals, and 2) produce detailed neuropsychological profiles in close temporal proximity to death. We translated (culturally and literally) the Severe Impairment Battery (SIB) into German and examined 57 severely demented patients (42f, 15m; age = 83偯9 years; Mini-Mental State Examination, MMSE = 5.7 偯 5.3 [inclusion criterion: MMSE 啖 15]).
Results revealed high interrater-reliability (.992 - 1.0). 10/14 patients with an MMSE = 0 still obtained a score on the SIB. Therefore the SIB showed that the floor-effect commonly encountered in these patients using the MMSE could be avoided.
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