REMEDES for Alzheimer-R4Alz Battery: Design and Development of a New Tool of Cognitive Control Assessment for the Diagnosis of Minor and Major Neurocognitive Disorders

Article type: Research Article

Authors: Poptsi, Eleni^{a; b; *} | Tsardoulias, Emmanouil^c | Moraitou, Despina^{a; b} | Symeonidis, Andreas L.^c | Tsolaki, Magda^{b; d; *}

Affiliations: [a] Laboratory of Psychology, Section of Cognitive and Experimental Psychology, Faculty of Philosophy, School of Psychology, Aristotle University of Thessaloniki (AUTh), Thessaloniki, Greece | [b] Greek Association of Alzheimer’s Disease and Related Disorders, Thessaloniki (GAADRD), Greece | [c] School of Electrical and Computer Engineering, Faculty of Engineering, Aristotle University of Thessaloniki (AUTh), Thessaloniki, Greece | [d] 1st Department of Neurology, School of Medicine, Aristotle University of Thessaloniki (AUTh), Thessaloniki, Greece

Correspondence: [*] Correspondence to: Eleni Poptsi, Laboratory of Psychology, Section of Cognitive and Experimental Psychology, Faculty of Philosophy, School of Psychology, Aristotle University of Thessaloniki (AUTh), Thessaloniki, Greece. E-mail: [email protected] and Magda Tsolaki, 1st Department of Neurology, School of Medicine, Aristotle University of Thessaloniki (AUTh), Greece; University Campus 54124 Thessaloniki, Greece. E-mail: [email protected].

Abstract: Background:Subjective cognitive decline (SCD) and mild cognitive impairment (MCI) are acknowledged stages of the clinical spectrum of Alzheimer’s disease (AD), and cognitive control seems to be among the first neuropsychological predictors of cognitive decline. Existing tests are usually affected by educational level, linguistic abilities, cultural differences, and social status, constituting them error-prone when differentiating between the aforementioned stages. Creating robust neuropsychological tests is therefore prominent. Objective:The design of a novel psychometric battery for the cognitive control and attention assessment, free of demographic effects, capable to discriminate cognitively healthy aging, SCD, MCI, and mild Dementia (mD). Methods:The battery initial hypothesis was tuned using iterations of administration on random sampling healthy older adults and people with SCD, MCI, and mD, from the area of Thessaloniki, Greece. This resulted in the first release of the REflexes MEasurement DEviceS for Alzheimer battery (REMEDES for Alzheimer-R4Alz). Results:The first release lasts for almost an hour. The battery was design to assess working memory (WM) including WM storage, processing, and updating, enriched by episodic buffer recruitment. It was also designed to assess attention control abilities comprising selective, sustained, and divided attention subtasks. Finally, it comprises an inhibitory control, a task/rule switching or set-shifting, and a cognitive flexibility subtask as a combination of inhibition and task/rule switching abilities. Conclusion:The R4Alz battery is an easy to use psychometric battery with increasing difficulty levels and assumingly ecological validity, being entertaining for older adults, potentially free of demographic effects, and promising as a more accurate and early diagnosis tool of neurodegeneration.

Keywords: Attentional control, cognitive control, dementia, healthy aging, mild cognitive impairment, psychometric assessment, subjective cognitive decline

DOI: 10.3233/JAD-190798

Journal: Journal of Alzheimer's Disease, vol. 72, no. 3, pp. 783-801, 2019