Neuropsychological Domains Altered at the Early Stage of Cognitive Decline

ABSTRACT

Objective@#A neuropsychological battery is a gold standard for thorough cognitive evaluation. However, it could not be used as a screening test due to its long inspection time and high cost. This study is conducted to identify specific cognitive subdomains that alter even at the early stage of cognitive decline. @*Methods@#Neuropsychological battery results of 575 persons who visited memory clinic were analysed. We classified stages of cognitive decline according to Clinical Dementia Rating (CDR) and CDR-Sum of boxes (CDR-SB). To explore which subdomains can sensitively distinguish normal cognition from the early cognitive impairment, we used Variable Importance in Projection (VIP) in addition to analysis of covariance. @*Results@#We found that scores in subdomain tests such as Rey Complex Figure Test immediate and delayed recall successfully differentiate persons with CDR 0 from those with CDR 0.5 and also persons with CDR-SB 0 from those with CDR-SB 0.5 as indicated by VIP values greater than 1. @*Conclusion@#These results suggest that alterations in visuospatial memory function might be a sensitive sign reflecting the early cognitive decline. The combination of only a few subtests could be also used as a reliable and sensitive screening tool to detect early cognitive impairment.