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. 2023 Jan 17;13(3):338.
doi: 10.3390/diagnostics13030338.

R4Alz-Revised: A Tool Able to Strongly Discriminate 'Subjective Cognitive Decline' from Healthy Cognition and 'Minor Neurocognitive Disorder'

Eleni Poptsi  1   2   3 , Despina Moraitou  1   2   3 , Emmanouil Tsardoulias  4 , Andreas L Symeonidis  4 , Vasileios Papaliagkas  5 , Magdalini Tsolaki  2   3   6
Affiliations

R4Alz-Revised: A Tool Able to Strongly Discriminate 'Subjective Cognitive Decline' from Healthy Cognition and 'Minor Neurocognitive Disorder'

Eleni Poptsi et al. Diagnostics (Basel). .

Abstract

Background: The diagnosis of the minor neurocognitive diseases in the clinical course of dementia before the clinical symptoms' appearance is the holy grail of neuropsychological research. The R4Alz battery is a novel and valid tool that was designed to assess cognitive control in people with minor cognitive disorders. The aim of the current study is the R4Alz battery's extension (namely R4Alz-R), enhanced by the design and administration of extra episodic memory tasks, as well as extra cognitive control tasks, towards improving the overall R4Alz discriminant validity.

Methods: The study comprised 80 people: (a) 20 Healthy adults (HC), (b) 29 people with Subjective Cognitive Decline (SCD), and (c) 31 people with Mild Cognitive Impairment (MCI). The groups differed in age and educational level.

Results: Updating, inhibition, attention switching, and cognitive flexibility tasks discriminated SCD from HC (p ≤ 0.003). Updating, switching, cognitive flexibility, and episodic memory tasks discriminated SCD from MCI (p ≤ 0.001). All the R4Alz-R's tasks discriminated HC from MCI (p ≤ 0.001). The R4Alz-R was free of age and educational level effects. The battery discriminated perfectly SCD from HC and HC from MCI (100% sensitivity-95% specificity and 100% sensitivity-90% specificity, respectively), whilst it discriminated excellently SCD from MCI (90.3% sensitivity-82.8% specificity).

Conclusion: SCD seems to be stage a of neurodegeneration since it can be objectively evaluated via the R4Alz-R battery, which seems to be a useful tool for early diagnosis.

Keywords: R4Alz-R battery; Subjective Cognitive Decline; early diagnosis; neurodegeneration.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
The R4Alz original version and the R4Alz-R (electronic form).
Figure 2
Figure 2
Condition A–C of the Cognitive Flexibility Task—1st, 2nd, and 3rd levels of difficulty and Visual Fluency Task (Planning, Inhibitory Control, and Visual Fluency).
Figure 3
Figure 3
Episodic Memory Task—Windows (1st level of difficulty)–Caption in Greek: Select the image you saw before.
Figure 4
Figure 4
ROC curve analysis of the 8 formulae that better discriminate between Subjective Cognitive Decline (SCD) and Cognitively Healthy Advanced-age Adults (HC).
Figure 5
Figure 5
ROC curve analysis of the 8 formulae that better discriminate between Subjective Cognitive Decline SCD and Mild Cognitive Impairment (MCI).
Figure 6
Figure 6
ROC curve analysis of the 8 formulae that better discriminate between Cognitively Healthy Advanced-age Adults (HC) and Mild Cognitive Impairment (MCI).
See this image and copyright information in PMC

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