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Associations of visual paired associative learning task with global cognition and its potential usefulness as a screening tool for Alzheimer’s Dementia

Published online by Cambridge University Press:  18 December 2020

Eleanora B. Hicks ,
Naba Ahsan ,
Apoorva Bhandari ,
Zaid Ghazala ,
Wei Wang ,
Bruce G. Pollock ,
Tarek K. Rajji  and
Sanjeev Kumar
Eleanora B. Hicks
Affiliation:
UCD School of Medicine, University College Dublin, Dublin, Ireland Adult Neurodevelopmental and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Canada
Naba Ahsan
Affiliation:
Adult Neurodevelopmental and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Canada
Apoorva Bhandari
Affiliation:
Adult Neurodevelopmental and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Canada
Zaid Ghazala
Affiliation:
Faculty of Medicine, University of Toronto, Toronto, Canada
Wei Wang
Affiliation:
Adult Neurodevelopmental and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Canada College of Public Health, University of South Florida, Tampa, FL, USA
Bruce G. Pollock
Affiliation:
Adult Neurodevelopmental and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Canada Faculty of Medicine, University of Toronto, Toronto, Canada
Tarek K. Rajji
Affiliation:
Adult Neurodevelopmental and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Canada Faculty of Medicine, University of Toronto, Toronto, Canada
Sanjeev Kumar*
Affiliation:
Adult Neurodevelopmental and Geriatric Psychiatry Division, Centre for Addiction and Mental Health, Toronto, Canada Faculty of Medicine, University of Toronto, Toronto, Canada
*
Correspondence should be addressed to: Sanjeev Kumar, 6324, 80 Workman Way, Toronto, ONM6J1H4, Canada. Phone: +416 535 8501 ext. 39384; Fax: +416 583 1296. Email: Sanjeev.kumar@camh.ca.
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Abstract

Objective:

Appropriate screening is integral to the early diagnosis and management of Alzheimer’s Dementia (AD). The Paired Associates Learning (PAL) task is a digital cognitive task that is free of cultural, language, and educational biases. This study examined the association between the PAL task performance and global cognition and the usefulness of the PAL task as a screening tool for AD.

Design:

Cross-sectional.

Setting:

Academic hospital.

Methods:

Twenty-five participants with AD and 22 healthy comparators (HC) were included. The Cambridge Neuropsychological Test Automated Battery PAL task and the Montreal Cognitive Assessment (MoCA) were used to assess cognition. We assessed the relationship between the PAL task and MoCA performance using Pearson correlation and linear regression. We also examined the PAL task’s ability to distinguish between AD and HC participants using Receiver Operating Characteristic curve (ROC) analysis.

Measurements:

MoCA Total Score had a strong positive correlation with PAL Stages Completed score (r = 0.8, p < 0.001), and a strong negative correlation with PAL Total Errors (adjusted) score (r = −0.9, p < 0.001). Further, PAL Total Errors (adjusted) score predicted the MoCA Total Score (F (4, 46) = 37.2, p < 0.001). On ROC analysis, PAL Total Errors (adjusted) score cut-off of 54 errors had 92% sensitivity and 86% specificity to detect AD.

Conclusions:

Performance on the PAL task is highly associated with global cognition. Further, the PAL task can differentiate patients with AD from HCs with high sensitivity and specificity. Thus, the PAL task may hold potential usage as an easy-to-administer screening tool for AD.

Keywords

agingmemoryneuropsychologyMoCACANTABPAL
Type
Original Research Article
Information
International Psychogeriatrics , Volume 33 , Special Issue 11: Issue Theme: Advances in Assessment and Diagnosis of Dementia , November 2021 , pp. 1135 - 1144
Copyright
© International Psychogeriatric Association 2020

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Footnotes

*

Wei Wang’s affiliations have been updated. An erratum detailing this change has also been published (doi:10.1017/S1041610221000545).

First Co-Authors.

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