The 10-word learning task in the differential diagnosis of early Alzheimer's disease and elderly depression: a cross-sectional pilot study

Objectives: Identification of early Alzheimer's disease (AD) has become very important. Episodic memory tasks appear to have predictive power for indicating early AD. Deficits in encoding and storage processes that are characteristic of AD, however, must be distinguished from non-AD deficits that can also affect memory, including difficulties that may be present in depression. This pilot study was set up to ascertain whether a 10-word-list-learning task (delayed recognition and rate of forgetting) may be useful in making the differentiation between mild AD and depression. Method: A Dutch version of Rey's auditory verbal learning test was administered to 36 mild AD patients, 41 depressed patients, and 47 healthy controls. Data were analyzed in a cross-sectional manner. Results: Receiver operating characteristic analyses showed that for differentiating mild AD and depression, both delayed recognition and percentage of forgetting have sufficient diagnostic accuracy. Conclusion: Percentage of forgetting had the highest diagnostic accuracy for differentiating mild AD and depressed patients and may be useful in the early detection of AD

Predicting at-fault car accidents of older drivers

Considerable research shows car accidents are difficult to predict using screening tests. The objective of this exploratory study is to determine whether detailed accident analysis taking into account the specific accident type might enhance the predictive power of a standardised road test and a set of selected neuropsychological tests. Moreover, this study addresses the validity and reliability of performance-based driving evaluation. The sample consisted of 84 older drivers between 65 and 96 years of age who were referred for a fitness-to-drive evaluation. Using discriminant analyses, the subjects were classified as drivers with and without at-fault accidents. We compared the accuracy of neuropsychological tests and a road test for postdicting all accidents, accidents classified into two categories and accidents classified into four different categories. The percentages of correctly classified subject were highest at the level of the most detailed classification. These results suggest that, although ac cident prediction is difficult, the predictability of car accidents by neurocognitive measurements and a road test increases when the kind of accident is specified. © 2001 Elsevier Science Ltd. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Short cognitive/neuropsychological test battery for first-tier fitness-to-drive assessment of older adults.

Since fitness-to-drive evaluation of elderly drivers has become an important issue, we developed a short firsttier screening battery to evaluate the necessity for further referral to specialised centres. Our sample consisted of 84 subjects between 65 and 96 years who came to the Belgian Road Safety institute for a fitness-to-drive evaluation. Using cross-validated discriminant analyses, the predictive power of a battery consisting of the Trail Making Test, Part A, a visual acuity test, a clock drawing test, the Mini-Mental State Examination (MMSE) and age was analysed. The judgement by an independent driver instructor (fit-to-drive vs. not unconditional fit-to-drive), based on a real world road test was used as the dependent variable. Classification functions based on the significant discriminant function yielded a specificity score of 85% (subjects fit-to-drive correctly classified) and a sensitivity score of 80% (subjects as not unconditional fit-to-drive correctly classified). These results highlight the potential value of a short screening instrument that can be used in primary health care settings. This instrument may be useful as a first step in a multi-tier assessment procedure.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Pain-provoking behaviour as a driven reaction to psychological distress: the bio-psycho-social neurotic loop model.

In clinical psychology and psychiatry, different complaints are generally perceived as problems with a different ethiology, despite the fact that it can also be hypothesised that they share the same dimension. We believe that many clinicians share the heuristic insight that a pure categorical approach to psychopathology underscores the potential value of a dimensional approach. The neurotic loop model attempts to explain how pain-provoking behaviour develops and how it persists, increases and expands in spite of continuing negative consequences. Pain-producing behaviour is postulated as a neurobiologically rooted reaction to the activation of distressing representations. In biologically vulnerable people, pain-provoking behaviour channels stress resulting from disturbing emotions. This behaviour will initially be very rudimentary and may become more sophisticated according to the operant history. In this way, the neurotic loop model postulates pain-provoking behaviour on a continuum from simple muscle contractions to more complex self-injurious behaviour. Negative consequences of pain-provoking behaviour will reactivate the distressing representations, resulting in a driven vicious circle: the neurotic loop. The model integrates the most influential models of learning theory with neurobiology and developmental aspects. The neurotic loop model attempts to provide insight into the dynamics of dysfunctional pain-provoking behaviour and yields implications for therapy. © 2002 Elsevier Science Ltd. All rights reserved.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Use of a measurement of actual and premorbid intelligence to differentiate MCI and depression among elderly

This study reveals that the difference between actual and premorbid intelligence cannot be used to differentiate MCI and depression among elderly. Probably the intellectual deterioration among MCI patients is not yet large enough to make an accurate differential diagnosis between MCI and depression. Yet further studies are necessary