The evaluation of cognitive function in the dementias: Methodological and regulatory considerations

Wesnes, Keith and Harrison, John (2003) The evaluation of cognitive function in the dementias: Methodological and regulatory considerations. Dialogues in Clinical Neuroscience, 5 (1). pp. 77-88. ISSN 1294-8322

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Abstract

Impairment of cognitive function is the central feature of dementia. Although, clinically, the cognitive deficit most often manifests itself as memory problems, a number of other areas of cognition are affected, and memory is but one of the cognitive skills compromised in dementia. Dementia with Lewy bodies, for example, accounts for 15% to 25% of all dementias and does not have memory deficits as a core feature. Our cognitive facilities underlie our abilities to engage successfully in the activities of daily living (ADL) and it follows that enhancement of cognitive function will facilitate performance of ADL. The assessment and understanding of these impairments are crucial to any treatment of the disorder. Unfortunately, the principal instrument used to assess cognitive function in most of the major clinical trials of Alzheimer's disease in recent years, the Alzheimer's Disease Assessment Scale-Cognitive Subsection (ADAS-COG), primarily assesses aspects of memory, which has resulted in other important cognitive deficits in dementia being overlooked. Automated cognitive tests are now available that can identify an earlier onset of improvements in dementia in smaller samples than the ADAS. Regulatory authorities should encourage - or even require - the use of automated procedures alongside the ADAS in pivotal trials to help determine the relative utility of the instruments in the fairest way possible. Whatever the outcome, this will be of long-term benefit to patients, carers, drug developers, clinicians, and regulators in this important area.

Item Type: Article
Uncontrolled Keywords: Alzheimer's disease, automated testing, cognitive function, cognitive testing, dementia, dementia with Lewy bodies
Subjects: C800 Psychology
Department: Faculties > Health and Life Sciences > School of Life Sciences > Psychology
Related URLs:
Depositing User: Becky Skoyles
Date Deposited: 05 Feb 2015 14:15
Last Modified: 10 Aug 2015 11:51
URI: http://nrl.northumbria.ac.uk/id/eprint/19490

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