Web viewAppendix e-1. Detailed methods of clinical data collection. Assessment of presenting...
Transcript of Web viewAppendix e-1. Detailed methods of clinical data collection. Assessment of presenting...
Appendix e-1. Detailed methods of clinical data collection
Assessment of presenting symptoms
Short-term memory: Consistent short-term memory deficits were diagnosed if the clinician rated
the individual as ≥0.5 in the Clinical Dementia Rating memory domain (clinical decision
integrating informant and individual report, and performance on neurological exam).
Judgment and problem solving: Judgement and problem solving deficits were diagnosed if the
clinician rated the individual as ≥0.5 in the Clinical Dementia Rating judgement and problem
solving domain.
Language: Present if the informant or individual expressed emergent word-finding or expressive
speech difficulties.
Behavioral and/or personality: Present if the informant or individual indicated consistent changes
in behavior and/or personality.
Motor dysfunction: Present if the informant or participant affirmed motor impairment, slowness
of movement, change in gait and/or falls.
Visuospatial difficulties: Present if the informant indicated that the individual “sometimes” or
“rarely” was able to “find his/her way about familiar streets”, or if problems with visuospatial
manipulation was noted.
Assessment of clinical features
Personality and behavioral changes: Present if moderate or severe changes were noted on the
Neuropsychiatric Inventory Questionnaire.
Mood disorder (depression): Present if the clinician indicated that the individual was
“depressed”, or that additional medical attention was required for the evaluation of depressive
mood (based on Geriatric Depression Scale score).
Falls: Present if the informant or individual indicated falls in the preceding one year.
Urinary incontinence: Present if the informant or individual indicated urinary incontinence in the
preceding one year.
Autobiographical memory: Impaired if the summed score of 1-week and 1-month recall of
events was 1.5 or less. The clinician rates the participant’s recall for each of the events as largely
correct (1 point), partially correct (0.5 points), or largely incorrect (0 points). Maximum possible
score: 1.0 + 1.0 = 2.0.
Short-term verbal recall: Impaired if one or more errors were made when recalling the encoded
phrase, “John Brown, 42 Market Street, Chicago”, following a short (2 minute) delay.
Object copy: Impaired if errors were made when copying a triangle, cube, or pentagon.
Assessment of Aphasia: Impaired when the answer to the clinician’s assessment of aphasia was
“present”. The clinical diagnosis of aphasia integrates findings from the clinical examination and
the Boston Diagnostic Aphasia Examination (Third Edition).
Extraocular movement abnormality: Present if impairment in extraocular movements were noted
on neurological examination (i.e., restricted range of motion, hypometric/hypometric saccades).
Asymmetrical features: Present if abnormal motor or sensory cortical findings (i.e., not
indicative of peripheral lesions) were detected on examination of motor and sensory function
(including assessment for graphesthesia and/or stereognosis).
Parkinsonism or dystonia: Present if ≥2 extrapyramidal signs were detected on neurological
examination, including rest tremor, bradykinesia, rigidity and postural instability, or if dystonia
was diagnosed.
Pathological hyperreflexia: Present if brisk (pathologic) reflexes (≥3+) were elicited on
neurological examination.
Limb Apraxia: Present if there was difficulty in demonstration of use of “toothbrush”, “key”
and/or “pencil” during the physical examination (demonstration following verbal command).
Alien Limb Phenomenon: Present when participant described dissociation from one’s own limb
(i.e., inter-manual conflict), and examiner observed asymmetric motor or sensory abnormalities
in corresponding limb. Simple levitation was excluded.
Myoclonus: Present if myoclonus was detected on neurological examination.
Abnormal gait: Present if abnormal gait pattern was detected, and not attributed to
musculoskeletal impairment or injury.