Clinical utility of the K-T cancellation test in a memory clinic population |
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| Authors: | Ya-Huei Wu Jocelyne de Rotrou Sietske A M Sikkes Anne-Sophie Rigaud Matthieu Plichart |
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| Institution: | 1. Assistance Publique–H?pitaux de Paris, Broca Hospital, Paris, France;2. University Paris Descartes, Sorbonne Paris Cité, EA 4468, Paris, Franceyahuei.wu@brc.aphp.fr;4. University Paris Descartes, Sorbonne Paris Cité, EA 4468, Paris, France;5. Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands;6. Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands |
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| Abstract: | Background/Aim: The K-T cancellation test (K-T) has been validated as a measure of executive functions (EF) but its clinical utility has not yet been examined. This study aimed to validate K-T in a memory clinic setting by examining its capacity to discriminate older adults with normal cognition (NC) from those with mild cognitive impairment (MCI) and Alzheimer’s disease (AD). Method: K-T was administered to 120 NC subjects, 146 patients with MCI, and 93 patients with AD. A one-way analysis of covariance was used to compare the correct cancellations of K-T between the groups. Linear regressions were run to identify significant demographic predictors of K-T for NC subjects and to determine the equation to calculate z scores for all subjects. The area under the curve (AUC), sensitivity (Se), specificity (Sp), and positive (PPV) and negative (NPV) predictive values were assessed to compare the diagnostic performance between K-T and the Mini-Mental State Examination (MMSE) for discrimination between NC subjects and patients with cognitive impairment. Results: After adjusting for age, education, and gender, the groups were significantly different from each other regarding the number of correct cancellations of K-T, F(2, 353) = 116.6, p < .001, η2p = .40. Compared to the NC group (Z = 0, SD = 1), the mean z score was –1.52 for the MCI group and –2.53 for the AD group, suggesting impaired performance for the patient groups. K-T showed a better diagnostic performance for discrimination between the NC subjects and the patients with MCI (AUC = .83; 95% CI .79, .88]; Se = .79; Sp = .74; PPV = .79; NPV = .74), compared to that of MMSE (AUC = .74, 95% CI .68, .80]; Se = .68; Sp = .73; PPV = .79; NPV = .64). Conclusion: The K-T cancellation test showed a good diagnostic performance in discriminating cognitively normal older adults from cognitively impaired patients. Our findings support the clinical utility of K-T in geriatric neuropsychological assessment for detection of early cognitive impairment. |
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| Keywords: | Alzheimer’s disease Executive function Mild cognitive impairment Neuropsychological test Psychometrics |
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