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Title: Prediciting the progression of cognitive impairment in memory clinics
Author: Giannakou, Antri
Awarding Body: University of Bristol
Current Institution: University of Bristol
Date of Award: 2013
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Neuropsychological tests are routinely undertaken at memory clinics to help diagnose Mild Cognitive Impairment (MCI) and Dementia. For those patients found to have MCI it would be clinically valuable to be able to distinguish patients at high risk of progressing to Dementia. The aim of this Thesis is to develop a prognostic algorithm using neuropsychological test performance, in order to estimate the probability of progressing to dementia in patients with MC!. The cohort providing data attended the BRACE memory clinic in Bristol, UK and comprises 643 MCI patients, 268 of whom were observed to progress to Dementia. To inform our analysis, a systematic search of the published literature and meta-analysis were conducted for an indication of which neuropsychological tests can distinguish those MCI patients at risk of progressing to dementia. This resulted in 38 articles fulfilling the inclusion criteria. A simulation experiment determined optimal methods for transforming the different types of estimate presented to a Diagnostic Odds Ratio (DOR) scale. Subsequently the meta-analysis revealed the most predominant domains associated with progression to dementia were Memory, Learning, and Language. Using the BRACE data, the best subset of neuropsychological tests to predict dementia was found to be compromising the tests of Mini Mental State Examination (MMSE), the Immediate Recall of the Story Test and the total score of Hopkins Verbal Learning Test (HVLT).
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available