Neuropsychometric Tests in Cross Sectional and Longitudinal Studies - A Regression Analysis of ADAS - Cog, SKT and MMSE

Introduction

In clinical and drug studies, different neuropsychometric tests are used. So far, no empirical data have been published to compare studies using different tests. The purpose of this study was to calculate a regression formula allowing a comparison of cross-sectional and longitudinal data from three neuropsychometric tests that are frequently used in drug studies (Alzheimer's Disease Assessment Scale, ADAS-cog; Syndrom Kurz Test, SKT; Mini Mental State Examination, MMSE). Method: 177 patients with dementia according to ICD10 criteria were studied for the cross sectional and 61 for the longitudinal analysis. Correlations and linear regressions were calculated between tests. Significance was proven with ANOVA and t-tests using the SPSS statistical package. Results: Significant Spearman correlations and slopes in the regression occurred in the cross sectional analysis (ADAS-cog-SKT r_s = 0.77, slope = 0.45, SKT-ADAS-cog slope =1.3, r² = 0.59; ADAS-cog-MMSE r₂ = 0.76, slope = -0.42, MMSE-ADAS-cog slope = -1.5, r² = 0.64; MMSE-SKT r_s = -0.79, slope = -0.87, SKT-MMSE slope = -0.71, r² = 0.62; p<0.001 after Bonferroni correction; N = 177) and in the longitudinal analysis (SKT-ADAS-cog, r_s = 0.48, slope = 0.69, ADAS-cog-SKT slope = 0.69, p<0.001, r² = 0.32, MMSE-SKT, r_s = 0.44, slope = -0.41, SKT-MMSE, slope = -0.55, p<0.001, r² = 0.21). Conclusions: The results allow calculation of ADAS-scores when SKT scores are given, and vice versa. In longitudinal studies or in the course of the disease, scores assessed with the ADAS-cog and the SKT may now be statistically compared. In all comparisons, bottom and ceiling effects of the tests have to be taken into account.