“Build Your Village”—Conducting the Village Test on Cognitively Impaired Patients: A First Journey into Alzheimerland
Abstract
:1. Introduction
2. Materials and Methods
2.1. Inclusion and Exclusion Criteria
2.2. Procedures
2.3. Statistical Analysis
3. Results
3.1. VT Quantitative Analysis
3.2. VT Qualitative Analysis
3.3. Neuropsychological Assessment
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Cognitive Functions | Test |
---|---|
Global cognitive function indices | MMSE (range: 0–30) [19], MMSE corrected for age and education (range: 0–30; cut-off: <23.8) [20] |
Brief Mental Deterioration Battery (BBDM) with Final Result (FR) (cut-off: <0) [21,22] | |
Memory | Rey’s 15 Words *: immediate recall (range: 0–75; cut-off: <28.53); delayed recall * (range: 0–15; cut-off: <4.69) [23] |
Immediate Visual Memory * (range: 0–22; cut-off: <13.85) [23] | |
Digit Span Forward (range: 0–9; cut-off: <3.75) [24] | |
Corsi Block-tapping Test (range: 0-infinite; cut-off: <3.75) [25] | |
Rey–Osterrieth Complex Figure Test: delayed recall (range: 0–36; cut-off: <6.20) [27] | |
Attention/Executive functions | Barrage Test * (time cut-off: ≥90; score cut-off: ≤9; errors cut-off: ≥2; result cut-off: >2.5) [21,22] Digit Span Backward (range: 0–9; cut-off: <2.65) [28] |
Stroop Test (time cut-off: >27.5; errors cut-off: >7.5) [26] | |
Abstract/concrete thinking | Analogies * (range: 0–20; cut-off: <13.92) [29] |
Language | Verbal Fluency: phonemic (range: 0–infinite; cut-off: <17.35) [23]; semantic (range: 0–infinite; cut-off: <25) [30] |
Constructional praxis | Copy Design: simple (range: 0–12; cut-off: <7.18) [23] |
Rey–Osterrieth Complex Figure Test: direct copy (range: 0–36; cut-off: <28) [27] | |
Visuospatial and perceptual functions | Judgment of Line Orientation Test (range: 0–30; cut-off: <19) [31] Street’s Completion Test (range: 0–14; cut-off: <2.25) [25] |
AD n = 50 | MCI n = 28 | Controls n = 38 | p-Value | p-Value AD vs. MCI | p-Value AD vs. Ctrl | p-Value MCI vs. Ctrl | ||
---|---|---|---|---|---|---|---|---|
Age years | Mean (SD) Median [IQR] | 74.4 (9.5) 76 [70; 82] | 74 (6.1) 75.5 [72; 77.5] | 70.2 (8.4) 70 [63; 74] | 0.022 | 0.387 | 0.004 | 0.022 |
Sex f | N (%) | 22 (44) | 12 (42.9) | 20 (52.6) | 0.654 | 0.922 | 0.422 | 0.432 |
Education years | Mean (SD) Median [IQR] | 10.1 (4.5) 8 [5; 13] | 8.4 (3.6) 8 [5; 12.5] | 11.5 (3.8) 13 [8; 13] | 0.013 | 0.050 | 0.042 | 0.001 |
AD n = 50 | MCI n = 28 | Controls n = 38 | p-Value | p-Value AD vs. MCI | p-Value AD vs. Ctrl | p-Value MCI vs. Ctrl | |
---|---|---|---|---|---|---|---|
Time of execution (s) Median [IQR] | 339 [188; 549] | 312.5 [209; 477.5] | 513.5 [368; 657] | 0.007 | 0.422 | 0.003 | 0.005 |
Latency time (s) Median [IQR] | 3 [2; 5] | 3 [1.5; 7] | 2 [1; 3] | 0.273 | 0.424 | 0.077 | 0.079 |
Village area Median [IQR] | 1009.5 [736; 1947] | 1705.5 [885; 2964] | 3350 [2303; 4543] | <0.001 | 0.025 | <0.001 | <0.001 |
% used pieces/total Median [IQR] | 12.5 [6; 24] | 19 [12.5; 33] | 37 [24; 47] | <0.001 | 0.018 | <0.001 | <0.001 |
Human figures Median [IQR] | 0 [0; 1] | 1.5 [0; 8] | 6 [3; 10] | <0.001 | 0.007 | <0.001 | 0.002 |
Living pieces Median [IQR] | 8 [2; 20] | 16 [9.5; 30] | 36 [26; 46] | <0.001 | 0.008 | <0.001 | <0.001 |
Non-living pieces Median [IQR] | 14.5 [8; 25] | 21 [15.5; 43] | 35 [21; 50] | <0.001 | 0.028 | <0.001 | 0.029 |
Living/non-living ratio Median [IQR] | 0.5 [0.2; 1] | 0.7 [0.5; 1.1] | 1.1 [0.7; 1.4] | <0.001 | 0.115 | <0.001 | 0.005 |
Dynamic pieces Median [IQR] | 0 [0; 1] | 1 [0; 4] | 2.5 [1; 5] | <0.001 | 0.014 | <0.001 | 0.034 |
Static pieces Median [IQR] | 21.5 [12; 38] | 32.5 [22.5; 59] | 58.5 [39; 76] | <0.001 | 0.019 | <0.001 | 0.004 |
Dynamic/static ratio Median [IQR] | 0 [0; 0] | 0 [0; 0.1] | 0.1 [0; 0.1] | 0.019 | 0.018 | <0.001 | 0.229 |
Coeff | 95% CI | |
---|---|---|
Time of execution | ||
AD | −155.13 | −234.33; −109.25 |
MCI | −181.63 | −310.6; −60.85 |
Latency time | ||
AD | 0.93 | 0.11; 1.41 |
MCI | 0.89 | 0.32; 1.56 |
Village area | ||
AD | −2142.68 | −2522.46; −1101.65 |
MCI | −1314.76 | −2054.6; −488.97 |
% used pieces/total | ||
AD | −22.9 | −28.98; −15.62 |
MCI | −16.26 | −18.93; −6.52 |
Human figures | ||
AD | −4.89 | −7.86; −3.88 |
MCI | −3.97 | −7.74; −1.36 |
Living pieces | ||
AD | −23.86 | −29.25; −19.6 |
MCI | −15.76 | −20.27; −8.43 |
Non-living pieces | ||
AD | −20.2 | −31.35; −11.78 |
MCI | −13.6 | −24.17; −3.1 |
Living/non-living ratio | ||
AD | −0.68 | −0.78; −0.33 |
MCI | −0.45 | −0.62; −0.10 |
Dynamic pieces | ||
AD | −2 | −3.5; −1.13 |
MCI | −1 | −2.6; 0.43 |
Static pieces | ||
AD | −37.26 | −41.01; −25.85 |
MCI | −23.36 | −31.14; −10.01 |
Dynamic/static ratio | ||
AD | −0.1 | −0.1; −0.01 |
AD | MCI | Controls | p-Value | p-Value | p-Value | p-Value | |
---|---|---|---|---|---|---|---|
n = 50 | n = 28 | n = 38 | AD vs. MCI | AD vs. Ctrl | MCI vs. Ctrl | ||
MMSEc | |||||||
Mean (SD) | 18.7 (5.2) | 24.5 (3.5) | 27.9 (1.4) | <0.001 | <0.001 | <0.001 | <0.001 |
Median [IQR] | 19 [16; 22.7] | 25.4 [22.5; 27.6] | 28.1 [27.1; 29] | ||||
BBDM Final Result | |||||||
Mean (SD) | −0.7 (1.3) | 1.1 (0.9) | 2.4 (0.5) | <0.001 | <0.001 | <0.001 | <0.001 |
Median [IQR] | −1 [−1.4; 0.4] | 1.2 [0.8; 1.6] | 2.4 [1.9; 2.7] | ||||
Rey’s 15 Words imm_c | |||||||
Mean (SD) | 21.6 (5.6) | 33.6 (6.9) | 43.3 (6.7) | <0.001 | <0.001 | <0.001 | <0.001 |
Median [IQR] | 21.2 [17.1; 26.2] | 33 [30.4; 37.6] | 44.2 [36.4; 49.1] | ||||
Rey’s 15 Words del_c | |||||||
Mean (SD) | 2.4 (1.4) | 5.6 (2.5) | 8.8 (2.1) | <0.001 | <0.001 | <0.001 | <0.001 |
Median [IQR] | 2.8 [1.6; 3.3] | 5.5 [4; 7.2] | 8.3 [7.3; 10.4] | ||||
Imm Visual Mem_c | |||||||
Mean (SD) | 15.3 (4.5) | 19 (2.5) | 20 (1.9) | <0.001 | 0.001 | <0.001 | 0.074 |
Median [IQR] | 14.9 [12.3; 18.9] | 19.2 [17.7; 20.5] | 20 [19.5; 21.4] | ||||
Digit Span Forward_c | |||||||
Mean (SD) | 4.9 (1.2) | 5.4 (1) | 6.3 (1) | <0.001 | 0.066 | <0.001 | 0.001 |
Median [IQR] | 5.1 [4.1; 5.8] | 5.6 [4.8; 6.3] | 6.2 [5.7; 6.8] | ||||
Corsi Block-tapping_c | |||||||
Mean (SD) | 4.2 (4.3) | 4.8 (0.8) | 5.3 (1.2) | <0.001 | <0.001 | <0.001 | 0.109 |
Median [IQR] | 3.6 [2.9; 4.2] | 4.7 [4.3; 5.4] | 5.1 [4.4; 6] | ||||
Rey Fig delayed rec_c | |||||||
Mean (SD) | 7 (4) | 13.8 (8.2) | 20 (5.8) | <0.001 | <0.001 | <0.001 | <0.001 |
Median [IQR] | 6.6 [4.5; 9.5] | 11.6 [7.9; 19.8] | 19.2 [16.3; 21.8] | ||||
Barrage time | |||||||
Mean (SD) | 109.7 (50.6) | 64 (33) | 46.5 (10.6) | <0.001 | <0.001 | <0.001 | 0.006 |
Median [IQR] | 100 [65; 164] | 58 [43; 66.5] | 45 [38; 54] | ||||
Digit Span Back_c | |||||||
Mean (SD) | 3.1 (1.2) | 3.9 (1.3) | 5.5 (6) | <0.001 | 0.021 | <0.001 | 0.005 |
Median [IQR] | 3.1 [2.7; 3.6] | 3.7 [3; 4.6] | 4.6 [3.7; 5.3] | ||||
Stroop time_c | |||||||
Mean (SD) | 47.9 (51.3) | 60.5 (148.5) | 15.9 (7.9) | <0.001 | 0.499 | <0.001 | <0.001 |
Median [IQR] | 38.4 [14.3; 56.3] | 36.1 [19.8; 46.9] | 15.3 [9.8; 21.3] | ||||
Stroop err_c | |||||||
Mean (SD) | 14.4 (9.9) | 2.1 (5.2) | −1 (2.2) | <0.001 | <0.001 | <0.001 | 0.034 |
Median [IQR] | 14.4 [4.6; 23.8] | 0.6 [−1.7; 3.2] | −1 [−1.5; −0.5] | ||||
Analogies_c | |||||||
Mean (SD) | 9.4 (5.1) | 14.1 (4.4) | 18.2 (1.7) | <0.001 | 0.001 | <0.001 | <0.001 |
Median [IQR] | 9.8 [5.7; 13.1] | 14.8 [12.2; 17.4] | 18.1 [16.7; 19.1] | ||||
Phonemic fluency_c | |||||||
Mean (SD) | 15.7 (8.8) | 26.2 (10.9) | 34 (7.8) | <0.001 | <0.001 | <0.001 | 0.001 |
Median [IQR] | 16 [11.2; 22.4] | 24.9 [16.2; 33.4] | 32.8 [28.3; 40.3] | ||||
Semantic fluency_c | |||||||
Mean (SD) | 20.1 (6.8) | 31.7 (11.2) | 43.2 (6.2) | <0.001 | <0.001 | <0.001 | <0.001 |
Median [IQR] | 21 [17; 24] | 32 [25; 38.5] | 42.5 [39; 47] | ||||
Copy Design_c | |||||||
Mean (SD) | 9.3 (2.4) | 11.1 (1.8) | 11.6 (1) | <0.001 | 0.001 | <0.001 | 0.116 |
Median [IQR] | 9.8 [7.9; 11.1] | 11.6 [10.1; 12.3] | 11.7 [11.1; 12.4] | ||||
Rey Fig copy_c | |||||||
Mean (SD) | 21.5 (11.3) | 32.1 (5.9) | 36.5 (1.7) | <0.001 | 0.001 | <0.001 | 0.001 |
Median [IQR] | 24 [10.9; 31.5] | 33.7 [31.4; 36] | 36.8 [36; 37.3] | ||||
Judg of Line Orient_c | |||||||
Mean (SD) | 16 (8.8) | 22.7 (4.2) | 27.5 (3.7) | <0.001 | 0.007 | <0.001 | <0.001 |
Median [IQR] | 18 [6; 23] | 23.5 [19.5; 25.5] | 28 [25; 30] | ||||
Street’s Completion_c | |||||||
Mean (SD) | 4.1 (2) | 5.6 (2) | 7.3 (1.7) | <0.001 | 0.003 | <0.001 | 0.002 |
Median [IQR] | 4 [2.8; 5.3] | 5.8 [4.6; 6.9] | 7.3 [6.5; 8.5] |
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Stanzani-Maserati, M.; De Matteis, M.; Bosco, L.; Baccari, F.; Zenesini, C.; Mitolo, M.; La Morgia, C.; Gallassi, R.; Capellari, S. “Build Your Village”—Conducting the Village Test on Cognitively Impaired Patients: A First Journey into Alzheimerland. Brain Sci. 2024, 14, 523. https://doi.org/10.3390/brainsci14060523
Stanzani-Maserati M, De Matteis M, Bosco L, Baccari F, Zenesini C, Mitolo M, La Morgia C, Gallassi R, Capellari S. “Build Your Village”—Conducting the Village Test on Cognitively Impaired Patients: A First Journey into Alzheimerland. Brain Sciences. 2024; 14(6):523. https://doi.org/10.3390/brainsci14060523
Chicago/Turabian StyleStanzani-Maserati, Michelangelo, Maddalena De Matteis, Luca Bosco, Flavia Baccari, Corrado Zenesini, Micaela Mitolo, Chiara La Morgia, Roberto Gallassi, and Sabina Capellari. 2024. "“Build Your Village”—Conducting the Village Test on Cognitively Impaired Patients: A First Journey into Alzheimerland" Brain Sciences 14, no. 6: 523. https://doi.org/10.3390/brainsci14060523