The Brain Health Assessment for Detecting and Diagnosing Neurocognitive Disorders

Katherine L. Possin, Tacie Moskowitz, Sabrina J. Erlhoff, Kirsten M. Rogers, Erica T. Johnson, Natasha Z.R. Steele, Joseph J. Higgins, Jordan Stiver, Andrea G. Alioto, Sarah E Tomaszewski Farias, Bruce L. Miller, Katherine P. Rankin

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background/Objectives: Brief cognitive screens lack the sensitivity to detect mild cognitive impairment (MCI) or support differential diagnoses. The objective of this study was to validate the 10-minute, tablet-based University of California, San Francisco (UCSF) Brain Health Assessment (BHA) to overcome these limitations. Design: Cross-sectional. Setting: UCSF Memory and Aging Center. Participants: Older adults (N = 347) (neurologically healthy controls (n = 185), and individuals diagnosed with MCI (n = 99), dementia (n = 42), and as normal with concerns (n = 21)). Measurements: The BHA includes subtests of memory, executive function and speed, visuospatial skills, and language and an optional informant survey. Participants completed the Montreal Cognitive Assessment (MoCA) and criterion-standard neuropsychological tests. Standardized structural 3T brain magnetic resonance imaging was performed in 145 participants. Results: At a fixed 85% specificity rate, the BHA had 100% sensitivity to dementia and 84% to MCI; the MoCA had 75% sensitivity to dementia and 25% to MCI. The BHA had 83% sensitivity to MCI likely due to AD and 88% to MCI unlikely due to AD, and the MoCA had 58% sensitivity to MCI likely AD and 24% to MCI unlikely AD. The BHA subtests demonstrated moderate to high correlations with the criterion-standard tests from their respective cognitive domains. Memory test performance correlated with medial temporal lobe volumes; executive and speed with frontal, parietal, and basal ganglia volumes; and visuospatial with right parietal volumes. Conclusion: The BHA had excellent combined sensitivity and specificity to detect dementia and MCI, including MCI due to diverse etiologies. The subtests provide efficient, valid measures of neurocognition that are critical in making a differential diagnosis.

Original languageEnglish (US)
Pages (from-to)150-156
Number of pages7
JournalJournal of the American Geriatrics Society
Volume66
Issue number1
DOIs
StatePublished - Jan 1 2018

Fingerprint

Health
Brain
Dementia
San Francisco
Differential Diagnosis
Cognitive Dysfunction
Neurocognitive Disorders
Neuropsychological Tests
Executive Function
Temporal Lobe
Basal Ganglia
Tablets
Language
Magnetic Resonance Imaging
Sensitivity and Specificity

Keywords

  • cognitive screening
  • mild cognitive impairment
  • primary care

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

Possin, K. L., Moskowitz, T., Erlhoff, S. J., Rogers, K. M., Johnson, E. T., Steele, N. Z. R., ... Rankin, K. P. (2018). The Brain Health Assessment for Detecting and Diagnosing Neurocognitive Disorders. Journal of the American Geriatrics Society, 66(1), 150-156. https://doi.org/10.1111/jgs.15208

The Brain Health Assessment for Detecting and Diagnosing Neurocognitive Disorders. / Possin, Katherine L.; Moskowitz, Tacie; Erlhoff, Sabrina J.; Rogers, Kirsten M.; Johnson, Erica T.; Steele, Natasha Z.R.; Higgins, Joseph J.; Stiver, Jordan; Alioto, Andrea G.; Tomaszewski Farias, Sarah E; Miller, Bruce L.; Rankin, Katherine P.

In: Journal of the American Geriatrics Society, Vol. 66, No. 1, 01.01.2018, p. 150-156.

Research output: Contribution to journalArticle

Possin, KL, Moskowitz, T, Erlhoff, SJ, Rogers, KM, Johnson, ET, Steele, NZR, Higgins, JJ, Stiver, J, Alioto, AG, Tomaszewski Farias, SE, Miller, BL & Rankin, KP 2018, 'The Brain Health Assessment for Detecting and Diagnosing Neurocognitive Disorders', Journal of the American Geriatrics Society, vol. 66, no. 1, pp. 150-156. https://doi.org/10.1111/jgs.15208
Possin KL, Moskowitz T, Erlhoff SJ, Rogers KM, Johnson ET, Steele NZR et al. The Brain Health Assessment for Detecting and Diagnosing Neurocognitive Disorders. Journal of the American Geriatrics Society. 2018 Jan 1;66(1):150-156. https://doi.org/10.1111/jgs.15208
Possin, Katherine L. ; Moskowitz, Tacie ; Erlhoff, Sabrina J. ; Rogers, Kirsten M. ; Johnson, Erica T. ; Steele, Natasha Z.R. ; Higgins, Joseph J. ; Stiver, Jordan ; Alioto, Andrea G. ; Tomaszewski Farias, Sarah E ; Miller, Bruce L. ; Rankin, Katherine P. / The Brain Health Assessment for Detecting and Diagnosing Neurocognitive Disorders. In: Journal of the American Geriatrics Society. 2018 ; Vol. 66, No. 1. pp. 150-156.
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