Selective Visual Attention Assessment Using Landolt-C in MCI and Mild Dementia
Valentin Bragin1, Ilya Bragin1,2,3
Valentin Bragin, M.D.1, Gary Shereshevsky, PhD1,2, Aysik Vaysman, M.D.1, Nataliia Brovdii, BS1 and Ilya Bragin, M.D.1,3,4
1. Stress Relief and Memory Training Center, Brooklyn, NY, USA
2. Staten Island University Hospital, Department of Rehabilitation Medicine, Staten Island, NY, USA
3. Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA
4. Saint Lukes University Health Network, Bethlehem, PA, USA
Poster presentation at the Alzheimer’s Association International Conference. Chicago, Illinois July 22- 26, 2018
Background: Attention problems accompany memory and executive function deficits in dementia. From our experience approximately 15 – 20% patients with memory complaints have primarily attention problems. The aim of this study was to investigate differences in selective visual attention of patients with MCI and mild dementia using a computerized version of the classical Landolt-C task of selective attention. To our knowledge, this is the first study analyzing attention in dementia using the aforementioned task which minimizes linguistic and semantic processing.
Methods: Data were collected from the charts of 208 patients (females – 147, males – 61), mean age 78.8±5.7, education 16.4±2.7 yrs, with dementia and depression. Cognitive testing included MMSE and Landolt-C continuous performance test (LC-CPT), with accuracy, target and non-target errors, reaction time variables. The patients were divided in 2 groups: group 1 (MCI) with MMSE ≥ 27 ( 147 patients) and group 2 with MMSE ≤ 24 ( 61 patients). Patients with MMSE 25 and 26 were excluded. Statistics included Wilcoxon signed-rank and Mann-Whitney U tests and Spearman’s rho correlations.
Results: The mean standard MMSE score was 28.6± 1.0 in group 1 and 21.8 ± 2.77 in group 2 (p< 0.0001). Performance on the LC-CPT in group 1 was significantly higher than in group 2 on all variables (mean scores for accuracy: group 1= 76.3±4.7, group 2 = 73.3±6.3; omission errors: group 1 = 2.3±2.6, group 2 = 4.1±4.3; commission errors: group 1 = 0.7±2.0, group 2 = 1.4±1.8; p <.005 for all variables). No difference in reaction time was seen between groups. In group 1 LC-CPT accuracy and errors did not significantly correlate with the total MMSE score while they did in group 2, suggesting possible differential neurocognitive network recruitment.
Conclusions: Landolt-C continuous performance test is a clinically useful task that minimizes linguistic processing demands and that can also be used in cognitive interventions addressing processing speed and visual attention in MCI and mild dementia.