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17 The Chinese Version of Craft Story Recall: A Preliminary Study on the Diagnostic Values of Mild Cognitive Impairment and Dementia.
- Gelan Ying, Judith Neugroschl, Amy Aloysi, Dongming Cai, Tianxu Xia, Carolyn W Zhu, Xiaoyi Zeng, Jimmy Akrivos, Linghsi Liu, Yiyu Cao, Wei-Qian Wang, Mary Sano, Glenn E Smith, Clara Li
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 700-701
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- Article
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Objective:
Craft story recall test in the National Alzheimer’s Coordinating Center Uniformed Data Set 3 (NACC UDS3) neuropsychological battery has been employed to assess verbal memory and assist clinical diagnosis of mild cognitive impairment (MCI) and dementia. While a Chinese version of the test was adapted, no existing literature has examined the diagnostic validity of the test in Chinese Americans. This study aimed to evaluate the predictive validity of both immediate and delayed recall.
Participants and Methods:The Chinese version of Craft Story was administered in to 78 Chinese participants per their language preference of Mandarin or Cantonese. Outcome measures were verbatim and paraphrase recall of the story immediately and after a 20-minute delay. A multiple linear regression was performed to investigate the association of each outcome measure with age, education, gender, age when moved to the U.S., years in the U.S., and testing language. To assess its diagnostic value, cutoff standard deviation scores of -1.5 and -2.0 from the mean of the clinically cognitive normal participants were generated for MCI and dementia diagnoses, respectively. Due to the small sample size, a normative group fitting the mean age (73 years), years of education (12 years), and the majority gender (female) of the current sample were used to identify standard cut points. A receiver-operating characteristic analysis was used to compare predicted diagnosis with actual clinical diagnosis obtained through patients’ overall performance and a consensus meeting by licensed clinicians.
Results:Younger age (p < 0.05) and being tested in Mandarin (p < .01) were positively associated with immediate and delayed recall. Strong positive correlations between each measure were observed (all p < .001), indicating a significant relationship between information encoded and retained. Among all the participants, 15 (19.2%) were diagnosed with MCI and 22 (28.2%) with dementia. For MCI diagnosis, the standard cutoff scores demonstrated adequate sensitivity (verbatim=82%, paraphrase=91%) but low specificity (verbatim=44%, paraphrase=67%) in all outcome measures. For dementia diagnosis, delayed recall showed strong sensitivity (100%) and adequate specificity (75%) in both verbatim and paraphrasing scores. Immediate recall paraphrase (sensitivity = 95%, specificity = 50%) showed a better sensitivity but lower specificity than verbatim scoring (sensitivity = 86%, specificity = 58%). The accuracy was higher in delayed recall for both MCI and dementia diagnosis. A preliminary analysis on the optimal cut points indicated higher cutoff scores to distinguish MCI and dementia from clinically cognitive normal population, and from each other (e.g., the optimal cut point for delayed verbatim in distinguishing MCI from normal is 8.0 (sensitivity=89%, specificity=73%, AUC=84.3%)).
Conclusions:Consistent with previous literature, Craft Story delayed recall served as a more accurate diagnostic tool for both MCI and dementia compared to immediate recall in older Chinese Americans. However, poor specificity might increase the chance of following false positive subjects in clinical trials. In addition, testing language appeared to impact performance on verbal memory recall of constructed information. Thus, future studies should focus on developing normative scores that address both the overall cultural differences of Chinese Americans and the heterogeneity within this population.
10 - Molecular determinants of marsupial limb integration and constraint
- Edited by Robert J. Asher, University of Cambridge, Johannes Müller
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- Book:
- From Clone to Bone
- Published online:
- 05 November 2012
- Print publication:
- 18 October 2012, pp 257-278
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Summary
Introduction
What are the intrinsic factors responsible for shaping mammalian biodiversity? This question is highly relevant to discussion of the two groups of therian mammals alive today, marsupials (kangaroos, possums, etc.) and placentals (humans, bats, whales, etc.). Despite arising at the same time, marsupials have never achieved the taxonomic or morphologic diversity of their sister group, the placentals (Lillegraven 1975; Kirsch 1977; Sears 2004; Cooper and Steppan 2010). To explain this phenomenon, scientists hypothesized that the evolution of marsupials had been constrained relative to that of placentals as a result of marsupials’ unique mode of reproduction (Lillegraven 1975; Klima 1987; Sanchez-Villagra and Maier 2003).
Subsequent research confirmed that marsupials are less morphologically diverse and specialized than placentals (Sears 2004; Cooper and Steppan 2010; Kelly and Sears 2011a). Sears (2004) found that the shoulder girdles of living and extinct adult marsupials are less diverse than those of adult placentals, and adult marsupial scapulae are less morphologically diverse than adult marsupial pelves, as predicted by the marsupial constraint. Cooper and Steppan (2010) and Kelly and Sears (2011a) found that this pattern extended to forelimb versus hind limb comparisons in living mammals. Sears (2004) also linked this reduction in morphological diversity to a reduction in morphologic variation during development as a result of the functional requirements on the marsupial newborn.