Alzheimer’s disease dementia (ADD) is an important health problem in the world.
Objective:
The present study investigated the validity and reliability of a new version of the Frontal Assessment Battery (FAB) named the FAB-phonemic (FAB-P).
Methods:
A total of 76 patients with ADD, 107 patients with amnestic mild cognitive impairment (aMCI), 37 patients with non-amnestic MCI (naMCI), and 123 healthy controls were included in this study. All participants were evaluated with the FAB-P and the cognitive assessments according to a standard procedure.
Results:
The global FAB-P scores in patients with ADD were lower than those of patients with aMCI, patients with naMCI, and healthy controls (p < 0.001). Patients with aMCI performed worse than healthy controls (p < 0.001). The interrater reliability, test-retest reliability, and Cronbach’s alpha coefficient for the FAB-P were 0.997, 0.819, and 0.736, respectively. The test could distinguish the patients with mild ADD, aMCI, and naMCI from healthy controls with classification accuracy of 89.4%, 70.9%, and 61.6%, respectively. It could also discriminate between the patients with ADD and aMCI, between those with ADD and naMCI, and between those with aMCI and naMCI with classification accuracy of 73.8%, 83.9%, and 58.0%, respectively. The regression analysis revealed that the Montreal Cognitive Assessment and the Stroop Color Word Test Part C had the greatest contribution to FAB-P score variance.
Conclusion:
The FAB-P is a valid and reliable tool for evaluating frontal lobe function and can effectively discriminate ADD, aMCI, and naMCI.
JiaJ, WangF, WeiC, ZhouA, JiaX, LiF, TangM, ChueL, ZhouY, ZhouC, CuiY, WangQ, WangW, YinP, HuN, ZuoX, SongH, QinW, WuL, LiD, JiaL, SongJ, HanY, XingY, YangP, LiY, QiaoY, TangY, LvJ, DongX (2014) The prevalence of dementia in urban and rural areas of China. Alzheimers Dement10, 1–9.
2.
JiaJ, ZhouA, WeiC, JiaX, WangF, LiF, WuX, MokV, GauthierS, TangM, ChuL, ZhouY, ZhouC, CuiY, WangQ, WangW, YinP, HuN, ZuoX, SongH, QinW, WuL, LiD, JiaL, SongJ, HanY, XingY, YangP, LiY, QiaoY, TangY, LvJ, DongX (2014) The prevalence of mild cognitive impairment and its etiological subtypes in elderly Chinese. Alzheimers Dement10, 439–447.
3.
NagataT, ShinagawaS, OchiaiY, AokiR, KasaharaH, NukariyaK, NakayamaK (2011) Association between executive dysfunction and hippocampal volume in Alzheimer’s disease. Int Psychogeriatr23, 764–771.
4.
DuboisB, SlachevskyA, LitvanI, PillonB (2000) The FAB: A Frontal Assessment Battery at bedside. Neurology55, 1621–1626.
5.
MokVC, WongA, YimP, FuM, LamWW, HuiAC, YauC, WongKS (2004) The validity and reliability of Chinese frontal assessment battery in evaluating executive dysfunction among Chinese patients with small subcortical infarct. Alzheimer Dis Assoc Disord18, 68–74.
6.
WangTL, HungYH, YangCC (2016) Psychometric properties of the Taiwanese (traditional Chinese) version of the frontal assessment battery: A preliminary study. Appl Neuropsychol Adult23, 11–20.
7.
HsuYH, HuangCF, LoCP, WangTL, YangCC, TuMC (2016) Frontal assessment battery as a useful tool to differentiate mild cognitive impairment due to subcortical ischemic vascular disease from Alzheimer disease. Dement Geriatr Cogn Disord42, 331–341.
8.
McKhannGM, KnopmanDS, ChertkowH, HymanBT, JackCRJr, KawasCH, KlunkWE, KoroshetzWJ, ManlyJJ, MayeuxR, MohsRC, MorrisJC, RossorMN, ScheltensP, CarrilloMC, ThiesB, WeintraubS, PhelpsCH (2011) The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement7, 263–269.
9.
MorrisJC (1993) The Clinical Dementia Rating (CDR): Current version and scoring rules. Neurology43, 2412–2414.
10.
ZhangMY, KatzmanR, SalmonD, JinH, CaiGJ, WangZY, QuGY, GrantI, YuE, LevyP, KlauberMR, LiuWT (1990) The prevalence of dementia and Alzheimer’s disease in Shanghai, China: Impact of age, gender, and education. Ann Neurol27, 428–437.
11.
PetersenRC (2004) Mild cognitive impairment as a diagnostic entity. J Intern Med256, 183–194.
12.
StraussE, ShermanEM, SpreenO (2006) A compendium of neuropsychological tests: Administration, norms, and commentary, 3rd edn. Oxford University Press, New York.
13.
OsterriethPA (1994) Le test de copie d’une figure complexe. Arch Psychol30, 206–356.
14.
NasreddineZS, PhillipsNA, BédirianV, CharbonneauS, WhiteheadV, CollinI, CummingsJL, ChertkowH (2005) The Montreal Cognitive Assessment, MoCA: A brief screening tool for mild cognitive impairment. J Am Geriatr Soc53, 695–699.
15.
DaiXY, RyanJJ, PaoloAM, HarringtonRG (1990) Factor analysis of the mainland Chinese version of the Wechsler Adult Intelligence Scale (WAIS-RC) in a brain-damaged sample. Int J Neurosci55, 107–111.
16.
LuL, BiglerED (2000) Performance on original and a Chinese version of trail making test part B: A normative bilingual sample. Appl Neuropsychol7, 243–246.
17.
CheungRW, CheungMC, ChanAS (2004) Confrontation naming in Chinese patients with left, right or bilateral brain damage. J Int Neuropsychol Soc10, 46–53.
18.
RouleauI, SalmonDP, ButtersN, KennedyC, McGuireK (1992) Quantitative and qualitative analyses of clock drawings in Alzheimer’s and Huntington’s disease. Brain Cogn18, 70–87.
19.
KimJW, LeeDY, SeoEH, SohnBK, ParkSY, ChooIH, YounJC, JhooJH, KimKW, WooJI (2013) Improvement of dementia screening accuracy of Mini-Mental State Examination by education-adjustment and supplementation of frontal assessment battery performance. J Korean Med Sci28, 1522–1528.
20.
Hurtado-PomaresM, Carmen Terol-CanteroM, Sánchez-PérezA, Peral-GómezP, Valera-GranD, Navarrete-MuñozEM (2018) The frontal assessment battery in clinical practice: A systematic review. Int J Geriatr Psychiatry33, 237–251.
21.
KrudopWA, KerssensCJ, DolsA, PrinsND, MöllerC, SchouwsS, van der FlierWM, ScheltensP, SikkesS, StekML, PijnenburgYA (2015) Identifying bvFTD within the wide spectrum of late onset frontal lobe syndrome: A clinical approach. Am J Geriatr Psychiatry23, 1056–1066.
22.
RamananS, BertouxM, FlanaganE, IrishM, PiguetO, HodgesJR, HornbergerM (2017) Longitudinal executive function and episodic memory profiles in behavioral-variant frontotemporal dementia and Alzheimer’s disease. J Int Neuropsychol Soc23, 34–43.
23.
BobanM, MalojcićB, MimicaN, VukovićS, ZrilićI (2012) The frontal assessment battery in the differential diagnosis of dementia. J Geriatr Psychiatry Neurol25, 201–207.
24.
KawaiY, MiuraR, TsujimotoM, SakuraiT, YamaokaA, TakedaA, ArahataY, WashimiY, KachiT, TobaK (2013) Neuropsychological differentiation between Alzheimer’s disease and dementia with Lewy bodies in a memory clinic. Psychogeriatrics13, 157–163.
25.
D’OnofrioG, PanzaF, SancarloD, AddanteF, SolfrizziV, CantariniC, MangiacottiA, LauriolaM, CascavillaL, ParisF, LozuponeM, DanieleA, GrecoA, SeripaD (2018) Executive dysfunction detected with the frontal assessment battery in Alzheimer’s disease versus vascular dementia. J Alzheimers Dis62, 699–711.
26.
PaviourDC, WinterburnD, SimmondsS, BurgessG, WilkinsonL, FoxNC, LeesAJ, JahanshahiM (2005) Can the frontal assessment battery (FAB) differentiate bradykinetic rigid syndromes? Relation of the FAB to formal neuropsychological testing. Neurocase11, 274–282.
27.
ChongMS, LimWS, ChanSP, FengL, NitiM, YapP, YeoD, NgTP (2010) Diagnostic performance of the Chinese Frontal Assessment Battery in early cognitive impairment in an Asian population. Dement Geriatr Cogn Disord30, 525–532.
28.
GuoX, SongW, ChenK, ChenX, ZhengZ, CaoB, HuangR, ZhaoB, WuY, ShangHF (2015) Impact of frontal lobe function and behavioral changes on health-related quality of life in patients with Parkinson’s Disease: A cross-sectional study from southwest China. Eur Neurol74, 147–153.
29.
CaoB, ZhaoB, WeiQQ, ChenK, YangJ, OuR, WuY, ShangHF (2015) The global cognition, frontal lobe dysfunction and behavior changes in Chinese patients with multiple system atrophy. PLoS One10, e0139773.
30.
OuR, LiuH, HouY, WeiQ, CaoB, ZhaoB, ShangH (2017) Executive dysfunction, behavioral changes and quality of life in Chinese patients with progressive supranuclear palsy. J Neurol Sci380, 182–186.
31.
WeiQ, ChenX, ZhengZ, HuangR, GuoX, CaoB, ZhaoB, ShangHF (2014) Frontal lobe function and behavioral changes in amyotrophic lateral sclerosis: A study from southwest China. J Neurol261, 2393–2400.
32.
BaudicS, BarbaGD, ThibaudetMC, SmaggheA, RemyP, TraykovL (2006) Executive function deficits in early Alzheimer’s disease and their relations with episodic memory. Arch Clin Neuropsychol21, 15–21.
33.
KirovaAM, BaysRB, LagalwarS (2015) Working memory and executive function decline across normal aging, mild cognitive impairment, and Alzheimer’s disease. Biomed Res Int2015, 748212.
34.
YamaoA, NagataT, ShinagawaS, NukariyaK, OchiaiY, KasaharaH, NakayamaK (2011) Differentiation between amnestic-mild cognitive impairment and early-stage Alzheimer’s disease using the frontal assessment battery test. Psychogeriatrics11, 235–241.
35.
ClarkLR, SchiehserDM, WeissbergerGH, SalmonDP, DelisDC, BondiMW (2012) Specific measures of executive function predict cognitive decline in older adults. J Int Neuropsychol Soc18, 118–127.
36.
EwersM, BrendelM, Rizk-JacksonA, RomingerA, BartensteinP, SchuffN, WeinerMW; Alzheimer’s Disease Neuroimaging Initiative (ADNI) (2013) Reduced FDG-PET brain metabolism and executive function predict clinical progression in elderly healthy subjects. Neuroimage Clin4, 45–52.
37.
NagataT, IshiiK, ItoT, AokiK, EharaY, KadaH, KadaH, FurukawaH, TsumuraM, ShinagawaS, KasaharaH, NakayamaK (2009) Correlation between a reduction in Frontal Assessment Battery scores and delusional thoughts in patients with Alzheimer’s disease. Psychiatry Clin Neurosci63, 449–454.
38.
MartyrA, ClareL (2012) Executive function and activities of daily living in Alzheimer’s disease: A correlational meta-analysis. Dement Geriatr Cogn Disord33, 189–203.
39.
MarshallGA, RentzDM, FreyMT, LocascioJJ, JohnsonKA, SperlingRA; Alzheimer’s Disease Neuroimaging Initiative (2011) Executive function and instrumental activities of daily living in mild cognitive impairment and Alzheimer’s disease. Alzheimers Dement7, 300–308.
40.
ZhouB, ZhaoQ, TeramukaiS, DingD, GuoQ, FukushimaM, HongZ (2010) Executive function predicts survival in Alzheimer disease: A study in Shanghai. J Alzheimers Dis22, 673–682.
41.
HarringtonMG, ChiangJ, PogodaJM, GomezM, ThomasK, MarionSD, MillerKJ, SiddarthP, YiX, ZhouF, LeeS, ArakakiX, CowanRP, TranT, CharleswellC, RossBD, FontehAN (2013) Executive function changes before memory in preclinical Alzheimer’s pathology: A prospective, cross-sectional, case control study. PLoS One8, e79378.
42.
MatsuokaT, KatoY, ImaiA, FujimotoH, ShibataK, NakamuraK, YamadaK, NarumotoJ (2018) Differences in the neural correlates of frontal lobe tests. Psychogeriatrics18, 42–48.
43.
Nakamura-PalaciosEM, SouzaRS, Zago-GomesMP, de MeloAM, BragaFS, KuboTT, GasparettoEL (2014) Gray matter volume in left rostral middle frontal and left cerebellar cortices predicts frontal executive performance in alcoholic subjects. Alcohol Clin Exp Res38, 1126–1133.
44.
OshimaE, TeradaS, SatoS, IkedaC, NagaoS, TakedaN, HondaH, YokotaO, UchitomiY (2012) Frontal assessment battery and brain perfusion imaging in Alzheimer’s disease. Int Psychogeriatr24, 994–1001.
45.
YoshidaH, TeradaS, SatoS, KishimotoY, AtaT, OhshimaE, HondaH, IshiharaT, KurodaS (2009) Frontal assessment battery and brain perfusion imaging in early dementia. Dement Geriatr Cogn Disord27, 133–138.
TuMC, LoCP, HuangCF, HsuYH, HuangWH, DengJF, LeeYC (2017) Effectiveness of diffusion tensor imaging in differentiating early-stage subcortical ischemic vascular disease, Alzheimer’s disease and normal ageing. PLoS One12, e0175143.
48.
YuanB, ChenJ, GongL, ShuH, LiaoW, WangZ, LiuD, XieC, ZhangZ (2016) Mediation of episodic memory performance by the executive function network in patients with amnestic mild cognitive impairment: A resting-state functional MRI study. Oncotarget7, 64711–64725.
49.
BrownCA, SchmittFA, SmithCD, GoldBT (2019) Distinct patterns of default mode and executive control network circuitry contribute to present and future executive function in older adults. Neuroimage195, 320–332.
