BACKGROUND AND PURPOSE: The centres dedicated to dementia throughout Europe use different neuropsychological tests in clinical practice. The European Federation of Neurological Societies task force on neuropsychological tests produced this survey on neuropsychological tests currently being used in different European countries to gather knowledge on the practice of dementia centres and to promote the harmonization of such instruments and future multicentre collaborations. METHODS: National representatives of 34 countries received a questionnaire and 25 (73.5%) sent it back. RESULTS: A few instruments, Mini-Mental State Examination (MMSE), Trail Making Test (TMT), Verbal Fluency and Clock Drawing Test, were available in all countries. Wechsler Adult Intelligence Scales and MMSE were reported to be valid, respectively, in 20 (80%) and 19 (76%) countries, whereas Verbal Fluency and Stroop Test are valid in 18 (72%) of them. Of the 25 countries, 17 have validation norms for Clock Drawing Test and TMT (68%), and Neuropsychiatric Inventory, Alzheimer's Disease Assessment Scale - Cognitive Subscale, Rey Complex Figure Test, Digit Symbol and Beck Depression Inventory were standardized in 16 countries (64%). The remaining tests were validated, at most, in about half of them. Not all countries certificate neuropsychology. CONCLUSIONS: Despite the substantial differences in the tools used by the EFNS countries for most domains surveyed by the questionnaire, there is at least one neuropsychological instrument used by about 80% of the countries. There is clearly the need for a broader consensus in the use of neuropsychological tests for dementia diagnosis.

Department of Neurology VU University Medical Center Amsterdam The Netherlands

Institute of Molecular Medicine Faculty of Medicine University of Lisbon Lisbon Portugal

Memory Clinic Department of Neurology Charles University 2nd Medical Faculty and Motol Hospital Prague Prague Czech Republic

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Olesen J, Leonardi M. The burden of brain diseases in Europe. Eur J Neurol 2003; 10: 471-477.

Andlin-Sobocki P, Jonsson B, Wittchen H-U, Olesen J. Cost of disorders of the brain in Europe. Eur J Dementia 2005; 12(Suppl. 1): 1-27.

Lobo A, Launer LJ, Fratiglioni L, et al. Prevalence of dementia and major subtypes in Europe: a collaborative study of population-based cohorts. Neurologic diseases in the elderly research group. Neurology 2000; 54(Suppl. 1): S4-S9.

Waldemar G, Phungh KT, Burns A, et al. Access to diagnostic evaluation and treatment for dementia in Europe. Int J Geriatr Psychiatry 2006; 22: 47-54.

Waldemar G, Dubois B, Emre M, Scheltens P, Tariska P, Rossor M. Diagnosis and management of Alzheimer’s disease and related disorders: the role of neurologists in Europe. Eur J Neurol 2000; 7: 133-144.

Waldemar G, Dubois B, Emre M, et al. Recommendations for the diagnosis and management of Alzheimer’s disease and other disorders associated with dementia: EFNS guideline. Eur J Neurol 2007; 14: 1-26.

Pasquier F. Early diagnosis of dementia: neuropsychology. J Neurol 1999; 246(1): 6-15.

Hodges JR, Garrard P, Perry R, et al. The differentiation of semantic dementia and frontal lobe dementia (temporal and frontal variants of frontotemporal dementia) from early Alzheimer’s disease: a comparative neuropsychological study. Neuropsychology 1999; 13(1): 31-40.

Libon DJ, Xie SX, Wang X, et al. Neuropsychological decline in frontotemporal lobar degeneration: a longitudinal analysis. Neuropsychology 2009; 23(3): 337-346.

Johnstone B, Hogg JR, Schopp LH, Kapila C, Edwards S. Neuropsychological deficit profiles in senile dementia of the Alzheimer’s type. Arch Clin Neuropsychol 2002; 17: 273-281.

Artero S, Tierney MC, Touchon J, Ritchie K. Prediction of transition from cognitive impairment to senile dementia: a prospective, longitudinal study. Acta Psychiatr Scand 2003; 107: 390-393.

Kelly C, Newton-Howes G. Guide to Assessment Scales in Dementia. London: Science Press, 2004.

Diaz SP, Gregório PG, Casado JM, et al. The need for a consensus in the use of assessment tools for Alzheimer’s disease: the feasibility study (assessment tools for dementia in Alzheimer centres across Europe), a European Alzheimer’s disease consortium’s (EADC) survey. Int J Geriatr Psychiatry 2005; 20: 744-748.

Folstein MF, Folstein SE, McHugh PR. Mini-mental state. J Psychiatr Res 1975; 12: 189-198.

Reitan RM. Validity of the Trail Making Test as an indicator of organic brain damage. Percept Mot Skills 1958; 8: 271-276.

Wechsler D. WAIS Manual. New York: The Psychological Corporation, 1955.

Wechlser D. WAIS-R Manual. New York: The Psychological Corporation, 1981.

Wechsler D. Wechsler Adult Intelligence Scale - III. San Antonio: The Psychological Corporation, 1997.

Wechsler D. A standardized memory scale for clinical use. J Psychol 1945; 19: 87-95.

Wechsler D. Wechsler Memory Scale-Revised Manual. San Antonio: The Psychological Corporation, 1987.

Wechsler D. Wechsler Memory Scale. Third Edition Manual. San Antonio: The Psychological Corporation, 1997.

Rosen WG, Mohs RC, Davis KL. A new rating scale for Alzheimer’s disease. Am J Psychiatry 1984; 141: 1356-1364.

Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia. Br J Psychiatry 1982; 140: 566-572.

Rey A. L’examen psychologique dans les cas d’encéphalopathie traumatique. Arch Psychol 1941; 28: 286-340.

Osterrieth PA. Le test de copie d’une figure complexe. Arch Psychol 1944; 30: 206-356.

Schmidt M. Rey Auditory Verbal Learning Test. A Handbook. Los Angeles: Western Psychological Services, 1996.

Stroop JR. Studies of interference in serial verbal reaction. J Exp Psychol 1935; 18: 643-662.

Grant DA, Berg EA. A behavioral analysis of the degree of reinforcement and ease of shifting to new responses in a weigl-type card sorting problem. J Exp Psychol 1948; 38: 404-411.

Kaplan EF, Goodglass H, Weintraub S. The Boston Naming Test, 2nd edn. Philadelphia: Lea & Febiger, 1983.

Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969; 9: 179-186.

Cummings JL, Mega M, Gray K, et al. The neuropsychiatric inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994; 44: 2308-2314.

Beck AT. Beck Depression Inventory. San Antonio: Psychological Corporation, 1987.

Yesavage J, Brink T, Rose T, et al. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1983; 17(1): 37-49.

Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist 1980; 20(6): 649-655.

European Medicines Agency. Guideline on medicinal products for the treatment of Alzheimer’s disease and other dementias. London 2007.

Verhey FR, Huppert FA, Korten EC, et al. Cross-national comparisons of the Cambridge Cognitive Examination-revised: the CAMCOG-R. Age Ageing 2003; 32: 534-540.

Verhey FR, Houx P, Van Lang N, et al. Cross-national comparison and validation of the Alzheimer’s Disease Assessment Scale: results from the European Harmonization Project for Instruments in Dementia (EURO-HARPID). Int J Geriatr Psychiatry 2004; 19: 41-50.

Weintraub S, Salmon D, Mercaldo N, et al. The Alzheimer’s Disease Centers’ Uniform Data Set (UDS): the neuropsychological test battery. Alzheimer Dis Assoc Disord 2009; 23(2): 91-101.

Mathuranath PS, Nestor PJ, Berrios GE, et al. A brief cognitive test battery to differentiate Alzheimer’s disease and frontotemporal dementia. Neurology 2000; 55: 1613-1620.

Nasreddine ZS, Philips NA, Bédirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc 2005; 53(4): 695-699.

Solomon PR, Hirschoff A, Kelly B, et al. A 7 minute neurocognitive screening battery highly sensitive to Alzheimer’s disease. Arch Neurol 1998; 55: 349-355.

Pfeiffer D. SPMSQ: Short Portable Mental Status Questionnaire. J Am Geriatr Soc 1975; 23: 433-441.

Blessed G, Tomlinson BE, Roth M. The association between quantitative measures of dementia and of senile changes in the cerebral grey matter of elderly subjects. Br J Psychiatry 1968; 114: 797-811.

Kiernan RJ, Mueller J, Langston JW. Cognistat (Neurobehavioral Cognitive Status Examination). Lutz, FL: Psychological Assessment Resources, 1995.

Wechsler D. Wechsler Abbreviated Scale of Intelligence Manual. San Antonio: The Psychological Corporation, 1999.

Huppert FA, Brayne C, Gill C, et al. CAMCOG - A concise neuropsychological test to assist dementia diagnosis: socio-demographic determinants in an elderly population sample. J Clin Psychol 1995; 34: 529-541.

Halstead WC. Brain and Intelligence. Chicago: University of Chicago Press, 1947.

Reitan RM, Wolfson D. The Halstead-Reitan Neuropsychological Test Battery. Theory and Clinical Interpretation. Tucson: Neuropsychology Press, 1985.

Reisberg B, Ferris SH, Borenstein J, et al. The Global Deterioration Scale for assessment of primary degenerative dementia. Am J Psychiatry 1982; 139: 1136-1139.

Mattis S. Dementia Rating Scale (DRS). Odessa, FL: Psychological Assessment Resources, 1988.

Reisberg B, Schneck MK, Ferris SH, et al. The Brief Cognitive Rating Scale (BCRS). Findings in primary degenerative dementia (PDD). Psychopharmacol Bull 1983; 19: 734-739.

Delis DC, Kramer JH, Kaplan E, Ober BA. California Verbal Learning Test (CVLT). Adult version (Research Ed.). New York: The Psychological Corporation, 1987.

Benton AL. Revised Visual Retention Test, 4th edn. New York: Psychological Corporation, 1974.

Sivan AB. Benton Visual Retention Test, 5th edn. San Antonio: The Psychological Corporation, 1992.

Morris JC, Heyman A, Mohs RC, et al. The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer’s disease. Neurology 1989; 39: 1159-1165.

Wilson BA, Cockburn J, Baddeley A. The Rivermead Behavioural Memory Test. Bury St. Edmunds, UK: Thames Valley Test, 1985.

Buschke H, Fuld PA. Evaluation of storage, retention, and retrieval in disordered memory and learning. Neurology 1974; 11: 1019-1025.

Warrington EK. The Camden Memory Tests. Hove, UK: Psychology Press, 1986.

Grober E, Buschke H. Genuine memory deficits in dementia. Dev Neuropsychol 1987; 3: 13-36.

Brandt J. The Hopkins Verbal Learning Test: development of a new verbal memory test with six equivalent forms. Clin Neuropsychol 1991; 5: 125-142.

Benedict RHB, Schretlen D, Groninger L, Brandt J. Hopkins Verbal Learning Test-Revised: normative data and analysis of inter-form and test-retest reliability. Clin Neuropsychol 1998; 12: 43-55.

Milner B. Interhemispheric differences in the localization of psychological processes in man. Br Med Bull 1971; 27: 272-277.

Trahan DE, Larrabee GJ. Continuous Visual Memory Test. Odessa, FL: Psychological Assessment Resources, 1988.

Arnett PA, Hammeke TA, Schwartz L. Quantitative and qualitative performance on Rey’s 15-Item Test in neurological patients and dissimulators. Clin Neuropsychol 1995; 9(1): 17-26.

Gronwall DMA. Paced Auditory Serial-Addition Task: a measure of recovery from concussion. Percept Mot Skills 1977; 44: 367-373.

Smith A. Symbol Digit Modalities Test (SDMT), Manual (revised). Los Angeles: Western Psychological Services, 1982.

Rosvold HE, Mirsky AF, Sarason I, et al. A continuous performance test of brain damage. J Consult Psychol 1956; 20: 343-350.

Porteus SD. The Maze Test and Clinical Psychology. Palo Alto, CA: Pacific Books, 1959.

Dubois B, Slachevsky A, Litvan I, Pillon B. The FAB: a frontal assessment battery at bedside. Neurology 2000; 55: 1621-1626.

Delis DC, Kaplan E, Kramer J. Delis-Kaplan Executive Function Scale. San Antonio: Psychological Corporation, 2001.

Norris G, Tate RL. The Behavioural Assessment of the Dysexecutive Syndrome (BADS): ecological, concurrent and construct validity. Neuropsychol Rehabil 2000; 10: 33-45.

Regard M, Strauss E, Knapp P. Children’s production on verbal and non-verbal fluency tasks. Percept Mot Skills 1982; 55: 839-844.

McFie J, Piercy MF. The relation of laterality of lesion to performance on Weigl’s sorting test. J Ment Sci 1952; 98: 299-305.

Burgess PW, Shallice T. The Hayling and Brixton Tests. Bury St., Edmunds, UK: Thames Valley Test Company, 1997.

Shallice T, Evans ME. The involvement of the frontal lobes in cognitive estimation. Cortex 1978; 14: 294-303.

Grigsby J, Kaye K. Behavioral Dyscontrol Scale: Manual, 2nd edn. Denver, CO: Authors, 1996.

Benton AL, Sivan AB, Hamsher KS. Contributions to Neuropsychological Assessment. A Clinical Manual, 2nd edn. New York: Oxford University Press, 1994.

Goodglass H, Kaplan E. Boston Diagnostic Aphasia Examination (BDAE). Philadelphia: Lea and Febiger, 1983.

Goodglass H, Kaplan E, Barresi B. The Boston Diagnostic Aphasia Examination (BDAE-3), 3rd edn. Philadelphia: Lippincott, 2000.

De Renzi E, Vignolo LA. The Token Test: a sensitive test to detect disturbances in aphasics. Brain 1962; 85: 665-678.

Benton Al, Hamsher KS. Multilingual Aphasia Examination. Iowa City: AJA Associates, 1989.

Kertesz A. Western Aphasia Battery. San Antonio: Psychological Corporation, 1982.

Benton AL, Hamsher KS, Sivan AB. Multilingual Aphasia Examination, 3rd edn. Iowa City: AJA Associates, 1994.

Snodgrass JG, Vanderwart M. A standardized set of 260 pictures: norms for name agreement, image agreement, familiarity and visual complexity. J Exp Psychol Hum Learn 1980; 6: 174-215.

Bishop DVM. Comprehension of English syntax by profoundly deaf children. J Child Psychol Psychiatry 1983; 24: 415-434.

Katz MM, Lyerly SB. Methods for measuring adjustment and social behavior in the community: I. Rationale, description, discriminative validity and scale development. Psychol Rep 1963; 13: 503-535.

Galasko D, Bennett D, Sano M, et al. An inventory to assess activities of daily living for clinical trials in Alzheimer’s disease. The Alzheimer’s Disease Cooperative Study. Alzheimer Dis Assoc Disord 1997; 11(Suppl. 2): S33-S39.

Gélinas I, Gauthier L, McIntyre M, Gauthier S. Development of a functional measure for persons with Alzheimer′s disease: the Disability Assessment for Dementia. Am J Occup Ther 1999; 53: 471-481.

Grundman M, Petersen RC, Morris JC, et al. Rate of dementia of Alzheimer type (DAT) in subjects with mild cognitive impairment: the Alzheimer’s Disease Cooperative Study. Neurology 1996; 46: A403.

Pfeffer RI, Kurosaki TT, Harrah CH Jr, Chance JM, Filos S. Measurement of functional activities in older adults in the community. J Gerontol 1982; 7(3): 323-329.

Kertesz A, Davidson W, Fox H. Frontal behavioral inventory: diagnostic criteria for frontal lobe dementia. Can J Neurol Sci 1997; 24: 29-36.

Alexopoulos GS, Abrams RC, Young RC, Shamoian CA. Cornell scale for depression in dementia. Biol Psychiatry 1988; 23: 271-284.

Montgomery SA, Asberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry 1979; 134: 382-389.

Spielberger CD, Gorsuch RL, Lushene RE. Manual for the State-Trait Anxiety Inventory. Palo Alto, CA: Consulting Psychologists Press, 1970.

Butcher JN, Dahlstrom WG, Graham JR, et al. Manual for the Restandardized Minnesota Multiphasic Personality Inventory: MMPI-2. Minneapolis: University of Minnesota Press, 1989.

Hathaway SR, McKinley JC. The Minnesota Multiphasic Personality Inventory Manual (rev.). New York: The Psychological Corporation, 1951.

Zung WWK. A self-rating depression scale. Arch Gen Psychiatry 1965; 12: 63-70.

Reisberg B, Borenstein J, Sclan SG, et al. BEHAVE-AD: a clinical rating scale for the assessment of pharmacologically remediable behavioral symptomatology in Alzheimer’s disease. In: Altman HJ, ed. Alzheimer’ Disease: Problems, Prospects, and Perspectives. New York: Plenum, 1987: 1-16.

Zung WWK. A rating instrument for anxiety disorders. Psychosomatics 1971; 12: 371-379.

Radloff LS. The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977; 1: 385-401.

Hamilton M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960; 23: 56-62.

Morey LC. The Personality Assessment Screener Professional Manual. Lutz, FL: Psychological Assessment Resources, 1997.

Morey LC. The Personality Assessment Inventory Professional Manual. Lutz, FL: Psychological Assessment Resources, 2007.

Contribution of Memory Tests to Early Identification of Conversion from Amnestic Mild Cognitive Impairment to Dementia

Blood markers of oxidative stress in Alzheimer's disease