www.alzselftest.com
Computerized Selftest (cst)
(5) Severe Alzheimer’s Disease (SEV):
CST MEAN SCORE:
9
The severe AD group shows extreme deficits in all cognitive domains. This
group in our database did not show symptoms of anosognosia. Numerous
difficulties may be present at this stage of AD, including aphasia
(language/communication) and a lack of self awareness and self concept.
There may also be difficulties remembering family members names and
faces. Additionally, patients may recall long-term memories in place of
recent items (eg, remembering adult sons or daughters as children).
Standard Deviation
1.80, Minimum 7,
Maximum 11
Activities of daily living are significantly impaired and, unfortunately,
treatment options at this stage of the disease are more limited.
Individuals may be unable to operate the toilet and may become
incontinent of both urine and stool. They may develop a fear of bathing.
In severe Alzheimer’s disease, ambulation may ultimately be impaired. Education of caregivers and steps to
accommodate the supportive care for the patient become increasingly important.
Neurocognitive domain mean raw scores for all SEV groups in cst database:
30
29
25
SCORE
20
15
15
legend:
10
9
9
or
e
sc
ta
l
to
nt
at
i
on
on
ie
SEVERE Alzheimer’s Disease
control group
3
0
or
en
ti
y
at
t
or
em
ue
nc
y
al
0
rb
al
fl
pa
ti
su
al
-s
vi
oc
e
ss
in
g
sp
ee
d
0
3
5
2
2
5
4
2
m
4
ve
5
Pr
SUMMARY: Noticeable differences between
the control group and patients with severe
alzheimer’s disease are found in all areas
definied, especially in their processing
speeds, verbal fluency, memory, attention
and orientation.
www.alzselftest.com
Computerized Selftest (cst)
(4) Moderate to Severe Alzheimer’s
Disease (Msev):
CST MEAN SCORE:
18
Moderate to severe AD shows global deficits in most cognitive domains.
Individuals may wear the same clothing repeatedly and may even require
assistance in choosing appropriate clothes for the season. Interestingly,
nearly half of this group exhibited anosognosic symptoms, or were
apparently unaware of deficits in memory and cognitive functions as well
as abnormalities in activities of daily living.
Standard Deviation
1.80, Minimum 15,
Maximum 22
Neurocognitive domain mean raw scores for all Msev groups in cst database:
30
29
25
18
Msev Alzheimer’s Disease
3
control group
3
1
or
e
on
ie
or
en
ti
y
or
em
m
nc
y
ue
pa
ti
4
0
al
d
ee
su
al
-s
sp
vi
ng
si
es
Pr
oc
2
3
0
5
at
t
4
rb
al
fl
5
4
sc
9
legend:
on
10
ta
l
10
to
15
nt
at
i
15
ve
SCORE
20
SUMMARY: Noticeable differences between
the control group and patients with
moderate to severe alzheimer’s disease are
found in all areas defined, especially in
their processing speeds, verbal fluency,
memory and orientation.
www.alzselftest.com
Computerized Selftest (cst)
(3) Mild to Moderate Alzheimer’s
Disease (Mmod):
CST MEAN SCORE:
22
Mild to moderate AD typically involves impairments in many cognitive
domains, with memory and verbal fluency being the most likely to show
significant deficits. Medications are very important at this stage of
impairment, and intensive monitoring is vital to the overall care and
quality of life for the patient.
Decreased ability to perform complex tasks such as preparing meals for guests,
Standard Deviation
1.50, Minimum 19,
Maximum 24
handling finances and grocery shopping are often impaired. Activities of daily
living (ADL) may also be impaired at this stage of the disease. These deficits depend on individual differences and possibly well-learned behaviors.
This stage may also increase difficulties with interpersonal communication, thereby decreasing social engagement
and activities. In our database, very few of the individuals exhibit lack of awareness of deficits in this group.
Additionally, motoric skills necessary for driving may also begin to be affected in individuals producing total scores of
less than 20. This driving effect has also been shown in research to be associated with MMSE scores less than 20.
Neurocognitive domain mean raw scores for all Mmod groups in cst database:
30
29
25
22
15
15
3
control group
e
to
ta
l
or
sc
or
on
on
2
ie
ti
nc
y
al
fl
ue
pa
ti
ve
rb
al
-s
su
4
0
al
d
sp
ee
vi
g
in
ss
oc
e
2
3
MMOD Alzheimer’s Disease
nt
at
i
4
en
4
5
at
t
5
or
y
9
0
Pr
legend:
12
10
m
em
SCORE
20
SUMMARY: Noticeable differences
between the control group and patients
with mild to moderate alzheimer’s disease
are found in all areas defined, especially
in their processing speeds, verbal fluency,
and memory.
www.alzselftest.com
Computerized Selftest (cst)
(2) Early Alzheimer’s Disease (EAD):
CST MEAN SCORE:
25
Early AD is characterized by neurocognitive deficits in two or more
cognitive domains. Early AD typically involves impairment in several
cognitive domains, with memory being the most likely to show
significant deficits. Repeating oneself and asking the same question
over again is frequently one of the earliest signs of Alzheimer’s disease.
Difficulty in traveling to a new location and decreased organizational
capacity are early symptoms, as well as difficulty in paying bills, writing
Standard Deviation
1.20, Minimum 22,
Maximum 27
checks and balancing the checkbook. Medications are very important at
this stage of impairment, and further monitoring is vital to the overall
care and quality of life for the patient.
Another area of concern is an individual’s reaction to a negative report of memory problems or other
cognitive symptoms. In our database, however, 48% of the Early AD group manifests symptoms of
anosognosia (unawareness) of memory or other cognitive deficits. In Early AD, activities of daily living may
or may not be compromised, and frequently objective confirmation of the clinical history may be necessary.
In this stage, the clinical examination and neuroimaging data are often critical in confirming the diagnosis.
Neurocognitive domain mean raw scores for all EAD groups in cst database:
30
29
25
25
15
15
13
legend:
Early Alzheimer’s Disease
8
2
e
or
on
ta
ti
en
or
y
em
m
on
or
i
rb
al
fl
ue
pa
ti
ve
al
-s
su
nc
y
al
d
ee
sp
vi
ng
si
oc
es
control group
2
1
0
Pr
3
5
sc
4
ti
4
en
5
to
ta
l
10
at
t
SCORE
20
SUMMARY: Noticeable differences between
the control group and patients with
early alzheimer’s disease are found in
their processing speeds, verbal fluency,
memory and orientation.
www.alzselftest.com
Computerized Selftest (cst)
(1) Mild Cognitive Impairment (MCI):
CST MEAN SCORE:
27
MCI is defined as a change in cognition that is noticed by the individual, as
well as by an informant or skilled clinician. Typically, MCI is attributed to a
deficit in memory, although occasionally other cognitive domains are involved. Patients with deficits in two or more cognitive domains convert to AD
at a greater rate (>8-9%/yr.) than those with impairment only in memory.
In MCI, the patient’s performance on neurocognitive tests in an impaired
domain such as memory would be 1 to 1.5 standard deviations lower, as
Standard Deviation
1.50, Minimum 24,
Maximum 29
contrasted with other domain scores, and lower than would be expected
given age and education. Unlike many of the stages within AD, MCI does
not impair activities of daily living (eg, paying bills, grooming or
preparing meals) and the patient may maintain a subjective awareness of
the deficit. Additional tests to rule out the effects of stress, anxiety, depression or other medical conditions may
be warranted since many of these conditions may produce changes in memory.
Neurocognitive domain mean raw scores for all MCI groups in cst database:
30
29
27
25
15
14
15
10
legend:
MCI Alzheimer’s Disease
8
or
e
sc
to
ta
l
nt
at
i
on
on
ie
or
y
m
em
al
fl
ue
pa
ti
ve
rb
al
-s
su
nc
y
al
d
sp
ee
vi
g
in
ss
oc
e
control group
3
1
0
Pr
5
2
4
or
4
en
ti
5
at
t
SCORE
20
SUMMARY: Noticeable differences
between the control group and patients
with mild Cognitive Impairment are found
in their processing speeds and memory.
www.alzselftest.com
Computerized Selftest (cst)
(0) Normal Aging:
CST MEAN SCORE:
29
The normal aging group may or may not show scores lower than the
mean. However, such scores do not necessarily reflect any objective
abnormalities of cognition, even though an individual may have some
cognitive complaints.
Standard Deviation
1.02, Minimum 28,
Maximum 30
Neurocognitive domain mean raw scores for normal aging groups in cst database:
30
29
25
SCORE
20
15
SUMMARY: there are no noticeable
differences between the control group and
patients with normal aging.
15
10
legend:
ve
e
or
sc
on
ta
l
nt
at
i
y
em
or
m
nc
y
io
ie
to
rb
al
fl
ue
pa
ti
al
d
ee
ua
ls
sp
vi
s
g
in
ss
oc
e
normal aging
3
n
2
0
Pr
5
or
4
en
t
4
at
t
5