Development of the Colorado posterior cortical questionnaire within an Alzheimer’s disease study cohort

ABSTRACT

Introduction

Non-amnestic presentations of neurodegenerative dementias, including posterior- and visual-predominant cognitive forms, are under-recognized. Specific screening measures for posterior cortical symptoms could allow for earlier, more accurate diagnosis and directed treatment.

Methods

Based on clinical experience with posterior cortical atrophy evaluations, high-yield screening questions were collected and organized into a 15-item self-report questionnaire, titled the Colorado Posterior Cortical Questionnaire (CPC-Q). The CPC-Q was then piloted within a longitudinal cohort of cognitive aging, including 63 older adults, including healthy older adults (n = 33) and adults with either amnestic Alzheimer’s disease (n = 21) or posterior cortical atrophy (PCA, n = 9).

Results

The CPC-Q demonstrated acceptable psychometric properties (internal consistency, α = 0.89; mean item-total correlation = 0.62), correlated strongly with visuospatial measures on cognitive testing (p < 0.001), and could distinguish PCA from non-PCA groups (p < 0.001; AUC 0.95 (95% CI 0.88, 1.0)).

Conclusions

The CPC-Q captured posterior cortical symptoms in older adults, using a gold standard of expert consensus PCA diagnosis. Future studies will validate the CPC-Q in a larger cohort, with recruitment of additional PCA participants, to evaluate its convergent and discriminant validity more thoroughly. As a short, self-report tool, the CPC-Q demonstrates potential to improve detection of non-amnestic neurodegenerative dementias in the clinical setting.

KEYWORDS:

• Cognitive impairment
• visuospatial
• screening
• posterior cortical atrophy
• Alzheimer’s disease

Acknowledgments

The authors would like to thank the professional research assistants of the University of Colorado Alzheimer’s and Cognition Center (CUACC), including Tanner Gustavsen, Rini Kaplan, Katherine Varley, Katrina Bengston, Jada Boyd, Erika Dallman, Grace Fishback, Jennifer Krupa, Natalie Lopez-Esquibel, Abigail Simpson, and Michelle Stocker, as well as the Behavioral Neurology fellows, including Dr. James Bateman, Dr. Tara Carlisle, Dr. Isaiah Kletenik, Dr. Zachary Macchi, Dr. Jakob Mrozewski, Dr. Justin Otis, and Dr. Justin Persson, who performed histories and examinations on participants. We thank Dr. Huntington Potter, director and founder of the CUACC, for his support of this longitudinal cohort. We also sincerely thank the Bio-AD study participants and their families for their donation of their time, mental energy, and support of this work.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work was supported by grants from the National Institute on Aging (NIA; PI; R01 AG058772, B. Bettcher, PI), NIH/NCATS Colorado CTSA UL1 TR002535 (R. Sokol, PI), and support from the State of Colorado and many generous philanthropists. Its contents are the authors’ sole responsibility and do not necessarily represent official NIH views.