cognito - inserm u1061 · 2. introduction . cognito is a computerized neuropsychometric examination...

Introduction Construction of the

battery Getting started

Page 2

Administration How to administer the tests and record

performance

Page 4

Results How performance is

recorded in the Results file

Page 29

COGNITO 2012

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Introduction COGNITO is a computerized neuropsychometric examination based on well-known cognitive tests designed for both cognition research and clinical assessment. It was originally developed with MacIntosh Hypercard software (version ECO) for use in both population and clinical studies of brain ageing and has now been up-dated into Flash, thus extending its hardware possibilities. The original version was used in a prospective population study from general practice from which normative data was derived, and the ability of the battery to detect difficulties in information processing two years prior to the diagnosis of dementia was also established. The battery has been subsequently used to track cognitive changes due to depression, following anesthesia, as a consequence of anticholinergic drug use, and in the development of diagnostic criteria for mild cognitive impairment (MCI). More recently COGNITO has been used to monitor cognitive changes during treatment in schizophrenia. COGNITO assesses reaction time, primary and working memory (an articulation sub-test further permitting identification of problems related to the articulatory loop) visuospatial and verbal secondary memory (with free, cued and multiple choice paradigms) , implicit learning (priming), language skills (word and syntax comprehension, naming, verbal fluency), functional and semantic categorization of visual data (visual reasoning and form perception), focused and divided attention (visual and auditory modalities) and crystallized intelligence (vocabulary).

Responses are made via a tactile screen which permits the recording of response latency (deducting reaction time provides an estimation of information processing time). The examination may be carried out by trained lay interviewers with the possibility of the interviewer’s voice being replaced by pre-recorded instructions. The interpretation of the results can only, however, be made by a clinician competent in neuropsychology. Qualitative aspects of performance (perseveration, intrusions, visual field neglect) are also recorded. The test is suitable for children over 12 and adults of any age provided they are able to read, hear instructions and see the words and images. Practice trials are given which may be repeated until the subject has understood what is required. In order to be able to test highly performing persons some of the tasks become very challenging, so some tests stop automatically after repeated failures to avoid discouragement. The examination takes 45 minutes to an hour to complete depending on the ability of the subject. While it is possible to select and administer specific tests, it is suggested that the whole battery be given where possible in order to standardize fatigue effects and the time delay between the presentation of memory stimuli and the recall trials.

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GETTING STARTED Home page

Identification page Subject details and test selection

1. HOME PAGE

On this page select either the French or the English version of COGNITO. From this page you may start a new testing session, complete an examination which has already been started or exit from the battery. You must select one of these options by the mouse or touching the screen in order to proceed with the examination or end the session.

2. IDENTIFICATION In order to begin testing a file name must be entered. This will be the name given to the Results file which will appear automatically on the Desktop upon completion of the examination. You may then either cancel the session (in which case no file will be created) or touch Enter in order to continue.

3. SUBJECT DETAILS The date and time of the examination will be entered automatically but may be modified. Age, sex and a subject identifier must be given. The interviewer may add remarks here relating to test conditions. The Summary button will show the list of tests and those which have already been administered (in the case of redoing the battery). A filled in white dot next to the test name indicates a completed test, a half-filled dot an uncompleted test. See page 5 for further functions on this menu.The Start button commences testing.

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1. REACTION TIME

The test measures simple reaction time using the dominant hand. When a stimulus (a clown) appears on the screen, the subject must press the space bar. The time recorded appears on the screen.

Trials are given with random inter-trial intervals.

The reaction time is recorded to one hundredth of a second. A correct response will be between 100 and 500 milliseconds.

If the subject responds before 100 milliseconds it is counted as an Anticipation error. If the subject responds between 500 and 2000 milliseconds it is considered a time Lapse problem (an very slow response - subject has probably been distracted from a correct response leading to a possible outlier score). If the subject does not respond at all after 2 seconds it is considered a failure (Over Time error).

The test is terminated when the subject has recorded 12 valid responses. A maximum of 36 trials may be given.

In the Results file the following are recorded:

- Validity of response for each trial

- The mean of the 12 valid responses

- Total number of trials by the subject

- The number of Anticipation errors

- The number of time Lapses

- The number of Over Time errors

After reading the instructions to the subject press the Start button to begin the 5 Practice trials.

The subject should have his finger just above the space bar in preparation for each stimulus. The practice trial may be repeated as often as necessary if the subject has difficulty in understanding the instructions or begins to touch the bar before the stimulus has appeared.

The interviewer should only start the real test when the instructions are understood

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2. FAMILIARISATION TASK USE OF THE TESTING MENU

Familiarisation

This task is designed to familiarize the subject with the tactile screen. It is not scored or recorded in the results. The subject is asked to touch the stimulus (the clown from the reaction time test) and differentiate two stimuli (name of the clown). The subject then touches the clown at 3 different places on the screen.

The testing menu

Taking the cursor or touching the upper part of the screen will make a menu bar appear in green. From this menu the interviewer may activate/disactivate a voice which reads the instructions for each test, see the list of tests which have been started and completed, go to the next test or back to the last test, return to the COGNITO home page or exit from the battery. This menu accompanies every test in the battery.

3. READING AND SYNTAX COMPREHENSION

The test is in two parts. The first a simple reading task and the second a comprehension task in which the subject carries out instructions of increasing syntactical complexity.

The subject is given one practice trial. If the subject is unable to read and understand the sentences then it is unlikely that the results for subsequent tests will be valid. Press the Start button to commence the test.

The subject is required to read the sentence. This is scored by the interviewer as C=Correct or I=Incorrect. The scoring options are activated by passing the mouse or touching the upper right hand part of the screen. This must be done in order to move on to the next part of the test. If the subject does not respond within 10 seconds the next trial is given and a Time error noted.

The subject must now carry out the instruction given in the sentence. This will be scored as Correct or Incorrect in the Results file along with the response latency (time taken to reply). The subject is given 5 trials.

The following appears in the Results file:

- Number of sentences read

- Number incorrectly read

- Number correctly understood

- Incorrect response corrected

- Number of Time errors

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4. AUDITORY ATTENTION

The subject is asked to discriminate between long and short sounds presented at variable intervals and to count only long sounds. The interviewer should use the practice trial to determine whether the subject has hearing difficulties which may hinder the completion of the task. Press the Start button to begin.The screen is blank and the subject should look at the screen while counting in order to standardize competing environmental stimuli.

10 trials are given. After each trial a counter appears on which the interviewer should note the reply given by the subject, then press OK to start the next trial.

The following will appear in the Results file:

- The number of correct responses

- The total number of errors

- The number of overestimations

- The number of underestimations

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5. VISUAL ATTENTION

The subject is shown a shape for 2 seconds then a screen with variations on this shape of which two are the same. The subject must visually locate and touch the two similar shapes. When the subject touches the correct shape it changes from red to blue. If a change of colour does not occur the subject should be asked to touch with a larger surface of the fingertip. Two practice trials are given.

10 trials are given. If the subject does not respond within 30 seconds then this is scored a Time error and the next trial is given. If the subject touches the wrong shape then corrects the response this is scored as a Correction.


- Number of correct trials

- Number of incorrect trials


- Number of non-responses

- Time taken for each trial

- Mean time for the first shape all trials

- Mean time for the second shape all trials

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6. VISUAL AND AUDITORY ATTENTION

In this “double-task” designed to assess working memory, the subject must combine the two previous tasks; locating the shapes and counting the sounds. In this task only long sounds are presented. The number of sounds will vary according to the time the subject takes to locate the shapes. Two practice trials are given.

Ten trials are given for this test. The number of sounds reported by the subject are recorded by the interviewer on the counter. If the subject takes more than ten seconds then a Time error is recorded and the next trial is given.


- Number correct trials

- Number incorrect trials


- Number of non-responses

- Time taken for each trial

- Mean time for the first shape all trials

- Mean time for the second shape all trials

- Sound counts Correct=1; Incorrect=0

- Total sound counts correct

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7. STROOP TEST

The test is presented in three parts. In the first the subject matches the name of a colour to a button of the same name, in the second a colour is matched to the button with the name and in the third the subject matches the colour in which the name of the colour is written to the colour name button. Two practice trials are given for each part.

Trials are given for 45 seconds. If 45 seconds is reached while the subject is making a response the trial continues so the subject can complete it. However, this final response, occurring outside the given period, will not be counted.


- Number of correct responses

- Number of errors

- Mean time taken for correct trials

- Mean time taken for all trials

- Total time taken

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8. ARTICULATION AND IMMEDIATE RECALL

The interviewer reads out loud 9 first names which appear one by one on the screen.The subject repeats each name. There is no practice trial. In the margin of the screen the interviewer records whether the subject has correctly articulated the name (C=Correct; I=Incorrect). Accents due to English not being the first language of the subject are not considered articulation errors. The interviewer should not correct a pronounciation error. Articulation problems should be taken into account in evaluating the “dual task” as they may interfere with the “articulatory loop” component of working memory. A new instruction screen appears. The subject is now required to look at the names which appear for 3 seconds on the screen in order to recall them.

The interviewer then turns the computer screen away from the subject who is asked to recall the names. For each name correctly recalled the interviewer touches the circle next to that name. The interviewer should recall a perseveration (a name already given), an intrusion (a name which was not part of the recall list), and refusal to perform the task, by touching the appropriate bar. When the subject has finished, the interviewer touches Validate.

Recorded in the Results file:

- Number correctly pronounced

- Number incorrectly pronounced

- Number correctly recalled

- Number of intrusions

- Number perseverations

- Refusal

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9. FACE RECALL

The names given in the previous test are presented with a corresponding face which the subject is required to recall at a later point in the examination.

Each face is shown for 5 seconds.

There is no practice trial.

No results are recorded in the Results file

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10. VISUO-SPATIAL SPAN

A screen is presented with 9 coloured squares. A clown appears on one square after

A screen is presented with 9 coloured squares. A clown appears on one of the squares and then moves to another, remaining on each for one second, with a one second interval between appearances. A beep signals the end of the clown’s “journey” after which the subject must repeat the journey by touching the squares on the screen. 2 training sessions are given with 2 and then 3 squares. The subject is given 8 trials of increasing length from 2 to 9 squares.

The following appears in the Results file :

- Correct or incorrect for each trial

- The sequence in which the squares are touched (each square has a number for this purpose)

- Time taken to complete the trial

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11. MATCHING GEOMETRIC FIGURES

This test requires the subject to discriminate form and line orientation by matching a sample complex figure on the left side of the screen to one of 6 on the right side. The position of the correct match changes across trials. Distractor figures are designed to detect visuospatial field neglect and difficulties with line orientation. The test is timed. The subject has 20 seconds to respond. There is one practice trial.

8 trials are given. A “Regret” key permits the interviewer to alter the initial response if the subject declares having made an error. In this case the time count continues.


- Response time for each trial

- The figure touched (the figures are numbered for this purpose)

- Occurrence of a “Regret” or auto-correction

- Total correct responses

- Total inversions

- Total “Regrets”

- Field neglect

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12. PHONEME COMPREHENSION

A word appears on the screen and is read by the interviewer.

A screen with 6 objects then appears. The subject touches the object illustrating the word among 6 objects which include shape,phonetic and semantic distractors. The subject has 10 seconds to respond.One practice trial is given followed by 10 test trials. The test is abandoned after one failure to respond within the time limit.



- Time for each correct response (when object touched and not when finger removed from screen)

- Total shape errors

- Total semantic errors

- Total phonetic errors

- Running over time

- Incorrect response

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13. NAMING FUNCTIONAL, SEMANTIC AND CONCEPTUAL ASSOCIATIONS

An object appears on the screen which the subject names. The interviewer indicates on the right margin whether the object has been correctly identified by touching ID. If not correctly identified the interviewer waits for the next panel to appear. One practice trial is given.

From the following screen of 6 objects the subject selects the one which belongs with the object named. 10 trials are given of which 5 are functional associations and 5 semantic category associations.The interviewer notes whether the response is correct=ID; a more general term is used=G; a word is given which identifies only part of the object=P; other errors=0. The interviewer may indicate a series of incorrect responses before the correct response. The subject must respond within 20 seconds.


- Total correct responses ID

- Total generalizations G

- Total partial responses P

- Frequency of running over time limit with object recognition

- Frequency of running over time limit with associations

For each trial :

- Correct or incorrect

- Sequence when several responses given

- Generalization absent/present

- Partial absent/present

- Other absent/present

- Number of the associated object chosen (objects numbered for this purpose)

- Response time

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14. MATRICES

This test of visuospatial logic requires the subject to select from the 8 options at the bottom of the screen the one which completes the logical sequences given in the incomplete figure in the top part of the screen. Three practice trials are given

15 trials are given. The subject must reply within 2 minutes otherwise the test moves on to the next trial.


- The number of the option chosen

- Whether correct or incorrect

- Response time


- Total errors

- Total time taken

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15. DRAWING HOUSE

The subject is required to copy the drawing of a house which appears on the screen. A piece of blank paper and pencil or black pen are provided by the interviewer. No practice trial is given. The interviewer indicates in the top right hand of the screen whether the test has been possible or not.

A coding guide is given for the interviewer to score the test after the completion of the COGNITO battery (see section 25). The interviewer clicks on each element which has been attempted in the reproduction, clicking twice if the element has been correctly executed and placed, and once if the element is present but either badly copied or misplaced.The element selected changes colour according to the number of clicks.


- Possible or impossible to do the test for practical reasons (eg injured hand).

- Refusal to perform the test

- Each of the 20 elements is scored 0=absent or unrecognizable; 1=present but badly done; 2=well executed and correctly placed

- Perspective is indicated 0=no; 1=yes

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16. DRAWING ABSTRACT FIGURE

The subject is required to copy the drawing of an abstract figure which appears on the screen. A piece of blank paper and pencil or black pen are provided by the interviewer. No practice trial is given. The interviewer indicates in the top right hand of the screen whether the test has been possible or not.

A coding guide is given for the interviewer to score the test after the completion of the COGNITO battery (see section 25). The interviewer clicks on each element which has been attempted in the reproduction, clicking twice if the element has been correctly executed and placed within the whole.


- Possible or impossible to do the test for practical reasons eg injured hand

- Refusal to perform the test

- Each of the 20 elements is scored 0=absent or unrecognizable; 1=present but badly done; 2=well executed and correctly placed

- Perspective is indicated 0=no; 1=yes

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17. DELAYED RECALL OF NAMES

The subject is required to recall the list of names learned previously. The interviewer must turn the screen away from the subject in order to score responses. As with the previous trial the interviewer records perseverations, intrusions, and refusals and validates the completion of the test. A second trial is given with a letter prompt (names beginning with C, J and M). For the third trial the subject is shown the computer screen and asked to select the names previously learnt from a list including distractor names.

Recorded in the Results file for the first two tasks:

- Number correctly recalled

- Number of intrusions

- Number of perseverations

- Refusal

For the recognition task :

- Number correctly identified

- Number falsely identified

- Refusal

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18. NAME FACE ASSOCIATION

The subject is shown a series of 18 faces of which 9 were previously associated with names. The subject decides whether the face appeared before. If yes, the interviewer records the response as Y; if not as N. If the subject says they have already seen the face, the name is asked for. Following the subject’s response the name is shown and scored as true=T or false=F.


- Number of correctly recognized faces

- Number of correctly recognized names

- Number of correct name/face associations

- Number of falsely recognized faces

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19. VERBAL FLUENCY SEMANTIC CUE

The subject is required to name all the vegetables they can think of within one minute. No practice trial is given. The interviewer records each correct response, intrusion or perseveration on the appropriate response bars. The time lapse is given by a moving scale.


- Total number of correct responses at 15 seconds




- Total number of intrusions at 15 seconds




- Total number of perseverations at 15 seconds




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20. VERBAL FLUENCY PHONEMIC CUE

The subject is required to name as many objects as they can think of beginning with the letter P within one minute. No practice trial is given. The interviewer records each correct response, intrusion or perseveration on the appropriate response bars. The time lapse is given by a moving scale.














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21. NARRATIVE RECALL

The test requires the subject to recall a series of elements which have a logical sequence. The subject is read a short story consisting of 27 elements after which the interviewer turns the screen away and asks the subject to recall the story. No practice trial is given.

The interviewer records, in the order given by the subject, each element recalled. Close approximations are acceptable eg “struck him” instead of “hit him” or “flat” instead of “apartment”. The interviewer records each intrusion (element not included in the story) and notes a refusal to do the test. When the subject has finished the interview touches the validation button. There is no practice trial or time limit for this test.


- The elements recorded and their order

- The number of intrusions

- A refusal

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22. DESCRIPTION RECALL

This test requires the subject to recall a series of elements which have a visual sequence. The subject is read a short description consisting of 27 elements after which the interviewer turns the screen away and asks the subject to recall the story. No practice trial is given.

The interviewer records in the order given by the subject each element recalled. Close approximations are acceptable eg “huge” instead of “enormous” or “in the centre” instead of “in the middle”. The interviewer records each inrusion (element not included in the story) and notes a refusal to do the test. When the subject has finished the interview the interviewer touches the validation button. There is no practice trial or time limit for this test.


- The elements recorded and their order

- The number of intrusions

- A refusal

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23. VOCABULARY

This test assesses crystallized (acquired) intelligence. A word is given on the left of the screen and the subject chooses its synonym from the choice of 6 words on the right of the screen. Two practice trials are given. The interviewer does not read the word to the subject. The subject is given 10 seconds to respond in which case this is counted as an error with a response time of 10 seconds. The trials are of varying difficulty.

35 Trials are given.


- Refusal or acceptance of the test

- Total number correct responses

- Total number of errors

- Total number of running over time limit

For each trial:

- The response chosen (number given to each option for this purpose)

- Response time – coded 10001ms if subject has run over time

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24. IMPLICIT MEMORY

The subject is required to recognize as soon as possible a name which is constructed progressively on the screen in 15 stages. A practice trial is given followed by 10 trials in which 5 names were amongst those learnt in the previous name recall tests and the other 5 are new names.The interviewer presses the OK button on the right of the screen when the subject recognizes the name. If the subject gives an incorrect name the interviewer should let the trial continue with further construction of the name until it is recognized.


- Success or failure of each trial

- Number of reconstructions necessary to arrive at correct response

- If not recognized the trial is scored 16

- Mean for names never seen calculated as the total number of reconstructions for trials 1+4+5+7+10/5

- Mean for names already learnt 2+3+5+8+9/5

- Difference between the above two

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25. CODING OF HOUSE AND ABSTRACT

On the right are the coding frames for the copying of the house and the abstract figure. The instructions for completing the frames are given with the relevant tests numbers 15 and 16 on pages 18 and 19.

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RESULTS

On completion of the battery a results file appears on the computer Desktop. Each of the tabs in blue at the top of the document designates a test in the order given. By clicking on a tab the results are shown for that test. The results are also presented in an Excel table.

The large number of results produced by the Cognito battery are designed principally for research purposes. For everyday clinical use the user also has the option at the end of the test of requesting in addition a Brief Clinical Summary which may be saved in the patient’s file or printed. This is a list of combined results which give a total score for each of the following :

1. Mean reaction time

2. Reading and comprehension of syntax

3. Auditory attention

4. Visual attention

5. Working memory

6. Stroop test

7. Immediate verbal recall

8. Visuo-spatial span

9. Geometric figure recognition

10. Word comprehension

11. Recognition of objects and their functions

12. Progressive Matrices

13. Delayed verbal recall

14. Recognition of faces

15. Name-Face association learning

16. Verbal fluency

17. Recall of text

18. Vocabulary

19. Implicit memory

20. Copying complex designs

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PUBLISHED STUDIES USING ECO/COGNITO

Ritchie K, Allard M, Huppert F, Nargeot C, Pinek B, Ledesert B. Computerized cognitive examination of the elderly : the development of a neuropsychological examination for clinic and population use. Int J Geriatr Psychiatry 1993;8:899-914.

Ritchie K, Touchon J, Ledesert B. Mixed cognitive and affective disorders in the elderly: A prospective study of related disability. Archives of Gerontology and Geriatrics 1998; S6:443-450.

Ritchie K, Touchon J, Ledesert B. Progressive disability in senile dementia is accelerated in the presence of depression. International Journal of Geriatric Psychiatry 1998; 13:459-461. Touchon J, Ritchie K. Early diagnosis of Alzheimer's disease. International Journal of Geriatric Psychopharmacology 1998; 1:103-109. Leibovici D, Ritchie K, Ledesert B, Touchon J. The effects of wine and tobacco consumption on cognitive performance in the elderly: A longitudinal study of relative risk. International Journal of Epidemiology 1999; 28:77-81. Richards M, Touchon J, Ledesert B, Ritchie K. Cognitive decline in ageing: Are AAMI and AACD distinct entities? International Journal of Geriatric Psychiatry 1999; 14:534-540. Ritchie K, Gilham C, Ledesert B, Touchon J, Kotzki PO. Depressive illness, depressive symptomatology and regional cerebral blood flow in elderly people with sub-clinical cognitive impairment. Age and Ageing 1999; 28:385-391. Touchon J, Ritchie K. Prodomal cognitive disorder in Alzheimer’s disease. International Journal of Geriatric Psychiatry 1999; 14:556-563. Ancelin ML, de Roquefeuil G, Ritchie K. Anesthésie et troubles cognitifs postopératoires chez le sujet âgé: Etat des connaissances cliniques et épidémiologiques. Revue d’Epidémiologie et de Santé Publique 2000; 48:459-472. Ancelin ML, de Roquefeuil G, Ledesert B, Bonnel F, Cheminal JC, Ritchie K. Exposure to anaesthetic agents, cognitive functioning, and depressive symptomatology in the elderly. British Journal of Psychiatry 2001; 178:360-366. Ancelin ML, de Roquefeuil G, Ledesert B, Bonnel F, Cheminal JC, Ritchie K. Déclin cognitif postopératoire, symptomatologie dépressive et degré d’incapacité physique du sujet âgé après une anesthésie. Année Gérontologique 2001; 15:37-47. Artero S, Ritchie K. Late-Onset depressive episodes in the elderly: examination of evidence for a separate nosological entity. Psychogeriatrics 2001; 1:194-202. Artero S, Touchon J, Ritchie K. Disability and mild cognitive impairment: a longitudinal population-based study. International Journal of Geriatric Psychiatry 2001; 16:1092-1097. Ritchie K, Artero S, Touchon J. Classification criteria for mild cognitive impairment: a population-based validation study. Neurology 2001; 56:37-42. Richards M, Touchon J, Ledesert B, Ritchie K. Mild extrapyramidal signs and functional impairment in ageing. International Journal of Geriatric Psychiatry 2002; 17(2):150-153. Allard J, Artero S, Ritchie K. Consumption of psychotropic medication in the elderly : A re-evaluation of its effects on cognitive performance. International Journal of Geriatric Psychiatry 2003; 18:874-878. Artero S, Ritchie K. The detection of mild cognitive impairment in the general practice setting. Aging and Mental Health 2003; 7(4):251-258 Artero S, Tierney MC, Touchon J, Ritchie K. Prediction of transition from cognitive impairment to senile dementia: a prospective, longitudinal study. Acta Psychiatrica Scandinavica 2003; 107(5):390-393. Seeker DL, Merrick PL, Madsen S, Melding P, Brown RG. Test-retest reliability of the ECO computerized cognitive battery for the elderly. Aging Neuropsychology and Cognition 2004; 11: 51-57

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12888436&dopt=Abstract�

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Artero S, Tierney MC, Touchon J, Ritchie K. Prediction of transition from cognitive impairment to senile dementia: a prospective, longitudinal study. Acta Psychiatrica Scandinavica 2003; 107(5):390-393. Ancelin ML, Artero S, Portet F, Dupuy AM, Touchon J, Ritchie K. Non-degenerative mild cognitive impairment in elderly people and use of anticholinergic drugs: longitudinal cohort study. British Medical Journal, 2006, Feb 25; 332(7539): 455-9. Artero S, Petersen R, Ritchie K. Revised criteria for Mild Cognitive Impairment: validation within a longitudinal population study. Dement Geriatr Cogn Disord 2006; 22: 465-470

Capdevielle D, Ritchie K, Villebrun D, Boulenger JP : Durée d’hospitalisation des patients souffrant de schizophrénie : facteurs cliniques de variations et leurs conséquences . L’Encéphale 2009 ; 35 : 90-96

Capdevielle D, Boulenger JP, Villebrun D, Ritchie K : Durée d’hospitalisation des patients souffrant de schizophrénie : implication des systèmes de soins et conséquences médico-économiques. L’Encéphale 2009 ; 35 : 394-399

Capdevielle D, Boulenger J-P, Villebrun D, Ritchie K. Schizophrenic patients’ length of stay : mental health care implications and medicoeconomic consequences L’Encéphale 2009 ; 35 : 394-399

Ancelin M-L, de Roquefeuil G, Scali J, Bonnel F, Adam J-F, Cheminal J-C, Carrière I, Ritchie K. Long-term post-operativedecline in the elderly : the effects of anesthesia type, apolipoprotein E genotype and clinical antecedents Journal of Alzheimer’s Disease 2010; 22: 105-103

ACKNOWLEDGEMENTS

Test development Karen Ritchie

Guilhem de Roquefeuil Marie-Laure Ancelin

Alain Besset Marie-Christine Nargeot

Field Testing

Guilhem de Roquefeuil Craig W Ritchie

Clair Josephs Cindy Prudhomme

Computer development Guihem de Roquefeuil

Michel Courtade

COGNITO data base Guilhem de Roquefeuil

Sylvaine Artero

cognito - inserm u1061 · 2. introduction . cognito is a computerized neuropsychometric examination...

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