Script generation a reliable tool to determine early cognitive impairment in older adults

Key takeaways:

• Healthy controls performed better in testing for everyday tasks than those with mild cognitive impairment.
• Those with MCI performed poorer than healthy counterparts in episodic memory and executive function.

PHILADELPHIA — Script generation task performance may be a cost-effective, reliable tool to assess early cognitive impairment in older adults, according to a poster presentation.

“We’re looking for a more accessible screening tool for early detection of cognitive changes, so we’re looking at script generation as an inexpensive way,” Melissa Rosahl, BA, a pending neuropsychology graduate student at Temple University, told Healio at the Alzheimer’s Association International Conference.

Rosahl and colleagues from Temple sought to examine whether script generation — which requires an individual to verbalize instructions for certain everyday tasks such as house work — could accurately detect signs of cognitive decline in older adults in underserved communities.

Their study included 74 individuals from the area adjacent to Temple University, 51 deemed of healthy cognition (mean age 72.8±5.3 years; 69% female) and 23 with mild cognitive impairment (MCI; mean age 75.8±8.7 years; 61% female) who completed a series of script-generation tasks in the kitchen such as completing all steps necessary in making toast, coffee and a sandwich along with a separate battery of cognitive tests. All participants additionally submitted to the Naturalistic Action Task (NAT), a standardized test of functioning, for the same kitchen-based duties.

The primary outcome for the study was script generation ability in healthy controls compared with the same ability in those in the MCI group. The secondary outcomes included a comparison of script generation performance in all participants against executive function and episodic memory, as well as script generation performance compared with NAT performance.

Results showed a significant difference in script generation task performance between healthy participants and their counterparts diagnosed with MCI, with respect to the average number of total essential and non-essential steps completed, the total time elapsed to complete the script, the number of verbalized words total number of scripted errors.

Those in the MCI group additionally performed poorer in episodic memory and executive function compared with healthy counterparts, as well as on the NAT version of the kitchen tasks with respect to the number of steps, total time and number of errors.

“They completed significantly fewer essential steps to the task,” Rosahl explained. “They were omitting essential steps and also non-essential task-related steps.”