Italian adaptation of the Uniform Data Set Neuropsychological Test Battery (I-UDSNB 1.0): development and normative data

(2022) 14:113 Conca et al. Alzheimer’s Research & Therapy https://doi.org/10.1186/s13195-022-01056-x Open Access RESEARCH Italian adaptation of the Uniform Data Set Neuropsychological Test Battery (I‑UDSNB 1.0): development and normative data Francesca Conca1†, Valentina Esposito1†, Francesco Rundo2, Davide Quaranta3,4, Cristina Muscio6,5, Rosa Manenti7, Giulia Caruso8, Ugo Lucca9, Alessia Antonella Galbussera9, Sonia Di Tella10, Francesca Baglio10, Federica L’Abbate3, Elisa Canu11, Valentina Catania12, Massimo Filippi11,13, Giulia Mattavelli14,15, Barbara Poletti16, Vincenzo Silani16,17,18, Raffaele Lodi19, Maddalena De Matteis19, Michelangelo Stanzani Maserati19, Andrea Arighi20, Emanuela Rotondo20, Antonio Tanzilli21, Andrea Pace21, Federica Garramone22, Carlo Cavaliere22, Matteo Pardini23,24, Cristiano Rizzetto23,24, Sandro Sorbi10, Roberta Perri8, Pietro Tiraboschi6, Nicola Canessa14,15, Maria Cotelli7, Raffaele Ferri2, Sandra Weintraub25, Camillo Marra3, Fabrizio Tagliavini6, Eleonora Catricalà1,14 and Stefano Francesco Cappa1,14* Abstract Background: Neuropsychological testing plays a cardinal role in the diagnosis and monitoring of Alzheimer’s disease. A major concern is represented by the heterogeneity of the neuropsychological batteries currently adopted in memory clinics and healthcare centers. The current study aimed to solve this issue. Methods: Following the initiative of the University of Washington’s National Alzheimer’s Coordinating Center (NACC), we presented the Italian adaptation of the Neuropsychological Test Battery of the Uniform Data Set (I-UDSNB). We collected data from 433 healthy Italian individuals and employed regression models to evaluate the impact of demographic variables on the performance, deriving the reference norms. Results: Higher education and lower age were associated with a better performance in the majority of tests, while sex affected only fluency tests and Digit Span Forward. Conclusions: The I-UDSNB offers a valuable and harmonized tool for neuropsychological testing in Italy, to be used in clinical and research settings. Keywords: Neuropsychological tests, UDS, Alzheimer’s disease, Cognition † Francesca Conca and Valentina Esposito contributed equally. *Correspondence: 14 IUSS Cognitive Neuroscience (ICON) Center, Scuola Universitaria Superiore IUSS, Palazzo del Broletto, Piazza Vittoria 15, 27100 Pavia, Italy Full list of author information is available at the end of the article Background Neuropsychological testing plays a central role in the diagnosis of Alzheimer’s disease (AD). The concept of AD as a biological diagnosis based on biomarker positivity has a clear relevance for research, but in most clinical settings, the presence of objective cognitive dysfunction is still representing a “gateway” for a decision about biomarker assessment. The presence of a specific profile of neuropsychological impairment, associated © The Author(s) 2022. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativeco mmons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data. Conca et al. Alzheimer’s Research & Therapy (2022) 14:113 with biomarker positivity, is required for a diagnosis of prodromal AD in a symptomatic individual [14] and is associated with the highest risk of dementia progression [12]. Notwithstanding the key role of neuropsychological assessment for early diagnosis, different tests are employed in memory clinics and healthcare centers, thus introducing heterogeneity in the diagnosis and longitudinal monitoring of AD and mild cognitive impairment (MCI) cases. This aspect constitutes a source of concern when neuropsychological data are shared among different sites, such as in the case of multi-center research projects and consortia. Attempts to solve this problem through the harmonization of instruments have been pursued, for example, in the USA [25, 26], China [24], and Australia [3]. In Europe, the need for a similar initiative was acknowledged in a consensus conference which recommended as a possible solution the multilingual adaptation of the Neuropsychological Test Battery of the Uniform Data Set (UDSNB) [4]. This battery was designed following the initiative of the University of Washington’s National Alzheimer’s Coordinating Center (NACC), with the initial aim to stage the continuum between normal aging in controls, MCI, and AD patients. The battery underwent revisions and enhancements leading to the currently available paper-and-pencil version 3.0 (UDSNB 3.0), including tests assessing episodic memory, language, executive functions, processing speed, and constructional ability, and has been administered to 3602 healthy controls [25]. Currently, UDSNB has been translated from English and adapted solely for Spanish-speaking individuals [1, 2]. The aim of the present multi-center project is the development of a UDSNB adaptation for the Italian-speaking population (I-UDSNB), including a newly developed tablet-based application to aid the experimenter in test administration and scoring. Here, we report the reference norms obtained from the data collected in a cohort of 433 Italian healthy individuals. Methods Procedures for battery creation The initiative, involving 17 centers members of the Virtual Dementia Institute of the RIN (Rete Italiana di Neuroscienze e Neuroriabilitazione-Italian Network of Neuroscience and Neuro-rehabilitation), was supported by a grant from the Italian Ministry of Health. The bases for the creation of the I-UDSNB were discussed during a consensus meeting in February 2020. On that occasion, representatives from six Scientific Institutes for Research, Hospitalization and Healthcare (IRCCS) discussed the feasibility to extend the initiative of the NACC to the Italian context. Permission was requested from the copyright owner, and Prof. Sandra Weintraub accepted to act as an Page 2 of 11 external advisor to the project in the representation of the UDSNB group. The translation/adaptation was based on the American version of UDSNB (UDSNB 3.0, [25]). Then (...truncated)