Table 3.
Some characteristics of the studies that have used the Wisconsin Card Sorting Test to assess executive dysfunction in patients with Alzheimer's disease.
| Studies | Participant N (mean age ±SD) | MMSE | Diagnostic criteria for AD | WCST typologies | Differences between AD group and CG group |
|---|---|---|---|---|---|
| Hart et al., 1988 | CG = 18 (70.6 ± 5.2) [78%F] | CDR | Non-specific criteria | mWCST (modified version: 72 cards): no ambiguous cards; after six correct responses there was the category shifting; no information about the shift in sorting (Nelson, 1976). | Achieved Categories: AD < CG |
| DEP = 17 (69.3 ± 6.2) [65%F] | Number of Errors: AD>CG | ||||
| Mild AD = 18 (71.6 ± 6.4) [76%F] | Perseverative Errors: AD>CG | ||||
| Moderate AD = 16 (72.1 ± 6.8) | |||||
| Bhutani et al., 1992 | CG = 12 (63.7 ± 8.27) | CG = 28. 8 ± 1.64 | CAMBEX | WCST (original version: 128 cards) (Milner, 1963). | Achieved Categories: AD = CG |
| MinimallyAD = 11 (71.5 ± 7.97) | Minimally AD = 25.5 ± 3.69 | Perseverative Errors: AD = CG | |||
| Mildly AD = 6 (74 ± 12.88) | Mildly AD = 18.7 ± 2.73 | Non-Perseverative Errors: AD = CG | |||
| Moderately AD = 8 (79.7 ± 6.45) | Moderately AD = 11.81 ± 3.95 | ||||
| Bondi et al., 1993 | CG = 75 (71.1 ± 7.6)[48F] | CG = 28.9 ± 1.2 | NINCDS-ADRDA | mWCST (modified version: 48 cards): no ambiguous cards; after six correct responses subject was informed of a shift in sorting principles (Nelson, 1976). | Achieved Categories: AD < CG |
| Mild AD = 23 (72.7 ± 5.9) [12F] | Mild AD = 23.9 ± 2.3 | Perseverative Errors: AD>CG | |||
| Moderate AD = 33 (72.3 ± 5.9) [20F] | Moderate AD = 21.2 ± 2.9 | Non-Perseverative Errors: AD>CG | |||
| Severe AD = 31 (71.8 ± 7.9) [14F] | Severe AD = 17.8 ± 3.7 | ||||
| Paulsen et al., 1995 | CG MiddleAge = 20 (49.7 ± 13.9) [10M;10F] | DRS Middle Age CG = 141.3 ± 2.7 | NINCDS-ADRDA | mWCST (modified version: 48 cards): no ambiguous cards; after six correct responses subject was informed of a shift in sorting principles (Nelson, 1976). | Achieved Categories: AD < CG |
| Elderly CG = 20 (69.7 ± 8.2) [10M;10F] AD = 20 (70.0 ± 6.9) [10M;10] | Elderly CG = 140.1 ± 2.3 | Correct Responses: AD < CG | |||
| HD = 20 (69.7 ± 8.2) [12M;8F] | AD = 121.4 ± 8.6 | Perseverative Errors: AD>CG | |||
| HD = 120.3 ± 9.6 | |||||
| Paolo et al., 1996 | CG = 35 (71.34 ± 7.73) [22M;13F] | DRS | NINCDS-ADRDA | WCST-64: classical WCST rules, but in a short version (Heaton, 1981). | Achieved Categories, Trials to complete the 1 st category, Number of Errors, Perseverative Responses, Perseverative Errors, Non-Perseverative Errors, Percent Conceptual Level Response: AD worse than CG. |
| PDN = 35 (70.51 ± 5.55) [22M;13F] | Failure to Maintain Set: AD = CG. | ||||
| PDD = 35 (71.77 ± 6.31) [22M;13F] | |||||
| AD = 35 (71.06 ± 5.75) [22M;13F] | |||||
| Tei et al., 1997 | CG = 30 (65.1 ± 8.2) | CG = 29.1 ± 0.6 | NINCDS-ADRDA MSI = Hacinski ischemic score >7 | WCST (original version: 128 cards) (Milner, 1963). | Achieved Categories: AD < CG |
| AD = 22 (67.3 ± 9.1) | AD = 23.6 ± 1.4 | Perseverative Errors: AD >CG | |||
| MCI = 22 (68.6 ± 7.3) | MCI = 24.6 ± 2.0 | ||||
| Nagahama et al., 2003 | CG = 22 (70.8 ± 9.1) | CG = 29.1 ± 0.8 | NINCDS- ADRDA | mWCST (computer version) 48 cards no ambiguous cards; participant was informed of the three possible categories before testing; after six correct responses there was the category shifting; no information about the shift in sorting (Nelson, 1976; Jenkins and Parsons, 1978). | Total Errors, Trials to complete the 1stcategory, Perseverative Errors: AD>CG; |
| AD = 54 (74.2 ± 5.1) | AD = 20.8 ± 3.3 | DSM-III-R | Achieved Categories, Non-perseverative Errors, Conceptual level responses: AD < CG. | ||
| MCI = 17 (72.8 ± 5.4) | MCI = 26.4 ± 2.0 | ||||
| Stokholm et al., 2006 | CG = 32 (74.3 ± 4.2) | CG = 29.3 ± 0.9 | NINCDS- ADRDA | mWCST (modified version: 48 cards): no ambiguous cards; after six correct responses subject was informed of a shift in sorting principles (Nelson, 1976). | Achieved Categories: AD>CG |
| AD = 36 (76 ± 5.6) | AD = 25 ± 1.5 | Number of Errors: AD = CG | |||
| Perseverative Errors: AD = CG | |||||
| Kugo et al., 2007 | CG = 25 (63.7 ± 2.4) [12M;13F] | CG = 28.2 ± 1.9 | NINCDS- ADRDA | KWCST (Keio version): participant was informed about the presences of three categories (Abe et al., 2004). | Achieved Categories: AD>CG |
| AD = 58 (75.3 ± 7.8) [14M;44F] | AD = 19.3 ± 4.1 | CDR | Perseverative Errors: AD = CG | ||
| VaD = 24 (75.1 ± 9.3) [10M;14F] | VaD = 20.7 ± 4.7 | ||||
| FTD = 23 (64.7 ± 9.5) [9M;14F] | FTD = 19.6 ± 5.9 | ||||
| Chen et al., 2009 | CG = 16 (69 ± 8.4) [9M;7F] | CDR | NINCDS-ADRDA | mWCST (modified version: 48 cards): no ambiguous cards; after six correct responses subject was informed of a shift in sorting principles (Nelson, 1976). | Achieved Categories: AD < CG |
| Early AD = 11 (76.7 ± 8.5) [7M;4F] | Mayo Clinic Criteria for aMCI | Perseverative Errors: AD>CG | |||
| aMCI = 13 (73.2 ± 9.3) [8M;5F] | |||||
| Chiu et al., 2014 | CG = 30 (64.4 ± 9.5) [13M;17F] | CG = 28.8 ± 1.6 | NIA-AA | WCST (original version: 128 cards) (Milner, 1963). | Achieved Categories: AD < CG |
| Early AD = 10 (69.3 ± 9.4) [4M;6F] | Early AD = 22.7 ± 3.6 | Perseverative Errors: AD = CG | |||
| MCI = 20 (71.2 ± 9.7) [9M;11F] | MCI = 26.3 ±2.7 | ||||
| Peltsch et al., 2014 | CG = 72 (73 ± 6) [22M;50F] | CG = 29 ± 1 | NINCDS-ADRDA | WCST (original version: 128 cards) (Milner, 1963). | % Errors: AD>CG |
| aMCI = 22 (76 ± 8) [10M;12F] | aMCI = 27 ± 2 | ||||
| Mild AD = 24 (76 ± 8) [9M;15F] | Mild AD = 27 ± 2 | ||||
| Huang et al., 2017 | CG = 31 (76.5 ± 5.9) [45.2%F] | CG = 27.0 ± 1.2 | NINCDS- ADRDA | WCST-64: classical WCST rules, but in a short version. (Heaton, 1981; Kongs et al., 2000). | Achieved Categories: AD = CG |
| Mild AD = 31 (78.9 ± 6.3) [64.5%F] | Mild AD = 21.2 ± 3.2 | DSM-IV-TR CDR | Perseverative Errors: AD = CG | ||
| Redondo et al., 2016 | CG = 23 (70.92 ± 4.25) [11M;12F] | CG = 28 ± 1.61 | NINCDS-ADRDA | WCST (original version: 128 cards) (Milner, 1963). | % perseverative responses: AD>CG |
| DiabetesG = 20 (70.82 ± 3.55) [12M;8F] | DiabetesG = 26.57 ±1.95 | % perseverative errors: AD>CG | |||
| AD = 22 (77.74 ± 3.90) [16M;6F] | AD = 23.71 ± 4.25 |
MMSE, Mini-Mental State Examination; AD, Alzheimer Disease Group; WCST, Wisconsin Card Sorting Test; CG, Control Group; DEP, Depression Group; CDR, Clinical Dementia Rating Scale; mWCST, Modified version of the Wisconsin Card Sorting Test; CAMBEX, Cambridge Diagnostic Examination of the Elderly; NINCDS-ADRDA, National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association; HD, Huntington's Disease; DRS, Dementia Rating Scale; PDN, Parkinson Disease without Dementia; PDD, Parkinson Disease with Dementia; MCI, Mild Cognitive Impairment; VaD, Vascular Dementia; FTD, Frontotemporal Dementia; KWCST, Keio Version of the Wisconsin Card Sorting Test; aMCI, Amnestic Mild Cognitive Impairment; NIA-AA, National Institute on Aging and Alzheimer's Association.