{"title":"临床计量学:基于阿尔茨海默病的诊断神经心理学。","authors":"Ciro Rosario Ilardi","doi":"10.1111/jnp.70008","DOIUrl":null,"url":null,"abstract":"<p><p>Neuropsychology's place in diagnosing dementia is still up for debate. With the advent of disease-modifying therapies, the optimisation of diagnostic pathways is increasingly urgent, particularly in the early stages of Alzheimer's disease. Yet, biomarker-driven frameworks eclipse neuropsychological testing as an ancillary tool rather than recognising it as a core component of clinical assessment. Emerging evidence indicates that relying solely on biomarkers does not provide a dependable forecast for the onset or progression of dementia. This drawback underscores how important neuropsychology is. Nonetheless, the clinical adoption of neuropsychological tests for diagnostic purposes requires a paradigm shift towards a more rigorous methodology. Despite its recognised diagnostic potential, the current neuropsychological framework is constrained by thresholds derived from normative distributions rather than Clinimetrics. Many existing tests rely on arbitrary cut-offs that do not account for disease prevalence, personological variability, or real-world cognitive performance. This oversimplified approach reduces the sensitivity of neuropsychological assessments and limits their integration into clinical practice. The development of population-specific clinimetric studies that establish weighted cut-offs for sensitivity and specificity based on clinical aims is crucial to ensure clinically meaningful decision-making.</p>","PeriodicalId":197,"journal":{"name":"Journal of Neuropsychology","volume":" ","pages":""},"PeriodicalIF":1.8000,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Clinimetrics: Towards a diagnostic neuropsychology grounded in Alzheimer's disease.\",\"authors\":\"Ciro Rosario Ilardi\",\"doi\":\"10.1111/jnp.70008\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Neuropsychology's place in diagnosing dementia is still up for debate. With the advent of disease-modifying therapies, the optimisation of diagnostic pathways is increasingly urgent, particularly in the early stages of Alzheimer's disease. Yet, biomarker-driven frameworks eclipse neuropsychological testing as an ancillary tool rather than recognising it as a core component of clinical assessment. Emerging evidence indicates that relying solely on biomarkers does not provide a dependable forecast for the onset or progression of dementia. This drawback underscores how important neuropsychology is. Nonetheless, the clinical adoption of neuropsychological tests for diagnostic purposes requires a paradigm shift towards a more rigorous methodology. Despite its recognised diagnostic potential, the current neuropsychological framework is constrained by thresholds derived from normative distributions rather than Clinimetrics. Many existing tests rely on arbitrary cut-offs that do not account for disease prevalence, personological variability, or real-world cognitive performance. This oversimplified approach reduces the sensitivity of neuropsychological assessments and limits their integration into clinical practice. The development of population-specific clinimetric studies that establish weighted cut-offs for sensitivity and specificity based on clinical aims is crucial to ensure clinically meaningful decision-making.</p>\",\"PeriodicalId\":197,\"journal\":{\"name\":\"Journal of Neuropsychology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.8000,\"publicationDate\":\"2025-08-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Neuropsychology\",\"FirstCategoryId\":\"102\",\"ListUrlMain\":\"https://doi.org/10.1111/jnp.70008\",\"RegionNum\":4,\"RegionCategory\":\"心理学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neuropsychology","FirstCategoryId":"102","ListUrlMain":"https://doi.org/10.1111/jnp.70008","RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHOLOGY","Score":null,"Total":0}
Clinimetrics: Towards a diagnostic neuropsychology grounded in Alzheimer's disease.
Neuropsychology's place in diagnosing dementia is still up for debate. With the advent of disease-modifying therapies, the optimisation of diagnostic pathways is increasingly urgent, particularly in the early stages of Alzheimer's disease. Yet, biomarker-driven frameworks eclipse neuropsychological testing as an ancillary tool rather than recognising it as a core component of clinical assessment. Emerging evidence indicates that relying solely on biomarkers does not provide a dependable forecast for the onset or progression of dementia. This drawback underscores how important neuropsychology is. Nonetheless, the clinical adoption of neuropsychological tests for diagnostic purposes requires a paradigm shift towards a more rigorous methodology. Despite its recognised diagnostic potential, the current neuropsychological framework is constrained by thresholds derived from normative distributions rather than Clinimetrics. Many existing tests rely on arbitrary cut-offs that do not account for disease prevalence, personological variability, or real-world cognitive performance. This oversimplified approach reduces the sensitivity of neuropsychological assessments and limits their integration into clinical practice. The development of population-specific clinimetric studies that establish weighted cut-offs for sensitivity and specificity based on clinical aims is crucial to ensure clinically meaningful decision-making.
期刊介绍:
The Journal of Neuropsychology publishes original contributions to scientific knowledge in neuropsychology including:
• clinical and research studies with neurological, psychiatric and psychological patient populations in all age groups
• behavioural or pharmacological treatment regimes
• cognitive experimentation and neuroimaging
• multidisciplinary approach embracing areas such as developmental psychology, neurology, psychiatry, physiology, endocrinology, pharmacology and imaging science
The following types of paper are invited:
• papers reporting original empirical investigations
• theoretical papers; provided that these are sufficiently related to empirical data
• review articles, which need not be exhaustive, but which should give an interpretation of the state of research in a given field and, where appropriate, identify its clinical implications
• brief reports and comments
• case reports
• fast-track papers (included in the issue following acceptation) reaction and rebuttals (short reactions to publications in JNP followed by an invited rebuttal of the original authors)
• special issues.