Performance on the Cognitive Abilities Screening Instrument (CASI) among Spanish and English Speakers at-risk for Autosomal Dominant Alzheimer’s Disease (P5.183)

Objective: We tested the utility of the Cognitive Abilities Screening Instrument (CASI) to screen for incipient dementia among at-risk individuals for autosomal dominant Alzheimer’s Disease (ADAD), and attempted to identify cognitive domains affected earliest in disease progression. Background: Given a growing elder population, screening tools for early Alzheimer’s Disease (AD) detection are essential, especially in English and Spanish. Design/Methods: Demographics, CASI scores, and Clinical Dementia Rating Scale (CDR) scores were compared between PSEN1/2 or APP mutation carriers (MCs) and non-carriers (NCs), and between MCs divided into tertiles based on age relative to the average family age of AD diagnosis (adjusted age). Results: 93 individuals from families harboring ADAD mutations, aged 19 to 64 years, were studied. Carrier groups (65 MCs and 28 NCs) did not differ by age, adjusted age, education, acculturation level, gender, language, or residence (US vs. Mexico). MCs had higher CDR scores ( M ( SD )= 0.48 (0.73); U = 585, p =.002) and lower CASI total scores ( M ( SD )= 83.41(22.9); U =639.5, p =.023) than NCs (CDR M ( SD )= 0.11(0.21); CASI M ( SD )= 93.9(4.93)). MCs had lower scores on CASI subscales for Orientation ( p =.02), Long-term Memory ( p =.02), and Short-term Memory ( p =.047). Carrier groups did not differ in the youngest and middle adjusted age groups. MCs in the oldest adjusted age group had lower total CASI scores ( U =51, p =.006), and lower scores on Concentration ( p =.005), Orientation ( p =.001), Short-term Memory ( p =.021), Language ( p =.036), Visuoconstruction ( p =.036), and Fluency ( p =.019). Among MCs, significant differences were found between adjusted age groups on all CASI subscales, except for Attention and Long-term Memory. Conclusions: CASI scores differed significantly between MCs and NCs, though total scores did not distinguish between at-risk groups early in the AD process. Of those within +/−6 years of the average family age of dementia diagnosis, MCs had lower total CASI scores than NCs, and lower scores in concentration, orientation, short-term memory, language, and visuoconstruction. Study Supported by: NIH U01 AG0051218, P50 AG0005142, K08 AG022228 Disclosure: Dr. D9Orazio has nothing to disclose. Dr. Medina has nothing to disclose. Dr. Ringman has nothing to disclose.