Practice effects are improvements in cognitive test performance due to repeated evaluation with the same or similar test materials. Prior studies have reported that these improvements can vary with age, education/intellect, and disease status. However, additional information is needed about variables that influence practice effects. The current study prospectively quantified short-term practice effects in 268 community-dwelling older adults and compared these practice effects to demographic variables, global cognition, premorbid intellect, depression, and individual cognitive domains. Overall, practice effects were not significantly related to most demographic and clinical characteristics or individual cognitive domains, which was contrary to our hypotheses. However, since practice effects appear to be uninfluenced by many variables that typically affect cognitive scores, they may be a unique and valuable tool that could be applied in a number of diverse patient groups.
Background: Practice effects are improvements in cognitive test performance associated with repeated administrations of same or similar measures and are traditionally seen as error variance. However, there is growing evidence that practice effects provide clinically useful information. Methods: Within-session practice effects (WISPE) across 2 h were collected from 61 non-consecutive patients referred for suspected dementia and compared to the Mini Mental Status Examination (MMSE), a screening measure of dementia severity. Results: In all patients, WISPE on two cognitive measures were significantly correlated with MMSE, even after controlling for baseline cognitive scores (partial r = 0.47, p < 0.001; partial r = 0.26, p = 0.046). In patients diagnosed with probable Alzheimer’s disease, the trend was even stronger (partial r = 0.72, p < 0.01; partial r = 0.58, p = 0.046). In both groups, lower WISPE were associated with lower MMSE scores (i.e. greater dementia severity), even after controlling for initial cognitive scores. Conclusion: If future research validates these findings with longitudinal studies, then WISPE may have important clinical applications in dementia evaluations.
Although amyloid deposition remains a marker of the development of Alzheimer's disease, results linking amyloid and cognition have been equivocal. Twenty-five community-dwelling non-demented older adults were examined with (18)F-flutemetamol, an amyloid imaging agent, and a cognitive battery, including an estimate of premorbid intellect and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). In the first model, (18)F-flutemetamol uptake significantly correlated with the Delayed Memory Index of the RBANS (r = -.51, p = .02) and premorbid intellect (r = .43, p = .03). In the second model, the relationship between (18)F-flutemetamol and cognition was notably stronger when controlling for premorbid intellect (e.g., three of the five RBANS Indexes and its Total score significantly correlated with (18)F-flutemetamol, r's = -.41 to -.58). Associations were found between amyloid-binding (18)F-flutemetamol and cognitive functioning in non-demented older adults. These associations were greatest with delayed memory and stronger when premorbid intellect was considered, suggesting that cognitive reserve partly compensates for the symptomatic expression of amyloid pathology in community-dwelling elderly.
Although not as popular as the Mini Mental State Examination (MMSE), the modified Telephone Interview for Cognitive Status (mTICS) has some distinct advantages when screening cognitive functioning in older adults. The current study compared these two cognitive screening measures in their ability to predict performance on a memory composite (i.e., delayed recall of verbal and visual information) in a cohort of 121 community-dwelling older adults, both at baseline and after one year. Both the MMSE and mTICS significantly correlated with the memory composite at baseline (r’s of 0.41 and 0.62, respectively) and one year (r’s of 0.36 and 0.50, respectively). At baseline, stepwise linear regression indicated that the mTICS and gender best predicted the memory composite score (R2=0.45, p<.001), and the MMSE and other demographic variables did not significantly improve the prediction. At one year, the results were very similar. Despite its lesser popularity, the mTICS may be a more attractive option when screening for cognitive abilities in this age range.
Despite the growing use of the modified Telephone Interview for Cognitive Status (mTICS) as a cognitive screening instrument, it does not yet have demographic corrections. Demographic data, mTICS, and a neuropsychological battery were collected from 274 community dwelling older adults with intact cognition or mild cognitive impairments. Age, education, premorbid intellect, and depression were correlated with mTICS scores. Using regression equations, age and education significantly predicted mTICS total score, and depression and premorbid intellect further enhanced this prediction. These results were comparable when only examining the 153 cognitively intact subjects. By using these corrections, clinicians and researchers can more accurately predict an individual’s cognitive status with this telephone screening measure.
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