To Change is Human: “Abnormal” Reliable Change Memory Scores are Common in Healthy Adults and Older Adults

Brooks, Brian L.; Holdnack, James A.; Iverson, Grant L.

doi:10.1093/arclin/acw079

Cited by 16 publications

(17 citation statements)

References 33 publications

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“…Also, the same cognitive assessments were applied at both baseline and the 2-year follow-up. Thus, improvements observed at the follow-up assessment could, in part, be attributed to practice effects (25). Since CHARLS did not record whether participants recalled specific questions from their baseline assessment, we were unable to control for these effects; future research should examine the relative impact of practice effects compared to benefits of behavioral interventions such as napping.…”

Section: Discussionmentioning

confidence: 99%

“…However, the scoring method is similar to that used in the Montreal Cognitive Assessment (28) and the Mini-Mental Status Exam (29). In addition, although measurements were taken 2 years apart, the use of the same cognitive assessments at both the baseline and follow-up could have resulted in small increases in cognitive score due to practice effects (25). We could not examine the possible impact of remembering specific questions with the available data in CHARLS.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Intermediate, But Not Extended, Afternoon Naps May Preserve Cognition in Chinese Older Adults

Chang

Riegel

et al. 2017

The Journals of Gerontology: Series A

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Intermediate, But Not Extended, Afternoon Naps May Preserve Cognition in Chinese Older Adults

Chang

Riegel

et al. 2017

The Journals of Gerontology: Series A

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“…Performing multiple tests amplifies false-positive rates-a phenomenon well established in the analogous practice of administering a battery of cognitive test measures. 29,30 This has important research and clinical implications when interpreting change from a previous time point. However, individuals exhibiting reliable change in 2 or more serum biomarkers (of the 4 analyzed) occurred relatively infrequently, suggesting that utilizing a biomarker panel may improve clinical applicability in cases in which reliable change is noted in multiple biomarkers.…”

Section: Discussionmentioning

confidence: 99%

Concussion Biomarkers Assessed in Collegiate Student-Athletes (BASICS) I

et al. 2018

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ObjectiveTo describe variability in concussion biomarker concentrations collected from serum in a sample of healthy collegiate athletes, as well as report reliability metrics in a subsample of female athletes.MethodsIn this observational cohort study, β-amyloid peptide 42 (Aβ42), total tau, S100 calcium binding protein B (S100B), ubiquitin carboxy-terminal hydrolyzing enzyme L1 (UCH-L1), glial fibrillary acidic protein, microtubule associated protein 2, and 2′,3′-cyclic-nucleotide 3′-phosphodiesterase (CNPase) serum concentrations were measured in 415 (61% male, 40% white, aged 19.0 ± 1.2 years) nonconcussed collegiate athletes without recent exposure to head impacts. Standardized normative distributions are reported for each biomarker. We evaluated main effects (analyses of variance) of sex and race, reporting demographic-specific normative metrics when appropriate. In a subset of 31 female participants, test-retest reliability (Pearson r) and reliable change indices (80%, 90%, and 95% confidence intervals) across a 6- to 12-month interval are reported for Aβ42, total tau, S100B, and UCH-L1.ResultsMales exhibited higher UCH-L1 (p < 0.001, Cohen d = 0.75) and S100B (p < 0.001, d = 0.56) than females, while females had higher CNPase (p < 0.001, d = 0.43). Regarding race, black participants had higher baseline levels of UCH-L1 (p < 0.001, d = 0.61) and S100B (p < 0.001, d = 1.1) than white participants. Conversely, white participants had higher baseline levels of Aβ42 (p = 0.005, d = 0.28) and CNPase (p < 0.001, d = 0.46). Test-retest reliability was generally poor, ranging from −0.02 to 0.40, and Aβ42 significantly increased from time 1 to time 2.ConclusionHealthy collegiate athletes express concussion-related serum biomarkers in variable concentrations. Accounting for demographic factors such as sex and race is essential. Evidence suggested poor reliability for serum biomarkers; however, understanding how other factors influence biomarker expression, as well as knowledge of reliable change metrics, may improve clinical interpretation and future study designs.

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“…This is important as the use of multiple tests increases the likelihood of finding reliable changes due to chance (Iverson et al, 2003). For this study, we considered a critical value of ±1.64 (90%CI) as a reliable change, as used by Brooks, Holdnack, & Iverson (2016). Based on this critical value~5% of reliably improved and~5% of reliably declined scores is expected in a nonclinical population.…”

Section: Neurocognitive Development Per Individualmentioning

confidence: 99%

“…The interval between measurements in this study of at least 1 year or more reduces the magnitude of practice effects, although a residual practice effect cannot be entirely discarded. Therefore, the RCI calculations were corrected for the average change in test scores between the first and second measurements as has been used by others (Brooks et al, 2016;Chelune, Naugle, Lüders, Sedlak, & Awad, 1993;Iverson, 2012). However, this method does not account for the range of practice effects, as some may improve and others may worsen (Iverson et al, 2003).…”

Section: Neurocognitive Development Per Individualmentioning

confidence: 99%

Cognitive development in absence epilepsy during long-term follow-up

Wald

Klinkenberg

Voncken

et al. 2019

Child Neuropsychology

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Absence epilepsy (AE) has been associated with lower than average cognitive functioning, which are clinically relevant in some and may predispose to problems later in life. This study aimed to assess cognitive development during long-term follow-up in children with AE. Thirty-one children with AE, who had undergone two neuropsychological assessments between 2010 and 2017 were analyzed retrospectively. Cognitive measurements were 1.7 ± 0.95 years apart. The difference in neurocognitive test scores was assessed on a group level and on an individual level using reliable change methodology. Results show that sustained attention was lower at the first measurement compared to the normative mean. Sustained attention improved during follow-up and 7 out of 14 children showed improvement after correction for practice effects. Receptive vocabulary showed a decline over time, but did not differ from the normative mean. Significant lower mean group scores were present for performance IQ, perceptual organization, processing speed, simple reaction times, and visual motor integration, while being stable over time in the majority of children. Cognitive development was not associated with seizure freedom. Mild-to-severe academic underachievement was present in 65% and comorbidities that might affect learning in 38%. This study in children with AE showed improvement in sustained attention during long-term follow-up while other cognitive weaknesses persisted over time, regardless of seizure freedom.

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To Change is Human: “Abnormal” Reliable Change Memory Scores are Common in Healthy Adults and Older Adults

Abstract: Having a single reliably changed score on retest is common when interpreting a battery of memory measures. This has implications for determining cognitive decline and cognitive recovery, suggesting that multivariate interpretation is necessary.

Cited by 16 publications

References 33 publications

Intermediate, But Not Extended, Afternoon Naps May Preserve Cognition in Chinese Older Adults

Intermediate, But Not Extended, Afternoon Naps May Preserve Cognition in Chinese Older Adults

Concussion Biomarkers Assessed in Collegiate Student-Athletes (BASICS) I

Cognitive development in absence epilepsy during long-term follow-up

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