Cognitive test performance predicts change in functional status at the population level: The MYHAT Project
- 8 July 2010
- journal article
- Published by Cambridge University Press (CUP) in Journal of the International Neuropsychological Society
- Vol. 16 (5), 761-770
- https://doi.org/10.1017/s1355617710000561
Abstract
In the community at large, many older adults with minimal cognitive and functional impairment remain stable or improve over time, unlike patients in clinical research settings, who typically progress to dementia. Within a prospective population-based study, we identified neuropsychological tests predicting improvement or worsening over 1 year in cognitively driven everyday functioning as measured by Clinical Dementia Rating (CDR). Participants were 1682 adults aged 65+ and dementia-free at baseline. CDR change was modeled as a function of baseline test scores, adjusting for demographics. Among those with baseline CDR = 0.5, 29.8% improved to CDR = 0; they had significantly better baseline scores on most tests. In a stepwise multiple logistic regression model, tests which remained independently associated with subsequent CDR improvement were Category Fluency, a modified Token Test, and the sum of learning trials on Object Memory Evaluation. In contrast, only 7.1% with baseline CDR = 0 worsened to CDR = 0.5. They had significantly lower baseline scores on most tests. In multiple regression analyses, only the Mini-Mental State Examination, delayed memory for visual reproduction, and recall susceptible to proactive interference, were independently associated with CDR worsening. At the population level, changes in both directions are observable in functional status, with different neuropsychological measures predicting the direction of change. (JINS, 2010, 16, 761–770.)Keywords
This publication has 48 references indexed in Scilit:
- Prevalence of Mild Cognitive Impairment by Multiple Classifications: The Monongahela-Youghiogheny Healthy Aging Team (MYHAT) ProjectAmerican Journal of Geriatric Psychiatry, 2010
- A novel approach to assessing memory at the population level: vulnerability to semantic interferenceInternational Psychogeriatrics, 2010
- Age and education effects and norms on a cognitive test battery from a population-based cohort: The Monongahela–Youghiogheny Healthy Aging TeamAging & Mental Health, 2010
- Mild Cognitive ImpairmentArchives of Neurology, 2009
- How much do depressive symptoms affect cognition at the population level? The monongahela–youghiogheny healthy aging team (MYHAT) studyInternational Journal of Geriatric Psychiatry, 2009
- Progression of Mild Cognitive Impairment to Dementia in Clinic- vs Community-Based CohortsArchives of Neurology, 2009
- Effects of age, gender, education and race on two tests of language ability in community-based older adultsInternational Psychogeriatrics, 2009
- Functional and cognitive criteria produce different rates of mild cognitive impairment and conversion to dementiaJournal of Neurology, Neurosurgery & Psychiatry, 2009
- Frequency and course of mild cognitive impairment in a multiethnic communityAnnals of Neurology, 2008
- Memory impairment, executive dysfunction, and intellectual decline in preclinical Alzheimer's diseaseJournal of the International Neuropsychological Society, 2008