Predicting Alzheimer's disease: Neuropsychological tests, self-reports, and informant reports of cognitive difficulties

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Abstract

OBJECTIVES: To investigate the independent and combined contributions to the risk of Alzheimer's disease (AD) of three important domains of cognitive assessment: neuropsychological measurement, self-reports, and informant reports. DESIGN: Longitudinal, community-based sample. SETTING: Einstein Aging Study. PARTICIPANTS: Six hundred twenty-seven individuals without dementia aged 70 and older systematically recruited from the Bronx, New York. MEASUREMENTS: Comprehensive assessment included neurological examination, behavioral questions, and neuropsychological testing. AD diagnoses were based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria assigned at a multidisciplinary consensus case conference. The major statistical analyses used Cox proportional hazards models (with age as the time scale) adjusted for sex, education, and depressive symptoms. RESULTS: Forty-eight participants developed incident AD during a median of 3.3 years of follow-up. Self- and informant reports of cognitive status and baseline scores on tests of episodic memory and psychomotor speed predicted the onset of AD, but in models examining all the variables simultaneously, only the episodic memory tests and informant reports were associated with risk of AD. A likelihood ratio test confirmed the incremental effect of informant reports in addition to the neuropsychological test scores (P = .03). CONCLUSION: Informant ratings improved the prediction of AD conversion in addition to objective memory impairment in older adults without dementia. Combining these cognitive measures may provide a useful, empirical method for identifying individuals at high risk of future AD.

Original languageEnglish (US)
Pages (from-to)1128-1134
Number of pages7
JournalJournal of the American Geriatrics Society
Volume60
Issue number6
DOIs
StatePublished - Jun 2012

Fingerprint

Neuropsychological Tests
Self Report
Alzheimer Disease
Episodic Memory
Dementia
Sex Education
Neurologic Examination
Proportional Hazards Models
Diagnostic and Statistical Manual of Mental Disorders
Consensus
Depression

Keywords

  • AD prediction
  • Cognitive complaints
  • Informant reports
  • Neuropsychological tests
  • Subjective memory complaints

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

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title = "Predicting Alzheimer's disease: Neuropsychological tests, self-reports, and informant reports of cognitive difficulties",
abstract = "OBJECTIVES: To investigate the independent and combined contributions to the risk of Alzheimer's disease (AD) of three important domains of cognitive assessment: neuropsychological measurement, self-reports, and informant reports. DESIGN: Longitudinal, community-based sample. SETTING: Einstein Aging Study. PARTICIPANTS: Six hundred twenty-seven individuals without dementia aged 70 and older systematically recruited from the Bronx, New York. MEASUREMENTS: Comprehensive assessment included neurological examination, behavioral questions, and neuropsychological testing. AD diagnoses were based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria assigned at a multidisciplinary consensus case conference. The major statistical analyses used Cox proportional hazards models (with age as the time scale) adjusted for sex, education, and depressive symptoms. RESULTS: Forty-eight participants developed incident AD during a median of 3.3 years of follow-up. Self- and informant reports of cognitive status and baseline scores on tests of episodic memory and psychomotor speed predicted the onset of AD, but in models examining all the variables simultaneously, only the episodic memory tests and informant reports were associated with risk of AD. A likelihood ratio test confirmed the incremental effect of informant reports in addition to the neuropsychological test scores (P = .03). CONCLUSION: Informant ratings improved the prediction of AD conversion in addition to objective memory impairment in older adults without dementia. Combining these cognitive measures may provide a useful, empirical method for identifying individuals at high risk of future AD.",
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author = "Rabin, {Laura A.} and Cuiling Wang and Katz, {Mindy Joy} and Derby, {Carol A.} and Herman Buschke and Lipton, {Richard B.}",
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AU - Rabin, Laura A.

AU - Wang, Cuiling

AU - Katz, Mindy Joy

AU - Derby, Carol A.

AU - Buschke, Herman

AU - Lipton, Richard B.

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N2 - OBJECTIVES: To investigate the independent and combined contributions to the risk of Alzheimer's disease (AD) of three important domains of cognitive assessment: neuropsychological measurement, self-reports, and informant reports. DESIGN: Longitudinal, community-based sample. SETTING: Einstein Aging Study. PARTICIPANTS: Six hundred twenty-seven individuals without dementia aged 70 and older systematically recruited from the Bronx, New York. MEASUREMENTS: Comprehensive assessment included neurological examination, behavioral questions, and neuropsychological testing. AD diagnoses were based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria assigned at a multidisciplinary consensus case conference. The major statistical analyses used Cox proportional hazards models (with age as the time scale) adjusted for sex, education, and depressive symptoms. RESULTS: Forty-eight participants developed incident AD during a median of 3.3 years of follow-up. Self- and informant reports of cognitive status and baseline scores on tests of episodic memory and psychomotor speed predicted the onset of AD, but in models examining all the variables simultaneously, only the episodic memory tests and informant reports were associated with risk of AD. A likelihood ratio test confirmed the incremental effect of informant reports in addition to the neuropsychological test scores (P = .03). CONCLUSION: Informant ratings improved the prediction of AD conversion in addition to objective memory impairment in older adults without dementia. Combining these cognitive measures may provide a useful, empirical method for identifying individuals at high risk of future AD.

AB - OBJECTIVES: To investigate the independent and combined contributions to the risk of Alzheimer's disease (AD) of three important domains of cognitive assessment: neuropsychological measurement, self-reports, and informant reports. DESIGN: Longitudinal, community-based sample. SETTING: Einstein Aging Study. PARTICIPANTS: Six hundred twenty-seven individuals without dementia aged 70 and older systematically recruited from the Bronx, New York. MEASUREMENTS: Comprehensive assessment included neurological examination, behavioral questions, and neuropsychological testing. AD diagnoses were based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria assigned at a multidisciplinary consensus case conference. The major statistical analyses used Cox proportional hazards models (with age as the time scale) adjusted for sex, education, and depressive symptoms. RESULTS: Forty-eight participants developed incident AD during a median of 3.3 years of follow-up. Self- and informant reports of cognitive status and baseline scores on tests of episodic memory and psychomotor speed predicted the onset of AD, but in models examining all the variables simultaneously, only the episodic memory tests and informant reports were associated with risk of AD. A likelihood ratio test confirmed the incremental effect of informant reports in addition to the neuropsychological test scores (P = .03). CONCLUSION: Informant ratings improved the prediction of AD conversion in addition to objective memory impairment in older adults without dementia. Combining these cognitive measures may provide a useful, empirical method for identifying individuals at high risk of future AD.

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