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Predicting A lzheimer's Disease: Neuropsychological Tests, Self‐Reports, and Informant Reports of Cognitive Difficulties
Author(s) -
Rabin Laura A.,
Wang Cuiling,
Katz Mindy J.,
Derby Carol A.,
Buschke Herman,
Lipton Richard B.
Publication year - 2012
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2012.03956.x
Subject(s) - dementia , medicine , episodic memory , neuropsychology , cognition , neuropsychological test , clinical psychology , neuropsychological assessment , psychiatry , disease , pathology
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 B ronx, N ew Y ork. Measurements Comprehensive assessment included neurological examination, behavioral questions, and neuropsychological testing. AD diagnoses were based on D iagnostic and S tatistical M anual of M ental D isorders, F ourth E dition , criteria assigned at a multidisciplinary consensus case conference. The major statistical analyses used C ox 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 .