Journal
CLINICAL NEUROPSYCHOLOGIST
Volume 27, Issue 8, Pages 1247-1264Publisher
TAYLOR & FRANCIS INC
DOI: 10.1080/13854046.2013.836567
Keywords
Cognition; Memory; Practice effects; Mild cognitive impairment; Alzheimer's disease
Categories
Funding
- NIH [P50 AG016574, U01 AG006786]
- Robert Wood Johnson Foundation
- Robert H. and Clarice Smith and Abigail van Buren Alzheimer's Disease Research Program
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The objective of this study was to examine practice effects and longitudinal cognitive change in a population-based cohort classified as clinically normal at their initial evaluation. We examined 1390 individuals with a median age of 78.1 years and re-evaluated them up to four times at approximate 15-month intervals, with an average follow-up time of 5 years. Of the 1390 participants, 947 (69%) individuals remained cognitively normal, 397 (29%) progressed to mild cognitive impairment (MCI), and 46 (3%) to dementia. The stable normal group showed an initial practice effect in all domains which was sustained in memory and visuospatial reasoning. There was only a slight decline in attention and language after visit 3. We combined individuals with incident MCI and dementia to form one group representing those who declined. The incident MCI/dementia group showed an unexpected practice effect in memory from baseline to visit 2, with a significant decline thereafter. This group did not demonstrate practice effects in any other domain and showed a downward trajectory in all domains at each evaluation. Modeling cognitive change in an epidemiologic sample may serve as a useful benchmark for evaluating cognitive change in future intervention studies.
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