Intraindividual Variability across Neuropsychological Tests: Dispersion and Disengaged Lifestyle Increase Risk for Alzheimer's Disease.
Intraindividual Variability across Neuropsychological Tests: Dispersion and Disengaged Lifestyle Increase Risk for Alzheimer's Disease.
复制标题
DOI：
10.3390/jintelligence6010012
复制
发表时间：
2018-03-01
影响因子：
3.5
通讯作者：
MacDonald, Stuart W S
中科院分区：
文献类型：
--
作者：
Halliday, Drew W R;Stawski, Robert S;MacDonald, Stuart W S
目的：功能的个体内变异性(IIV)增加与各种与年龄相关的结果有关，包括认知功能减退和痴呆。大多数研究都将IIV作为单一任务的试验波动(例如，反应潜伏期)进行操作，很少有研究检查给定个体的多个任务的可变性。在这项研究中，我们在广泛的神经心理学测量中得出了分散度的多变量可操作性，并使用该指数和参与生活方式的程度来预测认知障碍的风险。参与者和方法：参与者(n=60)是65岁以上的社区老年人(男性=74.1，SD=6.5)，他们参与了一项关于遗忘性轻度认知障碍(a-MCI)和可能的阿尔茨海默病(AD)危险因素的横断面调查。根据测试表现和临床判断，参与者被分为三个亚组。在没有记忆障碍或功能障碍的情况下，健康对照组(n=30)在所有分类措施上相对于现有常模的得分都高于-1 SD。A-MCI组(n=23)有自我或告密者报告的记忆问题，在没有功能障碍的情况下，至少在一项记忆任务中得分低于平均值1 SD或更多，而在所有其他认知领域的得分低于平均值1 SD。AD组(n=7)在两个有功能障碍的认知领域(包括记忆)的得分至少低于平均值2SD。测量范围涵盖了一系列认知领域(情景记忆、执行功能、语言)，得出的离散度估计反映了个人神经心理特征相对于群体平均水平的变异性。此外，活动生活方式问卷，索引社会，认知和身体行为，被用来评估从事生活方式的保护益处。结果：多项Logistic回归模型检验了被归类为a-MCI或AD的风险作为离散度增加、(Dis)参与的生活方式及其相互作用的函数。离散度越大，被归类为AD的可能性越大，保护性参与生活方式的好处只对a-MCI患者明显。结论：作为IIV的一种测量方法，跨神经心理学图谱的离散度有望检测出认知障碍。
Objective: Increased intraindividual variability (IIV) in function has been linked to various age-related outcomes including cognitive decline and dementia. Most studies have operationalized IIV as fluctuations across trials (e.g., response latencies) for a single task, with comparatively few studies examining variability across multiple tasks for a given individual. In the present study, we derive a multivariable operationalization of dispersion across a broad profile of neuropsychological measures and use this index along with degree of engaged lifestyle to predict risk of cognitive impairment. Participants and Methods: Participants (n = 60) were community-dwelling older adults aged 65+ years (M = 74.1, SD = 6.5) participating in a cross-sectional investigation of risk factors for amnestic mild cognitive impairment (a-MCI) and probable Alzheimer's Disease (AD). Participants were classified into three subgroups based on test performance and clinical judgement. Healthy controls (n = 30) scored better than -1 SD relative to existing norms on all classification measures, in the absence of memory complaints or functional impairments. The a-MCI group (n = 23) had self- or informant-reported memory complaints and scored 1 SD or more below the mean for at least one memory task while scoring better than 1 SD below the mean for all other cognitive domains, in the absence of functional impairments. The AD group (n = 7) scored at least 2 SD below the mean for two cognitive domains (including memory) with impairments in functioning. Measures spanned a range of cognitive domains (episodic memory, executive function, language), with the derived dispersion estimates reflecting variability across an individual's neuropsychological profile relative to the group average. Further, an Activities Lifestyle Questionnaire, indexing social, cognitive, and physical behaviors, was administered to assess the protective benefits of engaged lifestyle. Results: Multinomial logistic regression models examined the risk of being classified as a-MCI or AD as a function of increased dispersion, (dis)engaged lifestyle, and their interaction. Greater dispersion was associated with an increased likelihood of being classified with AD, with protective engaged-lifestyle benefits apparent for a-MCI individuals only. Conclusion: As a measure of IIV, dispersion across neuropsychological profiles holds promise for the detection of cognitive impairment.