Practice Effects in Mild Cognitive Impairment Increase Reversion Rates and Delay Detection of New Impairments.
Practice Effects in Mild Cognitive Impairment Increase Reversion Rates and Delay Detection of New Impairments.
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DOI：
10.3389/fnagi.2022.847315
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发表时间：
2022
影响因子：
4.8
通讯作者：
Kremen, William S.
中科院分区：
文献类型：
--
作者：
Sanderson-Cimino, Mark;Elman, Jeremy A.;Tu, Xin M.;Gross, Alden L.;Panizzon, Matthew S.;Gustavson, Daniel E.;Bondi, Mark W.;Edmonds, Emily C.;Eppig, Joel S.;Franz, Carol E.;Jak, Amy J.;Lyons, Michael J.;Thomas, Kelsey R.;Williams, McKenna E.;Kremen, William S.
关键词：
认知练习效应（PE）可以延迟从认知未受损到轻度认知障碍（MCI）的进展。它们还降低了诊断准确性，如生物标志物阳性数据所示。即使在那些下降的人中，PE也可以通过夸大认知分数来掩盖更急剧的下降。在MCI样本中，PE可能会增加回复率，从而阻碍进一步损伤的检测。在基线MCI样本中，我们评估了PE如何影响1年后的患病率、逆转率和痴呆进展。我们检查了329名基线阿尔茨海默病神经影像学倡议MCI参与者（平均年龄= 73.1; SD = 7.4）。我们确定了在1年随访中与返回者人口统计学匹配的测试初治参与者。由于两组之间唯一的主要差异是一个完成了一次测试，另一个完成了两次测试，因此比较各组的评分得出了PE。从每个测试中减去PE以产生PE调整的分数。生物标志物包括脑脊液磷酸化tau和淀粉样蛋白β。考克斯比例模型预测时间，直到第一次痴呆诊断使用PE未调整和PE调整的诊断。考虑PE使随访时MCI患病率增加9.2%（272 vs. 249 MCI），并使恢复正常率降低28.8%（57 vs. 80回复者）。PE还使单结构域MCI的稳定性增加了12.0%（164 vs. 147）。与PE未调整的诊断相比，使用PE调整的随访诊断导致痴呆事件的风险比增加了两倍。我们将个人分类为假回复者，如果他们恢复到认知未受损状态的基础上PE未调整的分数，但仍然归类为MCI病例后，占PE。当淀粉样蛋白和tau蛋白阳性一起检查时，72.2%的这些假回复突变体对至少一种生物标志物呈阳性。即使PE很小，它们也可以有意义地改变一些MCI患者在1年随访时是否保留诊断。考虑PE导致MCI患病率增加和稳定性/回复率改变。这种诊断准确性的提高也提高了MCI诊断的痴呆预测能力。
Cognitive practice effects (PEs) can delay detection of progression from cognitively unimpaired to mild cognitive impairment (MCI). They also reduce diagnostic accuracy as suggested by biomarker positivity data. Even among those who decline, PEs can mask steeper declines by inflating cognitive scores. Within MCI samples, PEs may increase reversion rates and thus impede detection of further impairment. Within an MCI sample at baseline, we evaluated how PEs impact prevalence, reversion rates, and dementia progression after 1 year. We examined 329 baseline Alzheimer’s Disease Neuroimaging Initiative MCI participants (mean age = 73.1; SD = 7.4). We identified test-naïve participants who were demographically matched to returnees at their 1-year follow-up. Since the only major difference between groups was that one completed testing once and the other twice, comparison of scores in each group yielded PEs. PEs were subtracted from each test to yield PE-adjusted scores. Biomarkers included cerebrospinal fluid phosphorylated tau and amyloid beta. Cox proportional models predicted time until first dementia diagnosis using PE-unadjusted and PE-adjusted diagnoses. Accounting for PEs increased MCI prevalence at follow-up by 9.2% (272 vs. 249 MCI), and reduced reversion to normal by 28.8% (57 vs. 80 reverters). PEs also increased stability of single-domain MCI by 12.0% (164 vs. 147). Compared to PE-unadjusted diagnoses, use of PE-adjusted follow-up diagnoses led to a twofold increase in hazard ratios for incident dementia. We classified individuals as false reverters if they reverted to cognitively unimpaired status based on PE-unadjusted scores, but remained classified as MCI cases after accounting for PEs. When amyloid and tau positivity were examined together, 72.2% of these false reverters were positive for at least one biomarker. Even when PEs are small, they can meaningfully change whether some individuals with MCI retain the diagnosis at a 1-year follow-up. Accounting for PEs resulted in increased MCI prevalence and altered stability/reversion rates. This improved diagnostic accuracy also increased the dementia-predicting ability of MCI diagnoses.
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影响因子：
7.2
作者：
Duff, Kevin;Lyketsos, Constantine G.;McCaffrey, Robert J.
通讯作者：
McCaffrey, Robert J.
影响因子：
6.7
作者：
Gross, Alden L.;Chu, Nadia;Jones, Richard N.
通讯作者：
Jones, Richard N.
DOI：
10.1097/jgp.0b013e31819431d5
发表时间：
2009-05
期刊：
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry
影响因子：
--
作者：
Jak AJ;Bondi MW;Delano-Wood L;Wierenga C;Corey-Bloom J;Salmon DP;Delis DC
通讯作者：
Delis DC
DOI：
10.1080/13854046.2020.1781933
发表时间：
2022-04
期刊：
The Clinical neuropsychologist
影响因子：
--
作者：
Duff K;Hammers DB
通讯作者：
Hammers DB
DOI：
10.1017/s1355617715000508
发表时间：
2015-08
期刊：
Journal of the International Neuropsychological Society : JINS
影响因子：
--
作者：
Gross AL;Benitez A;Shih R;Bangen KJ;Glymour MM;Sachs B;Sisco S;Skinner J;Schneider BC;Manly JJ
通讯作者：
Manly JJ