Performance variability during a multitrial list-learning task as a predictor of future cognitive decline in healthy elders.
Performance variability during a multitrial list-learning task as a predictor of future cognitive decline in healthy elders.
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多试验列表学习任务中的表现变异性可作为健康老年人未来认知能力下降的预测因子。
DOI：
10.1080/13803395.2013.877875
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发表时间：
2014
影响因子：
2.2
通讯作者：
Rao,StephenM
中科院分区：
文献类型：
--
作者：
Sugarman,MichaelA;Woodard,JohnL;Nielson,KristyA;Smith,JCarson;Seidenberg,Michael;Durgerian,Sally;Norman,AndriaL;Hantke,NathanC;Rao,StephenM
前言在临床环境中，神经心理测验的成绩传统上是用总分(TSS)来评价的。然而，最近的研究表明，个体内变异指数(IIV)产生了补充TSS的独特信息。这项为期18个月的纵向研究试图确定，与TSS相比，由多项试验清单学习测验(Rey听觉言语学习测验)得出的IIV指数是否在预测老年人认知能力下降方面提供了增量效用。方法99名认知正常的老年人(65岁至89岁)在基线和18个月的随访中接受了神经心理测试(包括Rey听觉言语学习测验)。根据他们神经心理测试成绩的变化，参与者被分为认知稳定(n=65)或下降(n=34)。Logistic回归模型检验了基线TSS指数(试验1-5的总和、立即回忆和延迟回忆)和IIV指数(失去通路和获得通路)区分稳定和下降个体的能力。结果基线时失去通路和获得通路的值越高，18个月后下降的风险就越大。此外，IIV指数提供了高于TSS指标的预测效用。结论这些结果强调了在老年人神经心理评估中除TSS外分析IIV的价值。高水平的IIV可能反映了顺行记忆系统的损害和/或执行功能障碍，这可能是认知能力下降的预后指标。
IntroductionIn clinical settings, neuropsychological test performance is traditionally evaluated with total summary scores (TSS). However, recent studies demonstrated that indices of intraindividual variability (IIV) yielded unique information complementing TSS. This 18-month longitudinal study sought to determine whether IIV indices derived from a multitrial list-learning test (the Rey Auditory Verbal Learning Test) provided incremental utility in predicting cognitive decline in older adults compared to TSS.MethodNinety-nine cognitively intact older adults (aged 65 to 89 years) underwent neuropsychological testing (including the Rey Auditory Verbal Learning Test) at baseline and 18-month follow-up. Participants were classified as cognitively stable (n= 65) or declining (n= 34) based on changes in their neuropsychological test performance. Logistic regression modeling tested the ability of baseline TSS indices (sum of Trials 1–5, immediate recall, and delayed recall) and IIV indices (lost access and gained access) to discriminate between stable and declining individuals.ResultsHigher values of both lost access and gained access at baseline were associated with an increased risk for decline at 18-month follow-up. Further, the IIV indices provided predictive utility above and beyond the TSS indices.ConclusionThese results highlight the value of analyzing IIV in addition to TSS during neuropsychological evaluation in older adults. High levels of IIV may reflect impairment in anterograde memory systems and/or executive dysfunction that may serve as a prognostic indicator of cognitive decline.