Neuropsychological test performance and cognitive reserve in healthy aging and the Alzheimer's disease spectrum: a theoretically driven factor analysis.
Neuropsychological test performance and cognitive reserve in healthy aging and the Alzheimer's disease spectrum: a theoretically driven factor analysis.
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DOI：
10.1017/s1355617712000859
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发表时间：
2012-11
影响因子：
2.6
通讯作者：
Atri, Alireza
中科院分区：
文献类型：
--
作者：
Mitchell, Meghan B.;Shaughnessy, Lynn W.;Shirk, Steven D.;Yang, Frances M.;Atri, Alireza
认知功能的准确测量对于了解阿尔茨海默病（AD）的病程至关重要。随着时间的推移检测认知变化可能会受到病前智力功能或认知储备水平的混淆，并导致认知障碍和AD的诊断不足或过度。包括认知储备的认知表现的统计模型可以提高对变化的敏感性和临床疗效。我们使用验证性因素分析来测试一个四因素模型，包括记忆/语言，处理速度/执行功能，注意力和认知储备因素，在一组认知健康的老年人和一组参与者沿着遗忘型轻度认知障碍的AD（aMCI-AD）的频谱。该模型显示出对于对照组的极好拟合（χ2 = 100，df = 78，CFI = .962，RMSEA = .049）和对于aMCI-AD组的充分拟合（χ2 = 1750，df = 78，CFI = .932，RMSEA = .085）。虽然不符合严格的不变性标准，但确定各组之间因子结构是否相似的不变性检验产生了可接受的绝对模型拟合，并提供了支持几何、度量和标量不变性的证据。这些结果进一步支持了认知储备在健康和记忆受损老年人中的结构效度。
Accurate measurement of cognitive function is critical for understanding the disease course of Alzheimer’s disease (AD). Detecting cognitive change over time can be confounded by level of premorbid intellectual function or cognitive reserve and lead to under or over diagnosis of cognitive impairment and AD. Statistical models of cognitive performance that include cognitive reserve can improve sensitivity to change and clinical efficacy. We used confirmatory factor analysis to test a four-factor model comprised of memory/language, processing speed/executive function, attention, and cognitive reserve factors in a group of cognitively healthy older adults and a group of participants along the spectrum of amnestic mild cognitive impairment to AD (aMCI-AD). The model showed excellent fit for the control group (χ2 = 100, df = 78, CFI = .962, RMSEA = .049) and adequate fit for the aMCI-AD group (χ2 = 1750, df = 78, CFI = .932, RMSEA = .085). Though strict invariance criteria were not met, invariance testing to determine if factor structures are similar across groups yielded acceptable absolute model fits and provide evidence in support of configural, metric, and scalar invariance. These results provide further support for the construct validity of cognitive reserve in healthy and memory impaired older adults.