Predictors of Retest Effects in a Longitudinal Study of Cognitive Aging in a Diverse Community-Based Sample.
Predictors of Retest Effects in a Longitudinal Study of Cognitive Aging in a Diverse Community-Based Sample.
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DOI：
10.1017/s1355617715000508
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发表时间：
2015-08
期刊：
影响因子：
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通讯作者：
Manly JJ
中科院分区：
文献类型：
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作者：
Gross AL;Benitez A;Shih R;Bangen KJ;Glymour MM;Sachs B;Sisco S;Skinner J;Schneider BC;Manly JJ
由于重复测试而获得的更好的表现可能会使认知老化的长期轨迹和变化的相关性产生偏差。我们检查了是否重复测试的效果不同的功能，个体差异相关的认知老化：种族/民族，年龄，性别，语言，教育年数，和痴呆的风险因素，包括APOE ε4状态，基线认知能力，和心血管风险。我们使用了来自华盛顿Heights-Inwood哥伦比亚老龄化项目的数据，这是一个以社区为基础的老年人队列（n=4,073）。我们使用多水平模型对一般认知表现、记忆、执行功能和语言的概括因素进行了认知变化和重测效应建模。重新测试的效果参数化的两种方式，第一次和随后的测试之间的改善，并作为先前测试的数量的平方根。我们评估了个体特征的重测效应是否不同。一般认知表现的平均重测效应为0.60标准差（95%CI：0.46，0.74），记忆、执行功能和语言的重测效应相似。认知表现最低四分位数的参与者的重测效果更大，与回归平均值一致。复检在其他特征方面没有差异。在这个以社区为基础的样本中，重测效应很大，但不因人口统计学或痴呆相关特征而异。差异重测效应可能不会限制纵向研究中不同群体之间推论的普遍性。
Better performance due to repeated testing can bias long-term trajectories of cognitive aging and correlates of change. We examined whether retest effects differ as a function of individual differences pertinent to cognitive aging: race/ethnicity, age, sex, language, years of education, and dementia risk factors including APOE ε4 status, baseline cognitive performance, and cardiovascular risk. We used data from the Washington Heights-Inwood Columbia Aging Project, a community-based cohort of older adults (n=4,073). We modeled cognitive change and retest effects in summary factors for general cognitive performance, memory, executive functioning, and language using multilevel models. Retest effects were parameterized in two ways, as improvement between the first and subsequent testings, and as the square root of the number of prior testings. We evaluated whether the retest effect differed by individual characteristics. The mean retest effect for general cognitive performance was 0.60 standard deviations (95%CI: 0.46, 0.74), and was similar for memory, executive functioning, and language. Retest effects were greater for participants in the lowest quartile of cognitive performance, consistent with regression to the mean. Retest did not differ by other characteristics. Retest effects are large in this community-based sample, but do not vary by demographic or dementia-related characteristics. Differential retest effects may not limit the generalizability of inferences across different groups in longitudinal research.