Robust Norms for Neuropsychological Tests of Verbal Episodic Memory in Australian Women
Robust Norms for Neuropsychological Tests of Verbal Episodic Memory in Australian Women
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DOI：
10.1037/neu0000522
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发表时间：
2019-05-01
期刊：
影响因子：
2.4
通讯作者：
Szoeke, Cassandra
中科院分区：
文献类型：
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作者：
Goodwill, Alicia M.;Campbell, Stephen;Szoeke, Cassandra
目的：神经心理学测试的稳健规范可能比传统规范具有更好的临床实用性，能够区分正常认知衰老和前驱痴呆。然而，中年时期可能出现疾病风险的认知变化的稳健规范的可用性是有限的。这项研究提出了澳大利亚女性言语记忆测试的人口统计分层稳健规范。方法：参与者来自以人口为基础的妇女健康老龄化项目。基线（1999 年至 2002 年；n = 368；年龄范围 = 53-67 岁）和随访（2012 年至 2014 年；n = 291；年龄范围 = 65-80 岁）单词表和故事回忆测量至少相隔 10 年。确定了四个样本：常规样本（源自横截面样本）、稳健样本（源自纵向样本）、轻度认知障碍 (MCI) 或阿尔茨海默病 (AD)，并且失访。生成曲线下面积 (AUC) 值，以评估使用 1 个标准差和 1.5 个标准差截止值的常规和稳健标准的诊断能力。结果：建立阿尔茨海默氏病单词表记忆登记库联盟的传统澳大利亚和美国规范数据之间存在差异。在随访期间拒绝 MCI/AD 的个体在基线时表现出较差的表现，但是没有观察到稳健标准（AUC 范围 0.54 至 64）和传统标准（AUC 范围 0.51 至 0.65）的分类能力存在差异。结论：中年时期的神经心理学表现预示着 10 年后的临床认知能力下降，但传统和稳健的规范同样可以预测该队列中疾病的转变。使用特定于国家的、具有代表性的常规规范仍然是神经心理学家评估整个中年认知表现的宝贵工具。一般科学摘要临床医生和神经心理学家使用特定于国家的、具有代表性的规范数据来区分正常的认知衰老和阿尔茨海默病相关认知障碍的早期迹象非常重要。中年女性的传统数据和稳健的规范数据同样有利于帮助临床医生及早发现有轻度认知障碍或阿尔茨海默病风险的女性；预防的重要一步。
Objective: Robust norms for neuropsychological tests may offer superior clinical utility to conventional norms, in their ability to distinguish normal cognitive aging from prodromal dementia. However, the availability of robust norms from midlife, where cognitive changes in those at risk of disease may arise, is limited. This study presents demographically stratified robust norms for tests of verbal memory in Australian women. Method: Participants were from the population-based Women's Healthy Ageing Project. Baseline (1999 to 2002; n = 368; age range = 53-67 years) and follow-up (2012 to 2014; n = 291; age range = 65-80 years) measures of word-list and story recall were administered at least 10 years apart. Four samples were identified: conventional (derived from a cross-sectional sample), robust (derived from a longitudinal sample), mild cognitive impairment (MCI) or Alzheimer's disease (AD), and lost to follow-up. Area under the curve (AUC) values were generated to assess the diagnostic ability of conventional and robust norms using 1 standard deviation and 1.5 standard deviation cut-offs. Results: There were differences between conventional Australian and American normative data for the Consortium to Establish a Registry for Alzheimer's Disease word-list recall. Individuals who declined to MCI/AD over the follow-up displayed poorer performance at baseline, however no differences in classification ability of robust (AUC range .54 to. 64) and conventional (AUC range .51 to .65) norms were observed. Conclusion: Neuropsychological performance in midlife predicted clinical cognitive decline 1 decade later, but conventional and robust norms was similarly predictive of conversion to disease in this cohort. The use of country-specific, representative conventional norms remains a valuable tool for neuropsychologists to assess cognitive performance throughout midlife.General Scientific SummaryIt is important that clinicians and neuropsychologists use country-specific, representative normative data to distinguish normal cognitive aging from the early signs of Alzheimer's disease-related cognitive impairment. Both conventional and robust normative data for women in midlife are equally beneficial to assist clinicians in early detection of women at risk of mild cognitive impairment or Alzheimer's disease; an important step toward prevention.