Underdiagnosis of mild cognitive impairment: A consequence of ignoring practice effects.
Underdiagnosis of mild cognitive impairment: A consequence of ignoring practice effects.
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DOI：
10.1016/j.dadm.2018.04.003
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发表时间：
2018
期刊：
影响因子：
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通讯作者：
Kremen WS
中科院分区：
文献类型：
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作者：
Elman JA;Jak AJ;Panizzon MS;Tu XM;Chen T;Reynolds CA;Gustavson DE;Franz CE;Hatton SN;Jacobson KC;Toomey R;McKenzie R;Xian H;Lyons MJ;Kremen WS
纵向测试是准确测量认知变化所必需的。然而，重复测试易受练习效应的影响，这可能会掩盖真正的认知下降和延迟轻度认知障碍（MCI）的检测。我们对995名中年晚期男性进行了为期106年的越南时代双胞胎衰老研究随访。此外，170名年龄匹配的替代者在研究波2首次接受了测试。在控制了损耗效应之后，组间差异被用来计算练习效应。MCI诊断是根据实践调整后的评分生成的。在大多数认知领域都存在显著的练习效应。在校正练习效果后，MCI的转化率翻了一番，从4.5%增加到9%。重要的是，尽管未纠正的分数有所下降，但练习效果仍然存在。考虑到实践效果对于MCI的早期发现至关重要。低于预期的下降仍然可以表明实践效果。需要替换受试者以准确评估疾病进展。
Longitudinal testing is necessary to accurately measure cognitive change. However, repeated testing is susceptible to practice effects, which may obscure true cognitive decline and delay detection of mild cognitive impairment (MCI). We retested 995 late-middle-aged men in a ∼6-year follow-up of the Vietnam Era Twin Study of Aging. In addition, 170 age-matched replacements were tested for the first time at study wave 2. Group differences were used to calculate practice effects after controlling for attrition effects. MCI diagnoses were generated from practice-adjusted scores. There were significant practice effects on most cognitive domains. Conversion to MCI doubled after correcting for practice effects, from 4.5% to 9%. Importantly, practice effects were present although there were declines in uncorrected scores. Accounting for practice effects is critical to early detection of MCI. Declines, when lower than expected, can still indicate practice effects. Replacement participants are needed for accurately assessing disease progression.