Using Multivariate Base Rates of Low Scores to Understand Early Cognitive Declines on the Uniform Data Set 3.0 Neuropsychological Battery
Using Multivariate Base Rates of Low Scores to Understand Early Cognitive Declines on the Uniform Data Set 3.0 Neuropsychological Battery
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DOI：
10.1037/neu0000640
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发表时间：
2020-09-01
期刊：
影响因子：
2.4
通讯作者：
Benge, Jared F.
中科院分区：
文献类型：
--
作者：
Kiselica, Andrew M.;Webber, Troy A.;Benge, Jared F.
目的：即使在认知健康的老年人中也经常观察到低神经心理学测试分数。用于评估和跟踪老年人认知能力下降的电池。记录低评分的多变量基本比率（MBR）对于区分预期的低评分模式和异常的低评分模式是重要的。此外，这对于我们理解轻度认知障碍和临床前下降以及确定这些评分模式如何预测未来的临床状态非常重要。方法：目前的研究使用了统一数据集神经心理电池3.0（UDS 3 NB）数据，这些数据来自2015年3月至2018年12月来自39个阿尔茨海默病研究中心的国家阿尔茨海默病协调中心的5，870名讲英语的老年人参与者。在完成所有认知测量的2,608名认知健康参与者中，确定了低分数的MBR。异常MBR模式与随后转化为轻度认知障碍和痴呆的相关性进行了探讨。结果：根据“低”分的操作化，人口统计学调整后的评分的MBR范围为1.40%至79.2%。使用MBR方法预测2年随访时痴呆状态的后测概率范围为0.06 - 0.33，而转换为轻度认知障碍（MCI）的后测概率范围为0.12 - 0.32。结论：数据证实，认知测试分数异常是常见的认知正常的老年人。使用MBR标准可以提高我们对MCI的理解。它们也可用于通过招募高风险个体来丰富临床试验选择过程。
Objective: Low neuropsychological test scores are commonly observed even in cognitively healthy older adults. For batteries designed to assess for and track cognitive decline in older adults. documenting the multivariate base rates (MBRs) of low scores is important to differentiate expected from abnormal low score patterns. Additionally, it is important for our understanding of mild cognitive impairment and preclinical declines to and determine how such score patterns predict future clinical states. Method: The current study utilized Uniform Data Set Neuropsychological Battery 3.0 (UDS3NB) data for 5,870 English-speaking, older adult participants from the National Alzheimer's Coordinating Center from 39 Alzheimer's disease Research Centers from March 2015 to December 2018. MBRs of low scores were identified for 2,608 cognitively healthy participants that had completed all cognitive measures. The association of abnormal MBR patterns with subsequent conversion to mild cognitive impairment and dementia were explored. Results: Depending on the operationalization of "low" score, the MBR of demographically adjusted scores ranged from 1.40 to 79.2%. Posttest probabilities using MBR methods to predict dementia status at 2-year follow up ranged from .06 to .33, while posttest probabilities for conversion to mild cognitive impairment (MCI) ranged from .12-.32. Conclusions: The data confirm that abnormal cognitive test scores are common among cognitively normal older adults. Using MBR criteria may improve our understanding of MCI. They may also be used to enrich clinical trial selection processes through recruitment of at-risk individuals.