Jump, Hop, or Skip: Modeling Practice Effects in Studies of Determinants of Cognitive Change in Older Adults
Jump, Hop, or Skip: Modeling Practice Effects in Studies of Determinants of Cognitive Change in Older Adults
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DOI：
10.1093/aje/kwv212
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发表时间：
2016-02-15
影响因子：
5
通讯作者：
Gross, Alden L.
中科院分区：
文献类型：
--
作者：
Vivot, Alexandre;Power, Melinda C.;Gross, Alden L.
由于练习效应（PE），在重复评估后认知测试分数的改善有据可查，但没有经验证据表明PE的替代规格是否会导致暴露与认知变化率之间的不同估计关联。如果替代PE规格产生不同的估计之间的关联暴露和认知变化率，这将是一个挑战，几乎所有的纵向研究认知老化的决定因素。使用来自三个队列研究的数据-三城市研究-第戎（第戎戎，法国，1999-2010），规范老化研究（大波士顿，马萨诸塞州，1993-2007），和华盛顿高地-因伍德社区老龄化项目（纽约，纽约，1999-2012年）-2次曝光（糖尿病和抑郁症）和3种认知结果，我们比较了使用替代PE规范的纵向模型的结果：无PE;使用首次认知访视的指标;先前测试时机的数量;以及先前测试时机的数量的平方根。替代规格导致认知变化的估计率差异很大，但在估计的接触与认知水平或变化的关联差异很小。基于模型拟合，首次访视使用指标通常（但不总是）是首选模型。PE规范可能导致认知变化的估计率存在实质性差异，但在这些不同的例子和研究样本中，它并没有实质性影响风险因素与变化的估计关联。
Improvements in cognitive test scores upon repeated assessment due to practice effects (PEs) are well documented, but there is no empirical evidence on whether alternative specifications of PEs result in different estimated associations between exposure and rate of cognitive change. If alternative PE specifications produce different estimates of association between an exposure and rate of cognitive change, this would be a challenge for nearly all longitudinal research on determinants of cognitive aging. Using data from 3 cohort studies-the Three-City Study-Dijon (Dijon, France, 1999-2010), the Normative Aging Study (Greater Boston, Massachusetts, 1993-2007), and the Washington Heights-Inwood Community Aging Project (New York, New York, 1999-2012)-for 2 exposures (diabetes and depression) and 3 cognitive outcomes, we compared results from longitudinal models using alternative PE specifications: no PEs; use of an indicator for the first cognitive visit; number of prior testing occasions; and square root of the number of prior testing occasions. Alternative specifications led to large differences in the estimated rates of cognitive change but minimal differences in estimated associations of exposure with cognitive level or change. Based on model fit, using an indicator for the first visit was often (but not always) the preferred model. PE specification can lead to substantial differences in estimated rates of cognitive change, but in these diverse examples and study samples it did not substantively affect estimated associations of risk factors with change.