Intraindividual variability measured with dispersion across diagnostic groups in a memory clinic sample

Appl Neuropsychol Adult. 2023 Nov-Dec;30(6):639-648. doi: 10.1080/23279095.2021.1970552. Epub 2021 Aug 29.

Abstract

Increased intraindividual variability (IIV) has been linked to outcomes such as cognitive decline and dementia, suggesting IIV might add valuable diagnostic information beyond traditional neuropsychological interpretation. We explored whether a subtype of IIV, dispersion, can provide additional information for dementia diagnosis. In a sample of memory clinic patients, three cognitive status groups were identified: subjective cognitive impairment (SCI; n = 85), amnestic mild cognitive impairment (a-MCI; n = 16), and dementia due to Alzheimer's disease (AD; n = 48). Dispersion was computed as intraindividual standard deviations across multiple neuropsychological measures within three cognitive domains (executive functioning; immediate and delayed memory) and was compared for each diagnostic group using profile analysis. Patients with AD and a-MCI demonstrated less dispersion than patients with SCI in delayed memory. Results support existing theoretic perspectives on cognitive variability and age-related cognitive decline but suggest floor effects underlie suppression of dispersion in amnestic cognitive presentations. Questions remain about the contribution of IIV beyond impressions of impairment versus no impairment in these constrained representations of cognitive domains. Future investigations should investigate variability in SCI groups against controls to examine whether observed dispersion similarities between SCI and a-MCI or AD in immediate memory and executive functioning are meaningful.

Keywords: AD; a-MCI; dispersion; executive functioning; intraindividual variability; memory.