Regression-based cognitive change norms applied in biochemically defined predementia Alzheimer's disease

Neuropsychology. 2023 Jan;37(1):32-43. doi: 10.1037/neu0000853. Epub 2022 Sep 22.

Abstract

Objective: We aim to develop 2-year cognitive change norms for adults ages 41-84 for six cognitive tests, and to evaluate these norms in groups with AD biomarkers.

Background: Practice effects are common in repeated neuropsychological testing. Not accounting for practice effects may obscure cognitive decline in early Alzheimer's disease (AD).

Method: We developed standardized regression-based change norms from normative samples consisting of healthy controls from the Dementia Disease Initiation study (n = 125), the Trønderbrain study (n = 57), and the Gothenburg mild cognitive impairment (MCI) study (n = 65). Norms were applied in a sample with cognitive symptoms (subjective cognitive decline or MCI) and AD cerebrospinal fluid (CSF) biomarkers (n = 246), classified according to the A/T/N system.

Results: The change norms adjusted for pertinent demographics and practice effects. The group with cognitive complaints displayed a trend toward cognitive decline compared to the normative group, with the A +T/N + subgroup showing the most marked decline. This was observed in tests of episodic memory and cognitive flexibility/divided attention.

Conclusions: We present 2-year cognitive change norms for adults between 41 and 84 years, adjusted for practice and demographics. A web-based change norm calculator is provided. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alzheimer Disease* / cerebrospinal fluid
  • Alzheimer Disease* / complications
  • Alzheimer Disease* / diagnosis
  • Amyloid beta-Peptides
  • Biomarkers / cerebrospinal fluid
  • Cognition
  • Cognitive Dysfunction* / diagnosis
  • Cognitive Dysfunction* / etiology
  • Humans
  • Middle Aged

Substances

  • Amyloid beta-Peptides
  • Biomarkers