Demographically unadjusted cognitive test scores may enhance the validity of mild cognitive impairment as a dementia prodrome.

IF 1.4 4区 心理学 Q4 CLINICAL NEUROLOGY
Mathilde Suhr Hemminghyth, Monica Haraldseid Breitve, Luiza Jadwiga Chwiszczuk, Berglind Gísladóttir, Erik Hessen, Nikias Siafarikas, Ragnhild Eide Skogseth, Gøril Rolfseng Grøntvedt, Henrik Karlsen, Arvid Rongve, Tormod Fladby, Bjørn-Eivind Kirsebom
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Abstract

Mild cognitive impairment (MCI) precedes most forms of neurodegenerative dementias and is considered an important time window for treatment initiation. It is however unclear whether the widespread use of demographically adjusted norms improve detection of dementia-related impairment and identification of individuals at risk for dementia. In the current multicenter study (n = 561), we compared three Petersen/Winblad criteria-based MCI diagnoses with varying levels of demographic adjustments, in relation to their associations with biomarkers for Alzheimer's disease and neurodegeneration, as well as risk of conversion to future dementia. Our MCI diagnoses were (1) demographically unadjusted; (2) adjusted for sex and education; or (3) adjusted for age, sex, and education. In our cohort, we found the differences between the models to be small, albeit consistent, and our results show a tendency for an unadjusted MCI diagnosis to be more strongly associated to dementia biomarkers and conversion to dementia. Our results thus suggest that an MCI diagnosis based on unadjusted test scores may provide a more valid diagnosis of prodromal dementia, while no evidence is provided to support this in other contexts. This goes against the recommendations from the major diagnostic classification systems, indicating the need for further research to explore these relationships.

人口统计学上未调整的认知测试分数可能会提高轻度认知障碍作为痴呆前驱症状的有效性。
轻度认知障碍(MCI)先于大多数形式的神经退行性痴呆,被认为是治疗开始的重要时间窗口。然而,目前尚不清楚的是,广泛使用经人口统计学调整的规范是否能提高对痴呆症相关损伤的检测和对痴呆症风险个体的识别。在当前的多中心研究中(n = 561),我们比较了三种基于Petersen/Winblad标准的MCI诊断,这些诊断具有不同程度的人口统计学调整,与阿尔茨海默病和神经退行性变的生物标志物以及转化为未来痴呆的风险相关。我们的MCI诊断是:(1)人口学未调整;(二)按性别和教育程度调整的;或(3)根据年龄、性别和教育程度进行调整。在我们的队列中,我们发现模型之间的差异很小,尽管是一致的,我们的结果显示,未经调整的MCI诊断与痴呆生物标志物和转化为痴呆的相关性更强。因此,我们的研究结果表明,基于未经调整的测试分数的MCI诊断可能提供更有效的前驱痴呆诊断,而在其他情况下没有证据支持这一点。这与主要诊断分类系统的建议相悖,表明需要进一步研究以探索这些关系。
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来源期刊
Applied Neuropsychology-Adult
Applied Neuropsychology-Adult CLINICAL NEUROLOGY-PSYCHOLOGY
CiteScore
4.50
自引率
11.80%
发文量
134
期刊介绍: pplied Neuropsychology-Adult publishes clinical neuropsychological articles concerning assessment, brain functioning and neuroimaging, neuropsychological treatment, and rehabilitation in adults. Full-length articles and brief communications are included. Case studies of adult patients carefully assessing the nature, course, or treatment of clinical neuropsychological dysfunctions in the context of scientific literature, are suitable. Review manuscripts addressing critical issues are encouraged. Preference is given to papers of clinical relevance to others in the field. All submitted manuscripts are subject to initial appraisal by the Editor-in-Chief, and, if found suitable for further considerations are peer reviewed by independent, anonymous expert referees. All peer review is single-blind and submission is online via ScholarOne Manuscripts.
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