Taylor Rigby, Voyko Kavcic, Sarah R Shair, Tanisha G Hill-Jarrett, Sarah Garcia, Jon Reader, Carol Persad, Arijit K Bhaumik, Subhamoy Pal, Benjamin M Hampstead, Bruno Giordani
{"title":"Retest reliability and reliable change of community-dwelling Black/African American older adults with and without mild cognitive impairment using NIH Toolbox-Cognition Battery and Cogstate Brief Battery for laptop.","authors":"Taylor Rigby, Voyko Kavcic, Sarah R Shair, Tanisha G Hill-Jarrett, Sarah Garcia, Jon Reader, Carol Persad, Arijit K Bhaumik, Subhamoy Pal, Benjamin M Hampstead, Bruno Giordani","doi":"10.1017/S1355617724000444","DOIUrl":"https://doi.org/10.1017/S1355617724000444","url":null,"abstract":"<p><strong>Objective: </strong>With the increased use of computer-based tests in clinical and research settings, assessing retest reliability and reliable change of NIH Toolbox-Cognition Battery (NIHTB-CB) and Cogstate Brief Battery (Cogstate) is essential. Previous studies used mostly White samples, but Black/African Americans (B/AAs) must be included in this research to ensure reliability.</p><p><strong>Method: </strong>Participants were B/AA consensus-confirmed healthy controls (HCs) (n = 49) or mild cognitive impairment (MCI) (n = 34) adults 60-85 years that completed NIHTB-CB and Cogstate for laptop at two timepoints within 4 months. Intraclass correlations, the Bland-Altman method, <i>t</i>-tests, and the Pearson correlation coefficient were used. Cut scores indicating reliable change provided.</p><p><strong>Results: </strong>NIHTB-CB composite reliability ranged from .81 to .93 (95% CIs [.37-.96]). The Fluid Composite demonstrated a significant difference between timepoints and was less consistent than the Crystallized Composite. Subtests were less consistent for MCIs (ICCs = .01-.89, CIs [-1.00-.95]) than for HCs (ICCs = .69-.93, CIs [.46-.92]). A moderate correlation was found for MCIs between timepoints and performance on the Total Composite (<i>r</i> = -.40, <i>p</i> = .03), Fluid Composite (<i>r</i> = -.38, <i>p</i> = .03), and Pattern Comparison Processing Speed (<i>r</i> = -.47, <i>p</i> = .006).On Cogstate, HCs had lower reliability (ICCs = .47-.76, CIs [.05-.86]) than MCIs (ICCs = .65-.89, CIs [.29-.95]). Identification reaction time significantly improved between testing timepoints across samples.</p><p><strong>Conclusions: </strong>The NIHTB-CB and Cogstate for laptop show promise for use in research with B/AAs and were reasonably stable up to 4 months. Still, differences were found between those with MCI and HCs. It is recommended that race and cognitive status be considered when using these measures.</p>","PeriodicalId":49995,"journal":{"name":"Journal of the International Neuropsychological Society","volume":" ","pages":"1-11"},"PeriodicalIF":2.6,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Disturbances in higher order consciousness encountered in neuropsychological rehabilitation and assessment.","authors":"George P Prigatano","doi":"10.1017/S1355617724000705","DOIUrl":"https://doi.org/10.1017/S1355617724000705","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this invited paper was to summarize my clinical research on disturbances of higher order consciousness (i.e., primarily on self-awareness but including anosognosia and impaired awareness of another person's cognitive/emotional state) that contributed to my receiving the Distinguished Career Award from the International Neuropsychology Society.</p><p><strong>Methods: </strong>I reviewed my early clinical encounters with disturbances in higher order consciousness and then a series of studies performed with various colleagues over the last 45 years to better understand the nature of these disturbances. The findings obtained are also discussed within the context of other researchers' observations during this time frame.</p><p><strong>Results: </strong>Disturbances in higher order consciousness include classic anosognosia, impaired self-awareness, denial of disability, and denial of ability. Proposed diagnostic features of each of these disturbances are outlined and a model for understanding their complex relationships suggested. Different treatment/rehabilitation approaches for these disturbances are also summarized.</p><p><strong>Conclusion: </strong>Disturbances in higher order consciousness are often revealed when exploring with the person their subjective experiences of their neurological and neuropsychological functioning following different brain disorders. These subjective experiences have diagnostic value and lead to different rehabilitation approaches. The neuropsychological investigation of disturbances in higher order consciousness should include integrating knowledge from the neurosciences with nonbiological understandings of how cultural and personality features of the person may also influences their subjective experiences associated with a known or suspected brain disorder.</p>","PeriodicalId":49995,"journal":{"name":"Journal of the International Neuropsychological Society","volume":" ","pages":"1-10"},"PeriodicalIF":2.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Savannah Rose, Allyson Gergoire, Subhamoy Pal, Jonathan Reader, Arijit Bhaumik, Jerry Slotkin, Emily Ho, Cindy J Nowinski, Carol C Persad, Amanda Cook Maher, Sandy Weintraub, Richard Gershon, Bruno Giordani
{"title":"Evaluating the factor structure and construct validity of the NIH toolbox in older adults, with a focus on cognitive normalcy and amnestic mild cognitive impairment: considerations for diversity, including insights from persons over 85 years of age and Black older Americans.","authors":"Savannah Rose, Allyson Gergoire, Subhamoy Pal, Jonathan Reader, Arijit Bhaumik, Jerry Slotkin, Emily Ho, Cindy J Nowinski, Carol C Persad, Amanda Cook Maher, Sandy Weintraub, Richard Gershon, Bruno Giordani","doi":"10.1017/S1355617724000699","DOIUrl":"https://doi.org/10.1017/S1355617724000699","url":null,"abstract":"<p><strong>Objective: </strong>Validated computerized assessments for cognitive functioning are crucial for older individuals and those at risk of cognitive decline. The National Institutes of Health (NIH) Toolbox Cognition Battery (NIHTB-CB) exhibits good construct validity but requires validation in diverse populations and for adults aged 85+. This study uses data from the Assessing Reliable Measurement in Alzheimer's Disease and cognitive Aging study to explore differences in the factor structure of the NIHTB-CB for adults 85 and older, Black participants versus White participants, and those diagnosed as amnestic Mild Cognitive Impairment (aMCI) vs cognitively normal (CN).</p><p><strong>Method: </strong>Subtests from the NACC UDS-3 and NIHTB-CB were administered to 503 community-dwelling Black and White adults ages 55-99 (367 CN; 136 aMCI). Confirmatory factor analyses were used to investigate the original factor structure of NIHTB-CB that forms the basis for NIHTB-CD Index factor scores.</p><p><strong>Results: </strong>Factor analyses for all participants and some participant subsets (aMCI, White, 85+) substantiated the two anticipated factors (Fluid and Crystallized). However, while Black aMCI participants had the expected two-factor structure, for Black CN participants, the List Sorting Working Memory and Picture Sequence tests loaded on the Crystallized factor.</p><p><strong>Conclusions: </strong>Findings provide psychometric support for the NIHTB-CB. Differences in factor structure between Black CN individuals and Black aMCI individuals suggest potential instability across levels of cognitive impairment. Future research should explore changes in NIHTB-CB across diagnoses in different populations.</p>","PeriodicalId":49995,"journal":{"name":"Journal of the International Neuropsychological Society","volume":" ","pages":"1-6"},"PeriodicalIF":2.6,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142830448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Determining associations between Big Five personality traits and executive function in an undergraduate student sample.","authors":"Emma Quarles, Samuel J West, Larry Keen","doi":"10.1017/S135561772400047X","DOIUrl":"https://doi.org/10.1017/S135561772400047X","url":null,"abstract":"<p><strong>Objective: </strong>The present study sought to determine the associations between executive functioning and Big Five personality traits in an undergraduate sample.</p><p><strong>Method: </strong>Participants included 200 undergraduates (73% women), with a mean age of approximately 21 years. Participants completed the Big Five Inventory-44 and a psychological assessment battery, which included the Trail Making Test and the Semantic Fluency Test.</p><p><strong>Results: </strong>Results from multiple regression analyses suggested agreeableness was negatively associated with Semantic Fluency - Animals (β = -0.310, <i>p</i> < 0.001). Moreover, conscientiousness was positively associated with Trail Making Test B-A (β = 0.197, <i>p</i> = 0.016), but negatively associated with Trail Making Test A (β = -0.193, <i>p</i> = 0.017).</p><p><strong>Conclusions: </strong>Overall results identified that executive function association with personality varies by construct. Given conscientiousness' differential associations within the executive function task performances, future research should examine the conscientious threshold that would result in psychological symptomatology associated with extreme lows and highs in conscientiousness.</p>","PeriodicalId":49995,"journal":{"name":"Journal of the International Neuropsychological Society","volume":" ","pages":"1-8"},"PeriodicalIF":2.6,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michelle Gereau Mora, Libby A DesRuisseaux, Yana Suchy
{"title":"Time-Based prospective memory predicts insight into functional abilities among community-dwelling older adults.","authors":"Michelle Gereau Mora, Libby A DesRuisseaux, Yana Suchy","doi":"10.1017/S1355617724000614","DOIUrl":"https://doi.org/10.1017/S1355617724000614","url":null,"abstract":"<p><strong>Objective: </strong>Accurate appraisal of one's own abilities (i.e., insight) is necessary for appropriate compensatory behaviors and sustained independence during aging. Although insight is often purported to be related to executive functioning (EF), nuanced understanding of the cognitive correlates of insight for functional abilities among nondemented older adults is lacking. Because insight shares neuroanatomic underpinnings with time-based prospective memory (PM), the present study examined the contributions of time-based PM, beyond event-based PM and other potential cognitive confounds (i.e., episodic memory, time estimation, and EF), in predicting insight into one's own performance on instrumental activities of daily living (IADLs) among community-dwelling older adults.</p><p><strong>Method: </strong>A group of 88 nondemented, community-dwelling older adults completed performance-based measures of time- and event-based PM, episodic memory, time estimation, and EF, as well as IADL tasks followed by self-appraisals of their own IADL performance as indices of insight.</p><p><strong>Results: </strong>Time-based PM was moderately-to-strongly associated with insight, beyond event-based PM, time estimation, and episodic memory [<i>F</i>(1,83) = 11.58, <i>p</i> = .001, <i>η<sub>p</sub></i><sup>2</sup> = .122], as well as beyond EF and demographic covariates [<i>F</i>(1,79) = 10.72, <i>p</i> = .002, <i>η<sub>p</sub></i><sup>2</sup> = .119].Specifically, older adults who performed more poorly on a time-based PM task overestimated the efficiency of their own IADL performance to a greater extent.</p><p><strong>Conclusions: </strong>Findings suggest that nondemented older adults with poorer time-based PM may be more prone to inaccurately appraising their functional abilities and that this vulnerability may not be adequately captured by traditional EF measures.</p>","PeriodicalId":49995,"journal":{"name":"Journal of the International Neuropsychological Society","volume":" ","pages":"1-11"},"PeriodicalIF":2.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Brett S Schneider, Melvin McInnis, Victor Di Rita, Benjamin M Hampstead
{"title":"Personalized high-definition transcranial direct current stimulation improves cognition following carbon monoxide poisoning induced amnesia: A case report.","authors":"Brett S Schneider, Melvin McInnis, Victor Di Rita, Benjamin M Hampstead","doi":"10.1017/S1355617724000304","DOIUrl":"https://doi.org/10.1017/S1355617724000304","url":null,"abstract":"<p><strong>Objective: </strong>High-definition transcranial direct current stimulation (HD-tDCS) has the potential to improve cognitive functioning following neurological injury and in neurodegenerative conditions. In this case report, we present the first use of HD-tDCS in a person with severe anterograde amnesia following carbon monoxide poisoning.</p><p><strong>Method: </strong>The participant underwent two rounds of HD-tDCS that were separated by 3 months (Round 1 = 30 sessions; Round 2 = 31 sessions). We used finite element modeling of the participant's structural MRI to develop an individualized montage that targeted multiple brain regions involved in memory encoding, as identified by Neurosynth.</p><p><strong>Results: </strong>Overall, the participant's objective cognitive functioning improved significantly following Round 1, declined during the 2 months without HD-tDCS, and again improved following Round 2. Subjective informant reports from family and medical personnel followed this same pattern of improvement following each round with a decline in between rounds. We also provide preliminary evidence of altered brain activity during a learning/memory task using functional near-infrared spectroscopy, which may help establish the physiological effects of HD-tDCS in future work.</p><p><strong>Conclusion: </strong>Overall, these findings reinforce the potential value of HD-tDCS as a user-friendly method of enhancing cognition following anoxic/hypoxic brain injury.</p>","PeriodicalId":49995,"journal":{"name":"Journal of the International Neuropsychological Society","volume":" ","pages":"1-7"},"PeriodicalIF":2.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Felicia C Goldstein, John J Hanfelt, Taylor A James, James J Lah, David W Loring
{"title":"Receptive vocabulary is superior to education level to account for Black and White neuropsychological performance discrepancies.","authors":"Felicia C Goldstein, John J Hanfelt, Taylor A James, James J Lah, David W Loring","doi":"10.1017/S135561772400064X","DOIUrl":"https://doi.org/10.1017/S135561772400064X","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the impact of receptive vocabulary versus years of education on neuropsychological performance of Black and White older adults.</p><p><strong>Method: </strong>A community-based prospectively enrolled cohort (<i>n</i> = 1,007; 130 Black, 877 White) in the Emory Healthy Brain Study were administered the NIH Toolbox Picture Vocabulary Test and neuropsychological measures. Group differences were evaluated with age, sex, and education or age, sex, and Toolbox Vocabulary scores as covariates to determine whether performance differences between Black versus White participants were attenuated or eliminated.</p><p><strong>Results: </strong>With vocabulary as a covariate, the main effect of race was no longer significant for the MoCA, Phonemic Fluency, Rey Auditory Verbal Learning Test, and Rey Complex Figure Test immediate and delayed recall. Although still significantly different between groups, the effect sizes for Animal Fluency, Trails B-A, Symbol Digit Modalities Test, and Rey Copy were attenuated, with the greatest reductions occurring for the Multilingual Naming Test and Judgment of Line Orientation.</p><p><strong>Conclusions: </strong>Findings support the value of using receptive vocabulary as a proxy for premorbid ability level when comparing the cognitive performance of Black and White older adults. The results extend investigations using measures of single word reading to encompass measures assessing word meaning.</p>","PeriodicalId":49995,"journal":{"name":"Journal of the International Neuropsychological Society","volume":" ","pages":"1-5"},"PeriodicalIF":2.6,"publicationDate":"2024-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ji Hyun Lee, Kiana A Scambray, Emily P Morris, Ketlyne Sol, Jordan D Palms, Afsara B Zaheed, Michelle N Martinez, Nicole Schupf, Jennifer J Manly, Adam M Brickman, Laura B Zahodne
{"title":"Marital status, brain health, and cognitive reserve among diverse older adults.","authors":"Ji Hyun Lee, Kiana A Scambray, Emily P Morris, Ketlyne Sol, Jordan D Palms, Afsara B Zaheed, Michelle N Martinez, Nicole Schupf, Jennifer J Manly, Adam M Brickman, Laura B Zahodne","doi":"10.1017/S1355617724000638","DOIUrl":"10.1017/S1355617724000638","url":null,"abstract":"<p><strong>Objective: </strong>Being married may protect late-life cognition. Less is known about living arrangement among unmarried adults and mechanisms such as brain health (BH) and cognitive reserve (CR) across race and ethnicity or sex/gender. The current study examines (1) associations between marital status, BH, and CR among diverse older adults and (2) whether one's living arrangement is linked to BH and CR among unmarried adults.</p><p><strong>Method: </strong>Cross-sectional data come from the Washington Heights-Inwood Columbia Aging Project (<i>N</i> = 778, 41% Hispanic, 33% non-Hispanic Black, 25% non-Hispanic White; 64% women). Magnetic resonance imaging (MRI) markers of BH included cortical thickness in Alzheimer's disease signature regions and hippocampal, gray matter, and white matter hyperintensity volumes. CR was residual variance in an episodic memory composite after partialing out MRI markers. Exploratory analyses stratified by race and ethnicity and sex/gender and included potential mediators.</p><p><strong>Results: </strong>Marital status was associated with CR, but not BH. Compared to married individuals, those who were previously married (i.e., divorced, widowed, and separated) had lower CR than their married counterparts in the full sample, among White and Hispanic subgroups, and among women. Never married women also had lower CR than married women. These findings were independent of age, education, physical health, and household income. Among never married individuals, living with others was negatively linked to BH.</p><p><strong>Conclusions: </strong>Marriage may protect late-life cognition via CR. Findings also highlight differential effects across race and ethnicity and sex/gender. Marital status could be considered when assessing the risk of cognitive impairment during routine screenings.</p>","PeriodicalId":49995,"journal":{"name":"Journal of the International Neuropsychological Society","volume":" ","pages":"1-10"},"PeriodicalIF":2.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Impact of white matter hyperintensity volume on cognition among US Mexican American adults.","authors":"Lisa V Graves, Monica M Diaz, Eran Dayan","doi":"10.1017/S1355617724000316","DOIUrl":"10.1017/S1355617724000316","url":null,"abstract":"<p><strong>Objective: </strong>Higher white matter hyperintensity (WMH) volume is a marker of cardiovascular disease (CVD) risk. CVD risk factors increase risk for Alzheimer's disease and related dementias (ADRD). Mexican Americans (MA) and individuals of other Hispanic/Latino heritages have higher risk for CVD and ADRD. However, knowledge of associations between WMH volume and cognition in these groups remains limited.</p><p><strong>Method: </strong>We conducted a cross-sectional study of associations between WMH volume and neuropsychological performance (attention/executive functioning, memory) in MA (<i>n</i> = 851) and non-Hispanic White (NHW; <i>n</i> = 747) adults in the Health and Aging Brain Study: Health Disparities.</p><p><strong>Results: </strong>The MA group (mean age = 63.72 ± 7.90 years; 66.3% female) had higher rates of consensus diagnoses of hypertension and diabetes, whereas the NHW group (mean age = 69.18 ± 8.65 years; 55.2% female) had higher rates of diagnosed CVD (<i>p</i>s < .01). WMH volumes were higher among individuals with CVD risk factors/conditions (<i>p</i>s < .01). There were differential associations between WMH and neuropsychological performance across ethnoracial groups (<i>p</i>s < .001), wherein associations were steeper in the NHW group than in the MA group. Lower educational level was associated with higher WMH volume in the NHW group (<i>p</i> < .001), but no association was seen in the MA group (<i>p</i> > .05).</p><p><strong>Conclusions: </strong>Negative effects of pathological changes in the form of WMH on cognition may be less robust or consistent for MA adults than NHW adults. Furthermore, the impact of WMH on cognition in NHW adults may be mitigated by cognitive reserve related to educational attainment.</p>","PeriodicalId":49995,"journal":{"name":"Journal of the International Neuropsychological Society","volume":" ","pages":"1-9"},"PeriodicalIF":2.6,"publicationDate":"2024-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jeremy G Grant, Amanda M Wisinger, Hilary F Abel, Jennifer M Hunter, Glenn E Smith
{"title":"Quick-reference criteria for identifying multivariate cognitive change in older adults with mild cognitive impairment and dementia: An ADNI study.","authors":"Jeremy G Grant, Amanda M Wisinger, Hilary F Abel, Jennifer M Hunter, Glenn E Smith","doi":"10.1017/S1355617724000407","DOIUrl":"https://doi.org/10.1017/S1355617724000407","url":null,"abstract":"<p><strong>Objective: </strong>To establish quick-reference criteria regarding the frequency of statistically rare changes in seven neuropsychological measures administered to older adults.</p><p><strong>Method: </strong>Data from 935 older adults examined over a two-year interval were obtained from the Alzheimer's Disease Neuroimaging Initiative. The sample included 401 cognitively normal older adults whose scores were used to determine the natural distribution of change scores for seven cognitive measures and to set change score thresholds corresponding to the 5<sup>th</sup> percentile. The number of test scores that exceeded these thresholds were counted for the cognitively normal group, as well as 381 individuals with mild cognitive impairment (MCI) and 153 individuals with dementia. Regression analyses examined whether the number of change scores predicted diagnostic group membership beyond demographic covariates.</p><p><strong>Results: </strong>Only 4.2% of cognitively normal participants obtained two or more change scores that fell below the 5<sup>th</sup> percentile of change scores, compared to 10.6% of the stable MCI participants and 38.6% of those who converted to dementia. After adjusting for age, gender, race/ethnicity, and premorbid estimates, the number of change scores below the 5<sup>th</sup> percentile significantly predicted diagnostic group membership.</p><p><strong>Conclusions: </strong>It was uncommon for older adults to have two or more change scores fall below the 5<sup>th</sup> percentile thresholds in a seven-test battery. Higher change counts may identify those showing atypical cognitive decline.</p>","PeriodicalId":49995,"journal":{"name":"Journal of the International Neuropsychological Society","volume":" ","pages":"1-10"},"PeriodicalIF":2.6,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142711176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}