检测高功能老年人的认知能力下降：主观认知问题、高神经心理测试分数的频率和额顶控制网络之间的关系。

IF 2.6 4区心理学 Q2 CLINICAL NEUROLOGY

Journal of the International Neuropsychological Society Pub Date : 2024-03-01 Epub Date: 2023-09-26 DOI:10.1017/S1355617723000607

Justin E Karr, Jonathan G Hakun, Daniel B Elbich, Cristina N Pinheiro, Frederick A Schmitt, Suzanne C Segerstrom

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引用次数: 0

摘要

目的：神经心理学家很难检测高功能老年人的认知能力下降，因为在认知能力下降到足以表明下降或受损之前，必须发生更大的神经变化。对于高功能的老年人来说，早期的神经系统变化可能与主观认知问题和没有高分相对应。这项研究比较了有和没有主观认知问题的高功能老年人，假设有认知问题的老年人在神经心理测试中的高分较少，额顶顶网络的体积、厚度和连接性也较低。方法：参与者具有较高的病前功能估计值（例如，估计智力≥75%或受过大学教育），并根据主观认知问题进行划分。有认知问题的参与者（n=35；74.0±9.6岁，62.9%的女性，94.3%的白人）和没有认知问题（n=33；71.2±7.1岁，75.8%的女性，100%的白人）完成了一组神经心理学记忆和执行功能测试，并接受了结构和静息状态磁共振成像，以及连接性。结果：有认知问题和没有认知问题的参与者的低测试分数数量相当（≤第16个百分位），p=.103，d=.40。有认知问题的参与者高分较少（≥第75百分位），p=0.004，d=.71，平均额顶顶网络体积较低（左：p=0.004，d=.74；右：p=0.011，d=.66）和皮层厚度较低（右：p=0.010，d=.66；右：p=0.033，d=.54），但网络连接没有差异。结论：在功能正常的老年人中，主观认知能力下降可能与神经心理测试中没有高分以及传统的低认知测试分数无法检测到的额顶顶网络的潜在变化相对应。

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Detecting cognitive decline in high-functioning older adults: The relationship between subjective cognitive concerns, frequency of high neuropsychological test scores, and the frontoparietal control network.

Objective: Neuropsychologists have difficulty detecting cognitive decline in high-functioning older adults because greater neurological change must occur before cognitive performances are low enough to indicate decline or impairment. For high-functioning older adults, early neurological changes may correspond with subjective cognitive concerns and an absence of high scores. This study compared high-functioning older adults with and without subjective cognitive concerns, hypothesizing those with cognitive concerns would have fewer high scores on neuropsychological testing and lower frontoparietal network volume, thickness, and connectivity.

Method: Participants had high estimated premorbid functioning (e.g., estimated intelligence ≥75th percentile or college-educated) and were divided based on subjective cognitive concerns. Participants with cognitive concerns (n = 35; 74.0 ± 9.6 years old, 62.9% female, 94.3% White) and without cognitive concerns (n = 33; 71.2 ± 7.1 years old, 75.8% female, 100% White) completed a neuropsychological battery of memory and executive function tests and underwent structural and resting-state magnetic resonance imaging, calculating frontoparietal network volume, thickness, and connectivity.

Results: Participants with and without cognitive concerns had comparable numbers of low test scores (≤16th percentile), p = .103, d = .40. Participants with cognitive concerns had fewer high scores (≥75th percentile), p = .004, d = .71, and lower mean frontoparietal network volumes (left: p = .004, d = .74; right: p = .011, d = .66) and cortical thickness (left: p = .010, d = .66; right: p = .033, d = .54), but did not differ in network connectivity.

Conclusions: Among high-functioning older adults, subjective cognitive decline may correspond with an absence of high scores on neuropsychological testing and underlying changes in the frontoparietal network that would not be detected by a traditional focus on low cognitive test scores.

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来源期刊

Journal of the International Neuropsychological Society 医学-精神病学

CiteScore

5.40

自引率

3.80%

发文量

185

审稿时长

4-8 weeks

期刊介绍： The Journal of the International Neuropsychological Society is the official journal of the International Neuropsychological Society, an organization of over 4,500 international members from a variety of disciplines. The Journal of the International Neuropsychological Society welcomes original, creative, high quality research papers covering all areas of neuropsychology. The focus of articles may be primarily experimental, applied, or clinical. Contributions will broadly reflect the interest of all areas of neuropsychology, including but not limited to: development of cognitive processes, brain-behavior relationships, adult and pediatric neuropsychology, neurobehavioral syndromes (such as aphasia or apraxia), and the interfaces of neuropsychology with related areas such as behavioral neurology, neuropsychiatry, genetics, and cognitive neuroscience. Papers that utilize behavioral, neuroimaging, and electrophysiological measures are appropriate. To assure maximum flexibility and to promote diverse mechanisms of scholarly communication, the following formats are available in addition to a Regular Research Article: Brief Communication is a shorter research article; Rapid Communication is intended for "fast breaking" new work that does not yet justify a full length article and is placed on a fast review track; Case Report is a theoretically important and unique case study; Critical Review and Short Review are thoughtful considerations of topics of importance to neuropsychology and include meta-analyses; Dialogue provides a forum for publishing two distinct positions on controversial issues in a point-counterpoint format; Special Issue and Special Section consist of several articles linked thematically; Letter to the Editor responds to recent articles published in the Journal of the International Neuropsychological Society; and Book Review, which is considered but is no longer solicited.