Neuropsychological Prediction of Decline to Dementia in Nondemented Elderly
Abstract
This study examined whether baseline neuropsychological performance in elderly assessed at a research clinic could accurately predict subsequent decline to dementia. Logistic regression analyses were applied to (1) 213 nondemented elderly with a Global Deterioration Scale (GDS) score of 1, 2, or 3, of whom 74 (35%) subsequently declined to any diagnosis of dementia, and (2) a diagnostically more restricted subset of this sample (N = 179), of whom 56 (31%) declined to a diagnosis of probable Alzheimer's disease (AD). The mean follow-up intervals were 3.8 and 3.7 years, respectively. A small set of baseline neuropsychological measures (especially a Paragraph Delayed Recall Test) significantly differentiated decliners from nondecliners to dementia or AD, after accounting for the contribution of age, sex, education, follow-up interval, and the rating of global clinical status. When examined in combination with the other factors or alone, the cognitive tests produced reasonably high specificities (91%-97%) and sensitivities (73%-89%). Using the obtained regression model, a similar level of classification accuracy was replicated on an independent sample of 119 nondemented elderly. A subanalysis of the high-risk GDS 3 subgroup indicated that cut scores from the paragraph test distinguished nondecliners from decliners (overall accuracies 87%-91%), implying that this assessment may accurately predict future cognitive status in elderly with mild cognitive impairment. (J Geriatr Psychiatry Neurol 1999; 12:168-179).
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Cognitive performance was assessed using the CPT, LNB, and NYU Paragraph Recall Task.
“Cognitive performance on the CPT [22] (sustained attention), LNB [23] (attention and working memory), and NYU Paragraph Recall Task [24] (verbal learning and verbal memory) were used to examine LDX’s impact on specific executive function domains.”
From Treating new-onset cognitive complaints after risk-reducing salpingo-oophorectomy: A randomized controlled crossover trial of lisdexamfetamine (2024) · cites this paper as [24]
Estimates based on 4 years of observation suggest that 50-70% of MCI subjects will decline.
“Estimates based on 4 years of observation suggest that 50–70% will decline (42).”
Not all subjects with MCI deteriorate to clinical AD.
“Not all subjects with MCI deteriorate to clinical AD.”
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- Authors
- Kluger, A., Ferris, S. H., Golomb, J., Mittelman, M. S., & Reisberg, B.
- Affiliations
- New York University (US)
- Venue
- Journal of Geriatric Psychiatry and Neurology
- Publisher
- SAGE Publications
- Published
- 1999-12
- Volume
- 12
- Issue
- 4
- Pages
- 168-179
- ISSN
- 0891-9887 (ISSN-L)
- 1552-5708
- OpenAlex
- W2031655994
- Cited by
- 227
- References
- 46
- Citations by year
- 2025: 1 · 2024: 2 · 2023: 4 · 2022: 2 · 2021: 5 · 2020: 5 · 2019: 5 · 2018: 6 · 2017: 9 · 2016: 4 · 2015: 11 · 2014: 9 · 2013: 13 · 2012: 9
- FWCI
- 3.56
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Geriatric Psychiatry and Neurology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r29mh044697-04)
- National Institute on Aging (R01AG003051, P30AG008051, AG-P30-08051, AG-R01-03051)
- National Institute of Mental Health (MH R29 44697)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Social Sciences › Psychology › Applied Psychology › Psychological Testing and Assessment
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Keywords
- dementia prediction, cognitive decline, non-demented elderly, neuropsychological assessment, Alzheimer's disease, Global Deterioration Scale, mild cognitive impairment, cut-off values
- MeSH terms
- Aged, Alzheimer Disease, Female, Follow-Up Studies, Humans, Male, Mental Status Schedule, Middle Aged, Neuropsychological Tests, Predictive Value of Tests, Prognosis, Regression Analysis, Disease Progression, Risk Assessment
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