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Neuropsychological Prediction of Decline to Dementia in Nondemented Elderly

Kluger, Alan, Ferris, Steven H., Golomb, James, Mittelman, Mary S., Reisberg, Barry·1999·Journal of Geriatric Psychiatry and Neurology

DOI 10.1177/089198879901200402

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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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Authors: Kluger, A., Ferris, S. H., Golomb, J., Mittelman, M. S., & Reisberg, B.
Affiliations: New York University (US)
ORCID: Ferris, Steven H.
Golomb, James
Mittelman, Mary S.
Reisberg, Barry
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
DOI: 10.1177/089198879901200402
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
Licence: journals.sagepub.com/page/policies/text-and-data-mining-license (tdm)
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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Neuropsychological Prediction of Decline to Dementia in Nondemented Elderly

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