Abstract
INTRODUCTION
The contribution of neuropsychological assessments to risk assessment for incident dementia is underappreciated.
METHODS
We analyzed neuropsychological testing results in dementia-free participants in the Atherosclerosis Risk in Communities (ARIC) study. We examined associations of index domain–specific neuropsychological test performance with incident dementia using cumulative incidence curves and Cox proportional hazards models.
RESULTS
Among 5296 initially dementia-free participants (mean [standard deviation] age of 75.8 [5.1] years; 60.1% women, 22.2% Black) over a median follow-up of 7.9 years, the covariate-adjusted hazard ratio varied substantially depending on the pattern of domain-specific performance and age, in an orderly manner from single domain language abnormalities (lowest risk) to single domain executive or memory abnormalities, to multidomain abnormalities including memory (highest risk).
DISCUSSION
By identifying normatively defined cognitive abnormalities by domains based on neuropsychological test performance, there is a conceptually orderly and age-sensitive spectrum of risk for incident dementia that provides valuable information about the likelihood of progression.
Highlights
Domain-specific cognitive profiles carry enhanced prognostic value compared to mild cognitive impairment.
Single-domain non-amnestic cognitive abnormalities have the most favorable prognosis.
Multidomain amnestic abnormalities have the greatest risk for incident dementia.
Patterns of domain-specific risks are similar by sex and race.
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This post is Copyright: David S. Knopman,
James Russell Pike,
Rebecca F. Gottesman,
A. Richey Sharrett,
B. Gwen Windham,
Thomas H. Mosley Jr.,
Kevin Sullivan,
Marilyn S. Albert,
Keenan A. Walker,
Sevil Yasar,
Sheila Burgard,
David Li,
Alden L Gross | June 15, 2024