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J Clin Exp Neuropsychol. 2014;36(3):236-43. doi: 10.1080/13803395.2013.877875. Epub 2014 Feb 19.

Performance variability during a multitrial list-learning task as a predictor of future cognitive decline in healthy elders.

Author information

1
a Department of Psychology , Wayne State University , Detroit , MI , USA.

Abstract

INTRODUCTION:

In clinical settings, neuropsychological test performance is traditionally evaluated with total summary scores (TSS). However, recent studies demonstrated that indices of intraindividual variability (IIV) yielded unique information complementing TSS. This 18-month longitudinal study sought to determine whether IIV indices derived from a multitrial list-learning test (the Rey Auditory Verbal Learning Test) provided incremental utility in predicting cognitive decline in older adults compared to TSS.

METHOD:

Ninety-nine cognitively intact older adults (aged 65 to 89 years) underwent neuropsychological testing (including the Rey Auditory Verbal Learning Test) at baseline and 18-month follow-up. Participants were classified as cognitively stable (n = 65) or declining (n = 34) based on changes in their neuropsychological test performance. Logistic regression modeling tested the ability of baseline TSS indices (sum of Trials 1-5, immediate recall, and delayed recall) and IIV indices (lost access and gained access) to discriminate between stable and declining individuals.

RESULTS:

Higher values of both lost access and gained access at baseline were associated with an increased risk for decline at 18-month follow-up. Further, the IIV indices provided predictive utility above and beyond the TSS indices.

CONCLUSION:

These results highlight the value of analyzing IIV in addition to TSS during neuropsychological evaluation in older adults. High levels of IIV may reflect impairment in anterograde memory systems and/or executive dysfunction that may serve as a prognostic indicator of cognitive decline.

PMID:
24552205
PMCID:
PMC3979935
DOI:
10.1080/13803395.2013.877875
[Indexed for MEDLINE]
Free PMC Article

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