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Longitudinal Standards for Mid-life Cognitive Performance: Identifying Abnormal Within-Person Changes in the Wisconsin Registry for Alzheimer’s Prevention

Published on Jan 1, 2019in Journal of The International Neuropsychological Society 2.78
· DOI :10.1017/s1355617718000929
Rebecca L. Koscik25
Estimated H-index: 25
(University of Wisconsin-Madison),
Erin Jonaitis12
Estimated H-index: 12
(University of Wisconsin-Madison)
+ 6 AuthorsSterling C. Johnson60
Estimated H-index: 60
(University of Wisconsin-Madison)
A major challenge in the field of cognitive aging is differentiating disease-related cognitive change that has not yet become overt impairment from the more gradual decline in performance expected with normal aging. Published normative reference values are nearly always for single time point performances rather than longitudinal change in performance. To gain insight into how we might tackle the problem of identifying worrisome trajectories, we borrow a method from anthropometry: the development of standards that are conditional on an individual9s past measurements. We use quantile regression to create growth-curve-like models of performance on several common neuropsychological tests of memory and executive function while accounting for age, sex, education, estimated verbal ability, and past performance on the test, and then use these to estimate individuals9 percentile ranks. Choosing the 7th percentile as a threshold (corresponding to approximately 1.5 standard deviations below the expected mean), we then explore relationships between subthreshold performance, clinical outcomes, and subjective impairment. Participants whose performance fell below the 7th percentile were more likely to be given an abnormal research diagnosis at the current visit, but not at later visits. Performance below this threshold was also linked to subjective and informant reports of worsening memory function. We discuss potential uses of this method in theoretical and applied research and clinical settings.
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Published on Apr 1, 2018in Alzheimers & Dementia 12.76
Clifford R Jr. Jack133
Estimated H-index: 133
(Mayo Clinic),
David A. Bennett152
Estimated H-index: 152
(Rush University)
+ 21 AuthorsJason Karlawish47
Estimated H-index: 47
(University of Pennsylvania)
Abstract In 2011, the National Institute on Aging and Alzheimer's Association created separate diagnostic recommendations for the preclinical, mild cognitive impairment, and dementia stages of Alzheimer's disease. Scientific progress in the interim led to an initiative by the National Institute on Aging and Alzheimer's Association to update and unify the 2011 guidelines. This unifying update is labeled a "research framework" because its intended use is for observational and interventional resear...
321 Citations Source Cite
Sterling C. Johnson60
Estimated H-index: 60
(University of Wisconsin-Madison),
Rebecca L. Koscik25
Estimated H-index: 25
(University of Wisconsin-Madison)
+ 11 AuthorsKirk Hogan28
Estimated H-index: 28
(University of Wisconsin-Madison)
Abstract The Wisconsin Registry for Alzheimer's Prevention is a longitudinal observational cohort study enriched with persons with a parental history (PH) of probable Alzheimer's disease (AD) dementia. Since late 2001, Wisconsin Registry for Alzheimer's Prevention has enrolled 1561 people at a mean baseline age of 54 years. Participants return for a second visit 4 years after baseline, and subsequent visits occur every 2 years. Eighty-one percent (1270) of participants remain active in the study...
13 Citations Source Cite
Published on May 1, 2017in Neuropsychologia 2.89
Patrizia Vannini15
Estimated H-index: 15
(Harvard University),
Rebecca E. Amariglio25
Estimated H-index: 25
(Harvard University)
+ 6 AuthorsReisa A. Sperling87
Estimated H-index: 87
While loss of insight of cognitive deficits, anosognosia, is a common symptom in Alzheimer's disease dementia, there is a lack of consensus regarding the presence of altered awareness of memory function in the preclinical and prodromal stages of the disease. Paradoxically, very early in the Alzheimer's disease process, individuals may experience heightened awareness of memory changes before any objective cognitive deficits can be detected, here referred to as hypernosognosia. In contrast, awaren...
11 Citations Source Cite
Published on Jan 2, 2017in Journal of the American Statistical Association 2.30
Andreas Hagemann5
Estimated H-index: 5
(University of Michigan)
In this article I develop a wild bootstrap procedure for cluster-robust inference in linear quantile regression models. I show that the bootstrap leads to asymptotically valid inference on the entire quantile regression process in a setting with a large number of small, heterogeneous clusters and provides consistent estimates of the asymptotic covariance function of that process. The proposed bootstrap procedure is easy to implement and performs well even when the number of clusters is much smal...
19 Citations Source Cite
Published on Nov 1, 2016in Archives of Clinical Neuropsychology 1.59
Lindsay R. Clark13
Estimated H-index: 13
(University of Wisconsin-Madison),
Rebecca L. Koscik25
Estimated H-index: 25
(University of Wisconsin-Madison)
+ 11 AuthorsCynthia M. Carlsson31
Estimated H-index: 31
(University of Wisconsin-Madison)
21 Citations Source Cite
Published on Sep 1, 2015in American Journal of Geriatric Psychiatry 3.48
Yin Bun Cheung43
Estimated H-index: 43
(National University of Singapore),
Ying Xu1
Estimated H-index: 1
(National University of Singapore)
+ 8 AuthorsKeng Bee Yap19
Estimated H-index: 19
(Alexandra Hospital)
Objective The conventional practice of assessing cognitive status and monitoring change over time in older adults using normative values of the Mini-Mental State Exam (MMSE) based on age bands is imprecise. Moreover, population-based normative data on changes in MMSE score over time are scarce and crude because they do not include age- and education-specific norms. This study aims to develop unconditional standards for assessing current cognitive status and conditional standards that take prior ...
3 Citations Source Cite
James E. Galvin42
Estimated H-index: 42
(New York University)
Introduction Test the validity and reliability of the Quick Dementia Rating System (QDRS), a rapid dementia staging tool.
11 Citations Source Cite
Published on Mar 20, 2015in Journal of Statistical Software 22.74
Anestis Touloumis1
Estimated H-index: 1
The R package multgee implements the local odds ratios generalized estimating equations (GEE) approach proposed by Touloumis, Agresti, and Kateri (2013), a GEE approach for correlated multinomial responses that circumvents theoretical and practical limitations of the GEE method. A main strength of multgee is that it provides GEE routines for both ordinal (ordLORgee) and nominal (nomLORgee) responses, while relevant other softwares in R and SAS are restricted to ordinal responses under a marginal...
19 Citations Source Cite
Published on Nov 1, 2014in American Journal of Geriatric Psychiatry 3.48
Kathleen M. Hayden30
Estimated H-index: 30
(Duke University),
Maragatha Kuchibhatla42
Estimated H-index: 42
(Duke University)
+ 4 AuthorsKathleen A. Welsh-Bohmer70
Estimated H-index: 70
(Duke University)
Background Cognitive profiles for pre-clinical Alzheimer disease (AD) can be used to identify groups of individuals at risk for disease and better characterize pre-clinical disease. Profiles or patterns of performance as pre-clinical phenotypes may be more useful than individual test scores or measures of global decline. Objective To evaluate patterns of cognitive performance in cognitively normal individuals to derive latent profiles associated with later onset of disease using a combination of...
11 Citations Source Cite
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