Neuropsychological Prediction of Decline to Dementia in Nondemented Elderly

Journal of Geriatric Psychiatry and Neurology - Tập 12 Số 4 - Trang 168-179 - 1999
Alan Kluger1, Mary Sano, James Golomb, Mary Mittelman, ‌Barry Reisberg
1Department of Psychiatry, William and Sylvia Silberstein Aging and Dementia Research Center, New York University School of Medicine, New York 10016, USA.

Tóm tắt

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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Thông tin xuất bản

Journal of Geriatric Psychiatry and Neurology

Tập 12 Số 4

168-179

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