Abstract
BackgroundAs research in treatments for neurocognitive diseases progresses, there is an increasing need to identify cognitive decline in the earliest stages of disease for initiation of treatment in addition to determining the efficacy of treatment. For early identification, accurate cognitive tests cutoff values for cognitive impairment are essential.MethodsWe conducted a study on 297 cognitively healthy elderly people from the BioFINDER study and created subgroups excluding people with signs of underlying neuropathology, i.e., abnormal cerebrospinal fluid [CSF] β-amyloid or phosphorylated tau, CSF neurofilament light (neurodegeneration), or cerebrovascular pathology. We compared cognitive test results between groups and examined the age effect on cognitive test results.ResultsIn our subcohort without any measurable pathology (n = 120), participants achieved better test scores and significantly stricter cutoffs for cognitive impairment for almost all the examined tests. The age effect in this subcohort disappeared for all cognitive tests, apart from some attention/executive tests, predominantly explained by the exclusion of cerebrovascular pathology.ConclusionOur study illustrates a new approach to establish normative data that could be useful to identify earlier cognitive changes in preclinical dementias. Future studies need to investigate if there is a genuine effect of healthy aging on cognitive tests or if this age effect is a proxy for higher prevalence of preclinical neurodegenerative diseases.
Highlights
As research in treatments for neurocognitive diseases progresses, there is an increasing need to identify cognitive decline in the earliest stages of disease for initiation of treatment in addition to determining the efficacy of treatment
In cohort B, there was no significant association between age and Alzheimer’s Disease Assessment Scale (ADAS)-delayed recall or ADAS naming
In the cohort excluding only cerebrovascular pathology, there was no significant correlation between age and Participants, N MMSE score, mean (SD)a
Summary
As research in treatments for neurocognitive diseases progresses, there is an increasing need to identify cognitive decline in the earliest stages of disease for initiation of treatment in addition to determining the efficacy of treatment. Norms based on persons without underlying cerebral pathology are crucial for identification of cognitive decline in neurocognitive disorders at early stages. To accurately capture the earliest declines in progression, it is necessary to know at what cognitive performance a cognitive decline should be suspected. Research on neurocognitive disorders, such as Alzheimer disease (AD), has switched focus from diagnosing clinically symptomatic AD, to a biological definition of the disease, in order to identify preclinical individuals with only subtle cognitive decline for earlier recognition and intervention [5, 6]
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