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The age-related effect on cognitive performance in cognitively healthy elderly is mainly caused by underlying AD pathology or cerebrovascular lesions : implications for cutoffs regarding cognitive impairment

Borland, Emma LU orcid ; Stomrud, Erik LU orcid ; van Westen, Danielle LU orcid ; Hansson, Oskar LU orcid and Palmqvist, Sebastian LU orcid (2020) In Alzheimer's Research & Therapy 12(1).
Abstract

BACKGROUND: 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. For early identification, accurate cognitive tests cutoff values for cognitive impairment are essential. METHODS: We 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... (More)

BACKGROUND: 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. For early identification, accurate cognitive tests cutoff values for cognitive impairment are essential. METHODS: We 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. RESULTS: In 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. CONCLUSION: Our 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.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Age, Cognitive assessment, Cutoff, Normative, Preclinical pathology, Robust norms, True norms
in
Alzheimer's Research & Therapy
volume
12
issue
1
article number
30
publisher
BioMed Central (BMC)
external identifiers
  • pmid:32209137
  • scopus:85082380461
ISSN
1758-9193
DOI
10.1186/s13195-020-00592-8
language
English
LU publication?
yes
id
5a470224-b275-4480-9364-7bc008a07514
date added to LUP
2020-04-03 10:31:39
date last changed
2024-05-15 08:49:41
@article{5a470224-b275-4480-9364-7bc008a07514,
  abstract     = {{<p>BACKGROUND: 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. For early identification, accurate cognitive tests cutoff values for cognitive impairment are essential. METHODS: We 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. RESULTS: In 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. CONCLUSION: Our 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.</p>}},
  author       = {{Borland, Emma and Stomrud, Erik and van Westen, Danielle and Hansson, Oskar and Palmqvist, Sebastian}},
  issn         = {{1758-9193}},
  keywords     = {{Age; Cognitive assessment; Cutoff; Normative; Preclinical pathology; Robust norms; True norms}},
  language     = {{eng}},
  month        = {{03}},
  number       = {{1}},
  publisher    = {{BioMed Central (BMC)}},
  series       = {{Alzheimer's Research & Therapy}},
  title        = {{The age-related effect on cognitive performance in cognitively healthy elderly is mainly caused by underlying AD pathology or cerebrovascular lesions : implications for cutoffs regarding cognitive impairment}},
  url          = {{http://dx.doi.org/10.1186/s13195-020-00592-8}},
  doi          = {{10.1186/s13195-020-00592-8}},
  volume       = {{12}},
  year         = {{2020}},
}