Abstract
This study examined trajectories of cognitive change in psychometrically matched measures of episodic memory, semantic memory, and executive function in an ethnically, demographically, and cognitively diverse sample of older persons. Individual rates of change showed considerable heterogeneity in each domain. Baseline clinical diagnosis predicted differential change in semantic memory and executive function, dementia > mild cognitive impairment (MCI) > normal, but average decline in verbal episodic memory was similar across all 3 diagnostic groups. There was substantial overlap of distributions of cognitive change across baseline diagnostic groups for all 3 measures. Cognitive change was strongly related to change in clinical diagnosis. Rapid and similar change was present for all 3 cognitive measures in patients with dementia and in those with normal cognition and those with MCI who progressed clinically. In cognitively normal patients, verbal episodic memory change was greater than change in the other two domains. Global status, measured by the Clinical Dementia Rating scale (Morris, 1993), predicted change in semantic memory and executive function, whereas APOE genotype predicted change in verbal episodic memory, and age had no effect on rates of change in any domain independent of global status and APOE. Results show important limitations in using cross-sectional diagnosis to predict prognosis and suggest that research to identify robust predictors of cognitive change across the full spectrum from normal to dementia is needed for better early identification of diseases that cause progressive decline.
| Original language | English (US) |
|---|---|
| Journal | Psychology and Aging |
| Volume | 25 |
| Issue number | 3 |
| DOIs | |
| State | Published - Sep 2010 |
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Keywords
- Aging
- Cognitive change
- Dementia
- Mild cognitive impairment
- Normal cognition
ASJC Scopus subject areas
- Aging
- Geriatrics and Gerontology
- Social Psychology
Cite this
Heterogeneity of cognitive trajectories in diverse older persons. / Mungas, Dan M; Beckett, Laurel A; Harvey, Danielle J; Tomaszewski Farias, Sarah E; Reed, Bruce R; Carmichael, Owen; Olichney, John M; Miller, Joshua; DeCarli, Charles.
In: Psychology and Aging, Vol. 25, No. 3, 09.2010.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Heterogeneity of cognitive trajectories in diverse older persons
AU - Mungas, Dan M
AU - Beckett, Laurel A
AU - Harvey, Danielle J
AU - Tomaszewski Farias, Sarah E
AU - Reed, Bruce R
AU - Carmichael, Owen
AU - Olichney, John M
AU - Miller, Joshua
AU - DeCarli, Charles
PY - 2010/9
Y1 - 2010/9
N2 - This study examined trajectories of cognitive change in psychometrically matched measures of episodic memory, semantic memory, and executive function in an ethnically, demographically, and cognitively diverse sample of older persons. Individual rates of change showed considerable heterogeneity in each domain. Baseline clinical diagnosis predicted differential change in semantic memory and executive function, dementia > mild cognitive impairment (MCI) > normal, but average decline in verbal episodic memory was similar across all 3 diagnostic groups. There was substantial overlap of distributions of cognitive change across baseline diagnostic groups for all 3 measures. Cognitive change was strongly related to change in clinical diagnosis. Rapid and similar change was present for all 3 cognitive measures in patients with dementia and in those with normal cognition and those with MCI who progressed clinically. In cognitively normal patients, verbal episodic memory change was greater than change in the other two domains. Global status, measured by the Clinical Dementia Rating scale (Morris, 1993), predicted change in semantic memory and executive function, whereas APOE genotype predicted change in verbal episodic memory, and age had no effect on rates of change in any domain independent of global status and APOE. Results show important limitations in using cross-sectional diagnosis to predict prognosis and suggest that research to identify robust predictors of cognitive change across the full spectrum from normal to dementia is needed for better early identification of diseases that cause progressive decline.
AB - This study examined trajectories of cognitive change in psychometrically matched measures of episodic memory, semantic memory, and executive function in an ethnically, demographically, and cognitively diverse sample of older persons. Individual rates of change showed considerable heterogeneity in each domain. Baseline clinical diagnosis predicted differential change in semantic memory and executive function, dementia > mild cognitive impairment (MCI) > normal, but average decline in verbal episodic memory was similar across all 3 diagnostic groups. There was substantial overlap of distributions of cognitive change across baseline diagnostic groups for all 3 measures. Cognitive change was strongly related to change in clinical diagnosis. Rapid and similar change was present for all 3 cognitive measures in patients with dementia and in those with normal cognition and those with MCI who progressed clinically. In cognitively normal patients, verbal episodic memory change was greater than change in the other two domains. Global status, measured by the Clinical Dementia Rating scale (Morris, 1993), predicted change in semantic memory and executive function, whereas APOE genotype predicted change in verbal episodic memory, and age had no effect on rates of change in any domain independent of global status and APOE. Results show important limitations in using cross-sectional diagnosis to predict prognosis and suggest that research to identify robust predictors of cognitive change across the full spectrum from normal to dementia is needed for better early identification of diseases that cause progressive decline.
KW - Aging
KW - Cognitive change
KW - Dementia
KW - Mild cognitive impairment
KW - Normal cognition
UR - http://www.scopus.com/inward/record.url?scp=77957276652&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77957276652&partnerID=8YFLogxK
U2 - 10.1037/a0019502
DO - 10.1037/a0019502
M3 - Article
C2 - 20677882
AN - SCOPUS:77957276652
VL - 25
JO - Psychology and Aging
JF - Psychology and Aging
SN - 0882-7974
IS - 3
ER -