Defining MCI in the framingham heart study offspring: Education versus WRAT-based norms

Richard E. Ahl, Alexa Beiser, Sudha Seshadri, Sanford Auerbach, Philip A. Wolf, Rhoda Au

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

INTRODUCTION:: Psychometric definitions of mild cognitive impairment (MCI) typically use cut-off levels set at 1.5 SDs below age-adjusted and education-adjusted norms, assuming that the education adjustment accounts for premorbid abilities. However, noncognitive factors impact educational attainment, potentially leading to incorrect categorization as MCI. We examined whether using an adjustment based on reading performance [Wide Range Achievement Test (WRAT) Reading] improved MCI diagnostic accuracy. METHODS:: A total of 935 Framingham Offspring (mean age, 72±5 y) underwent tests of memory, executive function, abstraction, language, and visuospatial function as part of a neuropsychological test battery. Domain-specific test scores were regressed onto age and WRAT score, or education, to define MCI. Survival analyses were used to relate baseline MCI to incident dementia. RESULTS:: The 2 MCI definitions differed most for the lowest and highest education groups. The WRAT definition was more strongly associated with incident dementia for all 5 tests. MCI level abstraction performance was associated with incident dementia using the WRAT definition (HR=3.20, P=0.033), but not the education definition (HR=1.19, P=0.814). DISCUSSION:: The WRAT should be considered along with the standard measure of years of education, as it may be a better surrogate marker of premorbid abilities.

Original languageEnglish (US)
Pages (from-to)330-336
Number of pages7
JournalAlzheimer Disease and Associated Disorders
Volume27
Issue number4
DOIs
StatePublished - Oct 1 2013
Externally publishedYes

Fingerprint

Education
Dementia
Social Adjustment
Aptitude
Reading
Neuropsychological Tests
Executive Function
Survival Analysis
Cognitive Dysfunction
Psychometrics
Language
Biomarkers

Keywords

  • Alzheimer disease
  • longitudinal
  • mild cognitive impairment
  • neuropsychological assessment
  • premorbid abilities

ASJC Scopus subject areas

  • Clinical Psychology
  • Gerontology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

Defining MCI in the framingham heart study offspring : Education versus WRAT-based norms. / Ahl, Richard E.; Beiser, Alexa; Seshadri, Sudha; Auerbach, Sanford; Wolf, Philip A.; Au, Rhoda.

In: Alzheimer Disease and Associated Disorders, Vol. 27, No. 4, 01.10.2013, p. 330-336.

Research output: Contribution to journalArticle

Ahl, Richard E. ; Beiser, Alexa ; Seshadri, Sudha ; Auerbach, Sanford ; Wolf, Philip A. ; Au, Rhoda. / Defining MCI in the framingham heart study offspring : Education versus WRAT-based norms. In: Alzheimer Disease and Associated Disorders. 2013 ; Vol. 27, No. 4. pp. 330-336.
@article{13cd92d1fff940aba3fa84eddd5e93e6,
title = "Defining MCI in the framingham heart study offspring: Education versus WRAT-based norms",
abstract = "INTRODUCTION:: Psychometric definitions of mild cognitive impairment (MCI) typically use cut-off levels set at 1.5 SDs below age-adjusted and education-adjusted norms, assuming that the education adjustment accounts for premorbid abilities. However, noncognitive factors impact educational attainment, potentially leading to incorrect categorization as MCI. We examined whether using an adjustment based on reading performance [Wide Range Achievement Test (WRAT) Reading] improved MCI diagnostic accuracy. METHODS:: A total of 935 Framingham Offspring (mean age, 72±5 y) underwent tests of memory, executive function, abstraction, language, and visuospatial function as part of a neuropsychological test battery. Domain-specific test scores were regressed onto age and WRAT score, or education, to define MCI. Survival analyses were used to relate baseline MCI to incident dementia. RESULTS:: The 2 MCI definitions differed most for the lowest and highest education groups. The WRAT definition was more strongly associated with incident dementia for all 5 tests. MCI level abstraction performance was associated with incident dementia using the WRAT definition (HR=3.20, P=0.033), but not the education definition (HR=1.19, P=0.814). DISCUSSION:: The WRAT should be considered along with the standard measure of years of education, as it may be a better surrogate marker of premorbid abilities.",
keywords = "Alzheimer disease, longitudinal, mild cognitive impairment, neuropsychological assessment, premorbid abilities",
author = "Ahl, {Richard E.} and Alexa Beiser and Sudha Seshadri and Sanford Auerbach and Wolf, {Philip A.} and Rhoda Au",
year = "2013",
month = "10",
day = "1",
doi = "10.1097/WAD.0b013e31827bde32",
language = "English (US)",
volume = "27",
pages = "330--336",
journal = "Alzheimer Disease and Associated Disorders",
issn = "0893-0341",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - Defining MCI in the framingham heart study offspring

T2 - Education versus WRAT-based norms

AU - Ahl, Richard E.

AU - Beiser, Alexa

AU - Seshadri, Sudha

AU - Auerbach, Sanford

AU - Wolf, Philip A.

AU - Au, Rhoda

PY - 2013/10/1

Y1 - 2013/10/1

N2 - INTRODUCTION:: Psychometric definitions of mild cognitive impairment (MCI) typically use cut-off levels set at 1.5 SDs below age-adjusted and education-adjusted norms, assuming that the education adjustment accounts for premorbid abilities. However, noncognitive factors impact educational attainment, potentially leading to incorrect categorization as MCI. We examined whether using an adjustment based on reading performance [Wide Range Achievement Test (WRAT) Reading] improved MCI diagnostic accuracy. METHODS:: A total of 935 Framingham Offspring (mean age, 72±5 y) underwent tests of memory, executive function, abstraction, language, and visuospatial function as part of a neuropsychological test battery. Domain-specific test scores were regressed onto age and WRAT score, or education, to define MCI. Survival analyses were used to relate baseline MCI to incident dementia. RESULTS:: The 2 MCI definitions differed most for the lowest and highest education groups. The WRAT definition was more strongly associated with incident dementia for all 5 tests. MCI level abstraction performance was associated with incident dementia using the WRAT definition (HR=3.20, P=0.033), but not the education definition (HR=1.19, P=0.814). DISCUSSION:: The WRAT should be considered along with the standard measure of years of education, as it may be a better surrogate marker of premorbid abilities.

AB - INTRODUCTION:: Psychometric definitions of mild cognitive impairment (MCI) typically use cut-off levels set at 1.5 SDs below age-adjusted and education-adjusted norms, assuming that the education adjustment accounts for premorbid abilities. However, noncognitive factors impact educational attainment, potentially leading to incorrect categorization as MCI. We examined whether using an adjustment based on reading performance [Wide Range Achievement Test (WRAT) Reading] improved MCI diagnostic accuracy. METHODS:: A total of 935 Framingham Offspring (mean age, 72±5 y) underwent tests of memory, executive function, abstraction, language, and visuospatial function as part of a neuropsychological test battery. Domain-specific test scores were regressed onto age and WRAT score, or education, to define MCI. Survival analyses were used to relate baseline MCI to incident dementia. RESULTS:: The 2 MCI definitions differed most for the lowest and highest education groups. The WRAT definition was more strongly associated with incident dementia for all 5 tests. MCI level abstraction performance was associated with incident dementia using the WRAT definition (HR=3.20, P=0.033), but not the education definition (HR=1.19, P=0.814). DISCUSSION:: The WRAT should be considered along with the standard measure of years of education, as it may be a better surrogate marker of premorbid abilities.

KW - Alzheimer disease

KW - longitudinal

KW - mild cognitive impairment

KW - neuropsychological assessment

KW - premorbid abilities

UR - http://www.scopus.com/inward/record.url?scp=84888132450&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84888132450&partnerID=8YFLogxK

U2 - 10.1097/WAD.0b013e31827bde32

DO - 10.1097/WAD.0b013e31827bde32

M3 - Article

C2 - 23314066

AN - SCOPUS:84888132450

VL - 27

SP - 330

EP - 336

JO - Alzheimer Disease and Associated Disorders

JF - Alzheimer Disease and Associated Disorders

SN - 0893-0341

IS - 4

ER -