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- Title
Combining Cognitive Markers to Identify Individuals at Increased Dementia Risk: Influence of Modifying Factors and Time to Diagnosis.
- Authors
Payton, Nicola M.; Rizzuto, Debora; Fratiglioni, Laura; Kivipelto, Miia; Bäckman, Lars; Laukka, Erika J.
- Abstract
Objective: We investigated the extent to which combining cognitive markers increases the predictive value for future dementia, when compared to individual markers. Furthermore, we examined whether predictivity of markers differed depending on a range of modifying factors and time to diagnosis. Method: Neuropsychological assessment was performed for 2357 participants (60+ years) without dementia from the population-based Swedish National Study on Aging and Care in Kungsholmen. In the main sample analyses, the outcome was dementia at 6 years. In the time-to-diagnosis analyses, a subsample of 407 participants underwent cognitive testing 12, 6, and 3 years before diagnosis, with dementia diagnosis at the 12-year follow-up. Results: Category fluency was the strongest individual predictor of dementia 6 years before diagnosis [area under the curve (AUC) =.903]. The final model included tests of verbal fluency, episodic memory, and perceptual speed (AUC =.913); these three domains were found to be the most predictive across a range of different subgroups. Twelve years before diagnosis, pattern comparison (perceptual speed) was the strongest individual predictor (AUC =.686). However, models 12 years before diagnosis did not show significantly increased predictivity above that of the covariates. Conclusions: This study shows that combining markers from different cognitive domains leads to increased accuracy in predicting future dementia 6 years later. Markers from the verbal fluency, episodic memory, and perceptual speed domains consistently showed high predictivity across subgroups stratified by age, sex, education, apolipoprotein E ϵ4 status, and dementia type. Predictivity increased closer to diagnosis and showed highest accuracy up to 6 years before a dementia diagnosis. (JINS, 2020, 00, 1–13)
- Subjects
DEMENTIA; COGNITION; VERBAL behavior testing; APOLIPOPROTEIN E; SENILE dementia; NEUROPSYCHOLOGICAL tests
- Publication
Journal of the International Neuropsychological Society, 2020, Vol 26, Issue 8, p785
- ISSN
1355-6177
- Publication type
Article
- DOI
10.1017/S1355617720000272