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Evidence for the Utility of Actuarial Neuropsychological Criteria Across the Continuum of Normal Aging, Mild Cognitive Impairment, and Dementia
- Source :
- Journal of Alzheimer's Disease
- Publication Year :
- 2020
- Publisher :
- IOS Press, 2020.
-
Abstract
- Background: Research suggests that actuarial neuropsychological criteria improve the accuracy of mild cognitive impairment (MCI) diagnoses relative to conventional diagnostic methods. Objective: We sought to examine the utility of actuarial criteria relative to consensus diagnostic methods used in the National Alzheimer’s Coordinating Center (NACC) Uniform Data Set (UDS), and more broadly across the continuum of normal aging, MCI, and dementia. Methods: We compared rates of cognitively normal (CN), MCI, and dementia diagnoses at baseline using actuarial versus consensus diagnostic methods in 1524 individuals from the NACC UDS. Results: Approximately one-third (33.59%) of individuals diagnosed as CN and more than one-fifth (22.03%) diagnosed with dementia based on consensus methods, met actuarial criteria for MCI. Many participants diagnosed with MCI via consensus methods also appeared to represent possible diagnostic errors. Notably, the CNa/CNc group (i.e., participants diagnosed as CN based on both actuarial [a] and consensus [c] criteria) had a lower proportion of apolipoprotein E ɛ4 carriers than the MCIa/MCIc group, which in turn had a lower proportion of ɛ4 carriers than the dementia (Dem)a/Demc group. Proportions of ɛ4 carriers were comparable between the CNa/CNc and CNa/MCIc, MCIa/MCIc and MCIa/CNc, MCIa/MCIc and MCIa/Demc, and Dema/Demc and Dema/MCIc groups. These results were largely consistent with diagnostic agreement/discrepancy group comparisons on neuropsychological performance. Conclusion: The present results extend previous findings and suggest that actuarial neuropsychological criteria may enhance diagnostic accuracy relative to consensus methods, and across the wider continuum of normal aging, MCI, and dementia. Findings have implications for both clinical practice and research.
- Subjects :
- Male
050103 clinical psychology
Diagnostic methods
neuropsychology
Normal aging
Neuropsychological Tests
Group comparison
diagnostic errors
03 medical and health sciences
Apolipoproteins E
Cognition
mild cognitive impairment
0302 clinical medicine
Actuarial Analysis
Alzheimer Disease
mental disorders
medicine
Humans
Dementia
Cognitive Dysfunction
0501 psychology and cognitive sciences
Longitudinal Studies
misdiagnosis
Medical diagnosis
Cognitive impairment
Aged
Aged, 80 and over
Actuarial science
business.industry
General Neuroscience
05 social sciences
Neuropsychology
General Medicine
medicine.disease
Clinical Practice
Psychiatry and Mental health
Clinical Psychology
Disease Progression
Female
Geriatrics and Gerontology
business
Alzheimer’s disease
030217 neurology & neurosurgery
Research Article
Subjects
Details
- ISSN :
- 18758908 and 13872877
- Volume :
- 78
- Database :
- OpenAIRE
- Journal :
- Journal of Alzheimer's Disease
- Accession number :
- edsair.doi.dedup.....c9cf7c603a8609ab1f16677898cd4598