A cognitive stress test for prodromal Alzheimer's disease: Multiethnic generalizability

Abstract Introduction Culturally fair cognitive assessments sensitive to detecting changes associated with prodromal Alzheimer's disease are needed. Methods Performance of Hispanic and non‐Hispanic older adults on the Loewenstein‐Acevedo Scale of Semantic Interference and Learning (LASSI‐L) was examined in persons with amnestic mild cognitive impairment (aMCI) or normal cognition. The association between a novel cognitive marker, the failure to recover from proactive semantic interference (frPSI), and cortical thinning was explored. Results English‐speaking aMCI participants scored lower than cognitively normal participants on all LASSI‐L indices, while Spanish‐speaking aMCI participants scored lower in learning, frPSI, and delayed recall. Healthy controls obtained equivalent scores on all indices except retroactive semantic interference. English‐speaking and Spanish‐speaking aMCI participants had equivalent scores except English speaker's greater vulnerability to frPSI. Across aMCI groups, frPSI was associated with cortical thinning of the entorhinal cortex and precuneus (r = −0.45 to r = 0.52; P < .005). Discussion In diverse populations, LASSI‐L performance differentiated patients with aMCI from cognitively normal older adults and was associated with thinning in Alzheimer's disease–prone regions, suggesting its clinical utility.