Dataset Information

Intraindividual variability in verbal fluency performance is moderated by and predictive of mild cognitive impairments.

ABSTRACT:

Objective

The current study was designed to achieve 2 primary objectives: (a) determine the moderating effect of mild cognitive impairments (MCI) on intraindividual variability in semantic and letter fluency performance taking into account longitudinal annual assessments; and (b) establish predictive utility for intraindividual variability in semantic and letter fluency performance as a risk factor of incident MCI.

Methods

Participants were community-residing older adults (n = 514; M age = 75.89 ± 6.45; 55.1% female). Sixty participants were diagnosed with MCI at baseline and 50 developed incident MCI during the follow-up. We operationalized intraindividual variability as word generation slopes derived from 3 consecutive time intervals during the standard 1-min administration of both letter and semantic fluency tasks (i.e., 0-20 s, 21-40 s, and 41-60 s).

Results

Linear mixed effects models revealed significant within task slope effects for semantic (estimate = -8.350; p < .0001; 95% confidence interval [CI] = -8.604, -8.095) and letter (estimate = -5.068; p < .0001; 95% CI [-5.268, -4.869]) fluency indicating that word generation declined over the course of both tasks. The two-way interactions of MCI × Slope were significant for semantic (estimate = 1.34; p = .001; 95% CI [0.551, 2.126]) and letter (estimate = 0.733; p = .020; 95% CI [0.116, 1.350]) fluency indicating attenuated slopes among MCI participants compared to controls taking into account repeated annual assessments. Cox proportional-hazards models revealed that attenuated word generation slope, at baseline, in semantic (hazard ratio [HR] = 2.063; p = .015; 95% = 1.149 to 3.702) but not letter (HR = 0.704; p = .243; 95% CI [0.391, 1.269]) fluency was associated with increased risk of incident MCI.

Conclusion

Intraindividual variability in verbal fluency performance has clinical and predictive utility; it can be easily incorporated into testing batteries in clinical and research settings. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

SUBMITTER: Holtzer R

PROVIDER: S-EPMC6908771 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Intraindividual variability in verbal fluency performance is moderated by and predictive of mild cognitive impairments.

Holtzer Roee R Jacobs Sydney S Demetriou Eleni E

Neuropsychology 20190613 1

<h4>Objective</h4>The current study was designed to achieve 2 primary objectives: (a) determine the moderating effect of mild cognitive impairments (MCI) on intraindividual variability in semantic and letter fluency performance taking into account longitudinal annual assessments; and (b) establish predictive utility for intraindividual variability in semantic and letter fluency performance as a risk factor of incident MCI.<h4>Methods</h4>Participants were community-residing older adults (n = 514 ...[more]

PMID: 31192656

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Project description:IntroductionParkinson's disease (PD) is a neurodegenerative disorder that commonly results in cognitive impairments and dementia. Intraindividual variability of neuropsychological performance is a sensitive marker of cognitive decline in other neurologic populations. However, studies have not examined the longitudinal utility of intraindividual variability in predicting future cognitive impairments among individuals with PD. In the current study, we hypothesized that increased intraindividual variability would predict future cognitive decline independent of traditional neuropsychological markers of cognitive impairment.MethodsThe sample included 423 newly diagnosed PD patients and 175 healthy controls, who were followed up to 5 years (baseline, first, second, third, fourth, and fifth annual follow-up). Participants underwent tests of learning, memory, processing speed, attention, verbal fluency, and visuospatial functioning. Cognitive status (cognitive intact, mild cognitive impairment, and dementia) was classified based on previously established criteria. Multilevel models were computed to examine the longitudinal relationship between intraindividual variability, cognitive status, and general cognitive functioning.ResultsAnalyses revealed that increased intraindividual variability was predictive of incident cognitive decline among individuals with PD. Specifically, greater dispersion in neuropsychological performance was associated with greater risk of transitioning from cognitively intact to mild cognitive impairment or transitioning from mild cognitive impairment to dementia. Additional analyses revealed a significant Intraindividual Variability × Group (PD or control) interaction, meaning that intraindividual variability was predictive of declines in cognitive functioning among PD participants only but not healthy controls.ConclusionIntraindividual variability may be a harbinger for future cognitive decline among individuals with PD. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Project description:Dementia researchers around the world prioritize the urgent need for sensitive measurement tools that can detect cognitive and functional change at the earliest stages of Alzheimer's disease (AD). Sensitive indicators of underlying neural pathology assist in the early detection of cognitive change and are thus important for the evaluation of early-intervention clinical trials. One method that may be particularly well-suited to help achieve this goal involves the quantification of intraindividual variability (IIV) in cognitive performance. The current study aimed to directly compare two methods of estimating IIV (fluctuations in accuracy-based scores vs. those in latency-based scores) to predict cognitive performance in AD. Specifically, we directly compared the relative sensitivity of reaction time (RT)-and accuracy-based estimates of IIV to cognitive compromise. The novelty of the present study, however, centered on the patients we tested [a group of patients with Alzheimer's disease (AD)] and the outcome measures we used (a measure of general cognitive function and a measure of episodic memory function). Hence, we compared intraindividual standard deviations (iSDs) from two RT tasks and three accuracy-based memory tasks in patients with possible or probable Alzheimer's dementia (n = 23) and matched healthy controls (n = 25). The main analyses modeled the relative contributions of RT vs. accuracy-based measures of IIV toward the prediction of performance on measures of (a) overall cognitive functioning, and (b) episodic memory functioning. Results indicated that RT-based IIV measures are superior predictors of neurocognitive impairment (as indexed by overall cognitive and memory performance) than accuracy-based IIV measures, even after adjusting for the timescale of measurement. However, one accuracy-based IIV measure (derived from a recognition memory test) also differentiated patients with AD from controls, and significantly predicted episodic memory performance. The findings suggest that both RT- and accuracy-based IIV measures may be useful indicators of underlying neuropathology. The present study therefore contributes toward an understanding of the relative utility of RT- and accuracy-based IIV measures in detecting neurocognitive impairment in older adults, and also advances the empirical evaluation of sensitive markers of cognitive change in patients with AD.

Dataset Information

Intraindividual variability in verbal fluency performance is moderated by and predictive of mild cognitive impairments.

Objective

Methods

Results

Conclusion

Publications

Intraindividual variability in verbal fluency performance is moderated by and predictive of mild cognitive impairments.

Similar Datasets

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