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Aggregation of Abnormal Memory Scores and Risk of Incident Alzheimer’s Disease Dementia: A Measure of Objective Memory Impairment in Amnestic Mild Cognitive Impairment

Published online by Cambridge University Press:  10 August 2020

Nicholas I. Bradfield Open the ORCID record for Nicholas I. Bradfield [Opens in a new window] ,
Kathryn A. Ellis ,
Greg Savage Open the ORCID record for Greg Savage [Opens in a new window] ,
Paul Maruff ,
Samantha Burnham ,
David Darby ,
Nicola T. Lautenschlager ,
Ralph N. Martins ,
Colin L. Masters  and
Stephanie R. Rainey-Smith
...Show all authors
Nicholas I. Bradfield*
Affiliation:
St Vincent’s Hospital, Fitzroy, Victoria, Australia
Kathryn A. Ellis
Affiliation:
Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
Greg Savage
Affiliation:
Department of Psychology, Macquarie University, Sydney, NSW, Australia
Paul Maruff
Affiliation:
Cogstate Pty Ltd, Melbourne, Victoria, Australia
Samantha Burnham
Affiliation:
CSIRO, Parkville, Victoria, Australia
David Darby
Affiliation:
The Florey Institute of Neurosciences and Mental Health, Parkville, Victoria, Australia
Nicola T. Lautenschlager
Affiliation:
Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia NorthWestern Mental Health, Melbourne Health, Parkville, Victoria, Australia
Ralph N. Martins
Affiliation:
Centre of Excellence for Alzheimer’s Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
Colin L. Masters
Affiliation:
Florey Institute, The University of Melbourne, Victoria, Australia
Stephanie R. Rainey-Smith
Affiliation:
Centre of Excellence for Alzheimer’s Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
Joanne Robertson
Affiliation:
The Florey Institute of Neurosciences and Mental Health, Parkville, Victoria, Australia
Christopher Rowe
Affiliation:
PET Centre, Austin Hospital, Heidelberg, Victoria, Australia
Michael Woodward
Affiliation:
Department of Geriatric Medicine, Repatriation Campus, Austin Hospital, Heidelberg, Victoria, Australia
David Ames
Affiliation:
Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia The Florey Institute of Neurosciences and Mental Health, Parkville, Victoria, Australia National Ageing Research Institute, Parkville, Victoria, Australia
*
*Correspondence and reprint requests to: Nicholas I. Bradfield, St Vincent’s Hospital, Fitzroy, Victoria, Australia. Tel: +61 3 9231 2211. E-mail: nicholas.bradfield@svha.org.au
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Abstract

Objectives:

The criteria for objective memory impairment in mild cognitive impairment (MCI) are vaguely defined. Aggregating the number of abnormal memory scores (NAMS) is one way to operationalise memory impairment, which we hypothesised would predict progression to Alzheimer’s disease (AD) dementia.

Methods:

As part of the Australian Imaging, Biomarkers and Lifestyle Flagship Study of Ageing, 896 older adults who did not have dementia were administered a psychometric battery including three neuropsychological tests of memory, yielding 10 indices of memory. We calculated the number of memory scores corresponding to z ≤ −1.5 (i.e., NAMS) for each participant. Incident diagnosis of AD dementia was established by consensus of an expert panel after 3 years.

Results:

Of the 722 (80.6%) participants who were followed up, 54 (7.5%) developed AD dementia. There was a strong correlation between NAMS and probability of developing AD dementia (r = .91, p = .0003). Each abnormal memory score conferred an additional 9.8% risk of progressing to AD dementia. The area under the receiver operating characteristic curve for NAMS was 0.87 [95% confidence interval (CI) .81–.93, p < .01]. The odds ratio for NAMS was 1.67 (95% CI 1.40–2.01, p < .01) after correcting for age, sex, education, estimated intelligence quotient, subjective memory complaint, Mini-Mental State Exam (MMSE) score and apolipoprotein E ϵ4 status.

Conclusions:

Aggregation of abnormal memory scores may be a useful way of operationalising objective memory impairment, predicting incident AD dementia and providing prognostic stratification for individuals with MCI.

Keywords

Cognitive ageingCognitive neuroscienceMild neurocognitive disorderNeuropsychologyNeurocognitive disorders
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 27 , Issue 2 , February 2021 , pp. 146 - 157
Copyright
Copyright © INS. The International Neuropsychological Society, 2020

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