Predicting cognitive impairment in high-functioning community-dwelling older persons: MacArthur Studies of Successful Aging.

Full Abstract

OBJECTIVES:
To examine whether simple cognitive tests, when applied to cognitively intact older persons, are useful predictors of cognitive impairment 7 years later.

DESIGN:
Cohort study.

SETTING:
Durham, North Carolina; East Boston, Massachusetts; and New Haven, Connecticut, areas that are part of the National Institute on Aging Established Populations for Epidemiological Studies of the Elderly.

PARTICIPANTS:
Participants, aged 70 to 79, from three community-based studies, who were in the top third of this age group, based on physical and cognitive functional status.

MEASUREMENTS:
New onset of cognitive impairment as defined by a score of less than 7 on the Short Portable Mental Status Questionnaire (SPMSQ) in 1995.

RESULTS:
At 7 years, 21.8% (149 of 684 subjects) scored lower than 7 on the SPMSQ. Using multivariate logistic regression, three baseline (1988) cognitive tests predicted impairment in 1995. These included two simple tests of delayed recall-the ability to remember up to six items from a short story and up to 18 words from recall of Boston Naming Test items. For each story item missed, the adjusted odds ratio (AOR) for cognitive impairment was 1.44 (95% confidence interval (CI) = 1.16-1.78, P <.001). For each missed item from the word list, the AOR was 1.20 (95% CI = 1.09-1.31, P <.001). The Delayed Recognition Span, which assesses nonverbal memory, also predicted cognitive impairment, albeit less strongly (odds ratio = 1.06 per each missed answer, 95% CI = 1.003-1.13, P =.04).

CONCLUSIONS:
This study identifies measures of delayed recall and recognition as significant early predictors of subsequent cognitive decline in high-functioning older persons. Future efforts to identify those at greatest risk of cognitive impairment may benefit by including these measures.

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Author information

Author/s: Chodosh, Joshua (J); Reuben, David B (DB); Albert, Marilyn S (MS); Seeman, Teresa E (TE);

Affiliation: Division of Geriatrics, UCLA School of Medicine, 10945 Le Conte Avenue, Los Angeles, CA 90095, USA. jchodosh(-atsign-)mednet.ucla.edu

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.

Journal: Journal of the American Geriatrics Society (J Am Geriatr Soc), published in United States. (Language: eng)

Reference: 2002-Jun; vol 50 (issue 6) : pp 1051-60

Dates: Created 2002/07/11; Completed 2002/08/02; Revised 2008/03/10;

PMID: 12110065, status: MEDLINE (last retrieval date: 12/26/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Aged
Cohort Studies
Dementia - diagnosis
Female
Humans
Intelligence Tests - standards

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