title: A method for assessing clinically relevant individual cognitive change in older adult populations.
abstract: The evaluation of individual cognitive change has relied heavily upon the raw change score, defined simply as the difference between follow-up and baseline scores. However, raw changes scores are susceptible to the confounding effects of both regression-to-the-mean and practice effect. The clinical relevance of raw change scores for the older adult is also obscured by normal, age-related cognitive change. The present study illustrates the use of a standardized regression-based (SRB) methodology to generate an alternative to the raw change score; the SRB change score. SRB change scores provide a standardized alternative to the raw change score, allowing the clinician to evaluate the magnitude of change on one or more variables along a common metric that controls for practice effect, regression-to-the-mean, and normal cognitive decline. Case data illustrate how SRB change scores can identify clinically relevant cognitive change in the individual older adult patient.
authors: Department of Neurology, University of Alabama at Birmingham, USA. ssawrie@uabmc.edu
authors: S M
authors: SM
authors: Sawrie
authors: D C
authors: DC
authors: Marson
authors: A L
authors: AL
authors: Boothe
authors: L E
authors: LE
authors: Harrell
mesh_terms: D000368:Aged / Q000502:physiology*; D001288:Attention; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology; D015986:Confounding Factors, Epidemiologic; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006801:Humans; D007802:Language; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D011594:Psychometrics; D012044:Regression Analysis; D015203:Reproducibility of Results; D012720:Severity of Illness Index