Practice effects in the prediction of long-term cognitive outcome in three patient samples: a novel prognostic index.
Practice effects, defined as improvements in cognitive test performance due to repeated exposure to the test materials, have traditionally been viewed as sources of error. However, they might provide useful information for predicting cognitive outcome. The current study used three separate patient samples (older adults with mild cognitive impairments, individuals who were HIV+, individuals with Huntington's disease) to examine the relationship between practice effects and cognitive functioning at a later point. Across all three samples, practice effects accounted for as much as 31-83% of the variance in the follow-up cognitive scores, after controlling for baseline cognitive functioning. If these findings can be replicated in other patients with neurodegenerative disorders, clinicians and researchers may be able to develop predictive models to identify the individuals who are most likely to demonstrate continued cognitive decline across time. The ability to utilize practice effects data would add a simple, convenient, and non-invasive marker for monitoring an individual patient's cognitive status. Additionally, this prognostic index could be used to offer interventions to patients who are in the earliest stages of progressive neurodegenerative disorders.
Duff
Kevin
K
University of Iowa, Department of Psychiatry, MEB 1-308, Iowa City, IA 52242-1000, United States. kevin-duff@uiowa.edu
Beglinger
Leigh J
LJ
Schultz
Susan K
SK
Moser
David J
DJ
McCaffrey
Robert J
RJ
Haase
Richard F
RF
Westervelt
Holly J K
HJ
Langbehn
Douglas R
DR
Paulsen
Jane S
JS
D000328:Adult; D000368:Aged; D003071:Cognition / Q000502:physiology*; D005260:Female; D015658:HIV Infections / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology; D006801:Humans; D006816:Huntington Disease / Q000175:diagnosis / Q000503:physiopathology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019636:Neurodegenerative Diseases / Q000175:diagnosis / Q000503:physiopathology; D009483:Neuropsychological Tests; D011214:Practice, Psychological; D011237:Predictive Value of Tests; D011379:Prognosis; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index