title: Robust and conventional neuropsychological norms: diagnosis and prediction of age-related cognitive decline.
abstract: The aim of the study was to compare the performance of Robust and Conventional neuropsychological norms in predicting clinical decline among healthy adults and in mild cognitive impairment (MCI). The authors developed Robust baseline cross sectional and longitudinal change norms from 113 healthy participants retaining a normal diagnosis for at least 4 years. Baseline Conventional norms were separately created for 256 similar healthy participants without follow-up. Conventional and Robust norms were tested in an independent cohort of longitudinally studied healthy (n=223), MCI (n=136), and Alzheimer's disease (AD, n=162) participants; 84 healthy participants declined to MCI or AD (NL-->DEC), and 44 MCI declined to AD (MCI-->AD). Compared to Conventional norms, baseline Robust norms correctly identified a higher proportion of NL-->DEC with impairment in delayed memory and attention-language domains. Both norms predicted decline from MCI-->AD. Change norms for delayed memory and attention-language significantly incremented baseline classification accuracies. These findings indicate that Robust norms improve identification of healthy individuals who will decline and may be useful for selecting at-risk participants for research studies and early interventions.
authors.affiliation: Department of Psychiatry, New York University School of Medicine, New York, NY 10016, USA. susan.desanti@med.nyu.edu
authors.forename: Susan
authors.initials: S
authors.lastname: De Santi
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Pirraglia
authors.forename: William
authors.initials: W
authors.lastname: Barr
authors.forename: James
authors.initials: J
authors.lastname: Babb
authors.forename: Schantel
authors.initials: S
authors.lastname: Williams
authors.forename: Kimberley
authors.initials: K
authors.lastname: Rogers
authors.forename: Lidia
authors.initials: L
authors.lastname: Glodzik
authors.forename: Miroslaw
authors.initials: M
authors.lastname: Brys
authors.forename: Lisa
authors.initials: L
authors.lastname: Mosconi
authors.forename: Barry
authors.initials: B
authors.lastname: Reisberg
authors.forename: Steven
authors.initials: S
authors.lastname: Ferris
authors.forename: Mony J
authors.initials: MJ
authors.lastname: de Leon
mesh_terms: D000368:Aged; D000375:Aging; D001288:Attention / Q000502:physiology; D003072:Cognition Disorders / Q000175:diagnosis* / Q000503:physiopathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007802:Language; D008137:Longitudinal Studies; D008297:Male; D008568:Memory / Q000502:physiology; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000592:standards* / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D012016:Reference Values; D012680:Sensitivity and Specificity