The assessment of changes in cognitive functioning: reliable change indices for neuropsychological instruments in the elderly - a systematic review.
OBJECTIVE
The determination of meaningful cognitive change over time is essential for the diagnosis of dementia in the elderly. Reliable change indices (RCIs) represent a suitable methodology to assess clinically significant cognitive change. The purpose of this paper is to provide a systematic review of RCI scores in elderly persons for neuropsychological tests currently available.


METHODS
A comprehensive literature search was conducted. Longitudinal studies dealing with the assessment of RCIs for cognitive instruments and cognitively healthy older participants were reviewed. Quality of studies was determined using a standardized system of evaluating methodical quality.


RESULTS
A total of 11 studies met the inclusion criteria; half of the studies rated highly for methodical quality. RCI scores were summarized for a number of neuropsychological instruments.


CONCLUSIONS
RCIs have important implications regarding the interpretation of change in test scores in older adults. Further assessment and standardization is needed for many neuropsychological instruments.
Stein
Janine
J
Department of Mental Health, Clinic of Psychiatry and Psychotherapy, University of Leipzig, Germany. Janine.Stein@medizin.uni-leipzig.de
Luppa
Melanie
M
Brähler
Elmar
E
König
Hans-Helmut
HH
Riedel-Heller
Steffi G
SG
D000368:Aged / Q000523:psychology*; D002986:Clinical Trials as Topic / Q000592:standards; D003071:Cognition / Q000502:physiology*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology*; D018450:Disease Progression; D015577:Geriatric Assessment; D006801:Humans; D011939:Mental Recall; D009483:Neuropsychological Tests; D016032:Randomized Controlled Trials as Topic; D012106:Research / Q000592:standards; D014706:Verbal Learning