Predicting Alzheimer's disease: neuropsychological tests, self-reports, and informant reports of cognitive difficulties.
OBJECTIVE
To investigate the independent and combined contributions to the risk of Alzheimer's disease (AD) of three important domains of cognitive assessment: neuropsychological measurement, self-reports, and informant reports.


METHODS
Longitudinal, community-based sample.


METHODS
Einstein Aging Study.


METHODS
Six hundred twenty-seven individuals without dementia aged 70 and older systematically recruited from the Bronx, New York.


METHODS
Comprehensive assessment included neurological examination, behavioral questions, and neuropsychological testing. AD diagnoses were based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria assigned at a multidisciplinary consensus case conference. The major statistical analyses used Cox proportional hazards models (with age as the time scale) adjusted for sex, education, and depressive symptoms.


RESULTS
Forty-eight participants developed incident AD during a median of 3.3 years of follow-up. Self- and informant reports of cognitive status and baseline scores on tests of episodic memory and psychomotor speed predicted the onset of AD, but in models examining all the variables simultaneously, only the episodic memory tests and informant reports were associated with risk of AD. A likelihood ratio test confirmed the incremental effect of informant reports in addition to the neuropsychological test scores (P = .03).


CONCLUSIONS
Informant ratings improved the prediction of AD conversion in addition to objective memory impairment in older adults without dementia. Combining these cognitive measures may provide a useful, empirical method for identifying individuals at high risk of future AD.
Department of Psychology, Brooklyn College and The Graduate Center, City University of New York, Brooklyn, New York 11210, USA. lrabin@brooklyn.cuny.edu
Laura A
LA
Rabin
Cuiling
C
Wang
Mindy J
MJ
Katz
Carol A
CA
Derby
Herman
H
Buschke
Richard B
RB
Lipton
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D018450:Disease Progression; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008137:Longitudinal Studies; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D009483:Neuropsychological Tests; D009519:New York City / Q000453:epidemiology; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D018570:Risk Assessment; D057566:Self Report; D013997:Time Factors