Word-List Intrusion Errors Predict Progression to Mild Cognitive Impairment

Authors

Kelsey R Thomas, Veterans Affairs San Diego Healthcare System
Joel Eppig, University of California - San Diego
Emily C Edmonds, Veterans Affairs San Diego Healthcare System
Diane M Jacobs, University of California - San Diego
David J Libon, Rowan University
Rhoda Au, Boston University
David P Salmon, University of California - San Diego
Mark W Bondi, Veterans Affairs San Diego Healthcare System
Alzheimer’s Disease Neuroimaging Initiative

Document Type

Article

Version Deposited

Accepted for publication (PostPrint)

Publication Date

2-1-2018

Publication Title

Neuropsychology

DOI

10.1037/neu0000413

Abstract

OBJECTIVE: Preclinical Alzheimer's disease (AD) defined by a positive AD biomarker in the presence of normal cognition is presumed to precede mild cognitive impairment (MCI). Subtle cognitive deficits and cognitive inefficiencies in preclinical AD may be detected through process and error scores on neuropsychological tests in those at risk for progression to MCI.

METHOD: Cognitively normal participants (n = 525) from the Alzheimer's Disease Neuroimaging Initiative were followed for up to 5 years and classified as either stable normal (n = 305) or progressed to MCI (n = 220). Cox regressions were used to determine whether baseline process scores on the Rey Auditory Verbal Learning Test (AVLT; intrusion errors, learning slope, proactive interference, retroactive interference) predicted progression to MCI and a Clinical Dementia Rating (CDR) score of 1 after considering demographic characteristics, apolipoprotein E ε4 status, cerebrospinal fluid AD biomarkers, ischemia risk, mood, functional difficulty, and standard neuropsychological total test scores for the model.

RESULTS: Baseline AVLT intrusion errors predicted progression to MCI (hazard ratio = 1.04, 95% confidence interval 1.01-1.07, p = .008) and improved model fit after the other valuable predictors were already in the model, χ2(df = 1) = 6.330, p = .012. AVLT intrusion errors also predicted progression to CDR = 1 (hazard ratio = 1.10, 95% confidence interval 1.02-1.18, p = .016) and again improved model fit, χ2(df = 1) = 4.682, p = .030.

CONCLUSIONS: Intrusion errors on the AVLT contribute unique value for predicting progression from normal cognition to MCI and normal cognition to mild dementia (CDR = 1). Intrusion errors appear to reflect subtle change and inefficiencies in cognition that precede impairment detected by neuropsychological total scores.

Comments

©American Psychological Association, 2018. This paper is not the copy of record and may not exactly replicate the authoritative document published in the APA journal. Please do not copy or cite without author's permission. The final article is available, upon publication, at: 10.1037/neu0000413

Recommended Citation

Thomas KR, Eppig J, Edmonds EC, Jacobs DM, Libon DJ, Au R, Salmon DP, Bondi MW, The Alzheimer’s Disease Neuroimaging Initiative. Word-list intrusion errors predict progression to mild cognitive impairment. Neuropsychology. 2018 Feb;32(2):235-245. doi: 10.1037/neu0000413. PMID: 29528684. PMCID: PMC5851458.