Duff Kevin, Dalley Bonnie C A, Suhrie Kayla R, Hammers Dustin B
Center for Alzheimer's Care, Imaging and Research, Department of Neurology, University of Utah, Salt Lake City, UT, USA.
Arch Clin Neuropsychol. 2019 May 1;34(3):395-402. doi: 10.1093/arclin/acy050.
Assessing cognitive change during a single visit requires the comparison of estimated premorbid abilities and current neuropsychological functioning. Although premorbid intellect has been widely examined, premorbid expectations for other cognitive abilities have received less attention. The current study sought to develop and validate premorbid estimates for the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).
Using demographic variables and an estimate of premorbid intellect, premorbid performance on the RBANS was predicted in a sample of 143 community-dwelling, cognitively intact older adults.
On all six Indexes of the RBANS, premorbid intellect was the best predictor of current cognitive functioning, with gender adding to one of the prediction models (R2 = 0.04-0.16, ps < .02). These prediction formulae were then applied to a sample of 122 individuals with amnestic Mild Cognitive Impairment to look for discrepancies between premorbid and current RBANS scores. Despite minimal differences between premorbid and current RBANS scores in the intact sample, large, and statistically significant differences were observed in the impaired sample, especially on the Immediate Memory Index (discrepancy = -29.00, p < .001), Delayed Memory Index (discrepancy = -32.28, p < .001), and Total Scale score (discrepancy = -25.58, p < .001).
Although validation in larger samples is needed, the current estimates of premorbid RBANS abilities may aid clinicians in determining change across time.
在单次就诊期间评估认知变化需要比较预估的病前能力和当前的神经心理功能。尽管病前智力已得到广泛研究,但对其他认知能力的病前预期却较少受到关注。本研究旨在开发并验证用于神经心理状态评估可重复成套测验(RBANS)的病前估计值。
利用人口统计学变量和病前智力估计值,在143名居住在社区、认知功能正常的老年人样本中预测RBANS的病前表现。
在RBANS的所有六个指标上,病前智力是当前认知功能的最佳预测指标,性别对其中一个预测模型有补充作用(R2 = 0.04 - 0.16,p值 <.02)。然后将这些预测公式应用于122名遗忘型轻度认知障碍患者的样本,以寻找病前和当前RBANS分数之间的差异。尽管在正常样本中病前和当前RBANS分数差异极小,但在受损样本中观察到了较大的、具有统计学意义的差异,尤其是在即时记忆指标(差异 = -29.00,p <.001)、延迟记忆指标(差异 = -32.28,p <.001)和总量表分数(差异 = -25.58,p <.001)方面。
尽管需要在更大样本中进行验证,但目前对RBANS病前能力的估计可能有助于临床医生确定随时间的变化。