a Function Area Aging Health and Functioning , Karolinska University Hospital , Stockholm , Sweden.
b Traffic Medicine Centre , Karolinska University Hospital , Stockholm , Sweden.
J Clin Exp Neuropsychol. 2019 Apr;41(3):229-245. doi: 10.1080/13803395.2018.1527292. Epub 2018 Oct 18.
Neuropsychological assessment of cognitive change over time is often conducted in clinical settings, but whether neuropsychological change scores are influenced by physical health has, as far as we know, not been examined previously.
In a sample of 153 older Swedish adults (age range, 72-86 years), we evaluated the influence of common age-related diseases, terminal decline pathology, age, education, and gender, to provide (a) preliminary test-specific regression weights and 90% confidence intervals to assess significant change in performance after five years on tests of visual scanning, mental shifting, visual spatial ability, memory, reaction time, and selective attention, and (b) normative data for the Useful Field of View test (UFOV) from a single testing occasion.
Multiple regression analyses showed that test-retest changes were affected by physical health for mental shifting, visual spatial ability, memory, and reaction time, by age for mental shifting and visual reaction time, by education for visual spatial ability, and by Age × Education for auditory reaction time. Gender did not affect any of the change scores. The overall average of variance explained was 2.5%: up to 8.1% for physical health, 4.4% for age, and 3.6% for education. The UFOV scores were mostly influenced by age, but also by physical health and education.
The findings indicate that considering the influence of health on normative change scores in old age in addition to demographic factors leads to more accurate predictions of whether true change has occurred.
神经心理学评估认知随时间的变化通常在临床环境中进行,但据我们所知,神经心理学变化评分是否受到身体健康的影响尚未得到检验。
在 153 名瑞典老年人样本(年龄范围为 72-86 岁)中,我们评估了常见的与年龄相关的疾病、终末期衰退病理、年龄、教育和性别对认知变化的影响,以提供(a)初步的、特定于测试的回归权重和 90%置信区间,用于评估在五年后进行视觉扫描、心理转移、视觉空间能力、记忆、反应时间和选择性注意测试的表现是否有显著变化,以及(b)在单次测试中有用视野测试(UFOV)的正常值。
多元回归分析表明,测试-重测变化受到身体健康对心理转移、视觉空间能力、记忆和反应时间的影响,年龄对心理转移和视觉反应时间的影响,教育对视觉空间能力的影响,以及年龄×教育对听觉反应时间的影响。性别对任何变化分数都没有影响。总方差解释平均为 2.5%:身体健康最高可达 8.1%,年龄最高可达 4.4%,教育最高可达 3.6%。UFOV 分数主要受年龄影响,但也受身体健康和教育的影响。
这些发现表明,在考虑健康对老年人群常模变化评分的影响时,除了人口统计学因素外,还需要考虑是否发生了真正的变化。