Instituto de Neurociencias, Centro Universitario de Ciencias Biológicas y Agropecuarias, Universidad de Guadalajara, Guadalajara, México.
Facultad de Medicina y Psicología, Universidad Autónoma de Baja California, Tijuana, México.
Arch Clin Neuropsychol. 2023 Aug 24;38(6):962-975. doi: 10.1093/arclin/acad009.
Since evidence of adults' cognition decline is based on standardized testing, we developed regression-based continuous norms by linear regression (LR) and nonlinear quantile regression (NQR) with years of schooling (YoS), age, and sex as covariates on the Mexican adaptation of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD-MX) and complementary tasks.
392 healthy, Spanish-speaking Mexican adults (50.25% women) aged 18-59 completed the 15 CERAD-MX cognitive tasks and complementary tasks. We used raw scores and examined YoS-related effects considering sex and age as covariates. For the NQR, we used calibrated scores for sex and age. While LR represents one line across the performance, NQR differentiated several nonlinear performance bands by quantiles.
LR showed positive relationships between YoS and cognitive performance with a funnel variance pattern. Therefore, this relationship is better represented with NQR than LR. A small, but significant, negative effect of age was found for this age range (18-59 years). The band with fewer years of schooling (1-6) showed greater variability in the cognitive measures than those with more years of schooling (16-22).
This study shows that NQR is useful for accurately positioning participants' performance relative to their peers. NQR accounts more than LR for the inconsistent variability of cognitive performance as a function of YoS by identifying the variability according to YoS (low, medium, high). Thus, NQR represents an appropriate way to construct norms for the cognitive performance of adults.
由于成年人认知能力下降的证据基于标准化测试，因此我们通过线性回归（LR）和非线性分位数回归（NQR），以受教育年限（YoS）、年龄和性别为协变量，针对墨西哥裔的认知评估协会（CERAD-MX）和补充任务的调整版，建立了连续的回归常模。
392 名健康的、讲西班牙语的墨西哥成年人（50.25%为女性）年龄在 18-59 岁之间，完成了 15 项 CERAD-MX 认知任务和补充任务。我们使用原始分数，并考虑了性别和年龄作为协变量，考察了 YoS 相关的影响。对于 NQR，我们使用了校准的性别和年龄分数。虽然 LR 代表了一条贯穿表现的线，但 NQR 通过分位数区分了几个非线性表现带。
LR 显示 YoS 与认知表现之间存在正相关关系，呈现出漏斗方差模式。因此，与 LR 相比，NQR 可以更好地表示这种关系。在这个年龄范围（18-59 岁），发现年龄存在一个小但显著的负面影响。受教育年限较少的组（1-6 年）的认知测量结果比受教育年限较多的组（16-22 年）的结果更具变异性。
本研究表明，NQR 可用于准确确定参与者相对于同龄人表现的位置。与 LR 相比，NQR 更能说明 YoS 对认知表现的不一致变异性，通过根据 YoS（低、中、高）识别变异性来解释这种变异性。因此，NQR 代表了构建成年人认知表现常模的一种合适方法。
