Mild Cognitive Impairment in Late Middle Age in the Wisconsin Registry for Alzheimer's Prevention Study: Prevalence and Characteristics Using Robust and Standard Neuropsychological Normative Data

Lindsay R Clark; Rebecca L Koscik; Christopher R Nicholas; Ozioma C Okonkwo; Corinne D Engelman; Lisa C Bratzke; Kirk J Hogan; Kimberly D Mueller; Barbara B Bendlin; Cynthia M Carlsson; Sanjay Asthana; Mark A Sager; Bruce P Hermann; Sterling C Johnson

doi:10.1093/arclin/acw024

Mild Cognitive Impairment in Late Middle Age in the Wisconsin Registry for Alzheimer's Prevention Study: Prevalence and Characteristics Using Robust and Standard Neuropsychological Normative Data

Arch Clin Neuropsychol. 2016 Nov 22;31(7):675-688. doi: 10.1093/arclin/acw024.

Authors

Lindsay R Clark^{1

2}, Rebecca L Koscik¹, Christopher R Nicholas^{2

3}, Ozioma C Okonkwo^{1

2

3}, Corinne D Engelman^{1

4}, Lisa C Bratzke^{1

5}, Kirk J Hogan^{1

6}, Kimberly D Mueller¹, Barbara B Bendlin^{2

3}, Cynthia M Carlsson^{1

2

3}, Sanjay Asthana^{1

2

3}, Mark A Sager¹, Bruce P Hermann^{1

7}, Sterling C Johnson^{1

2

3}

Affiliations

¹ Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53705, USA.
² Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53705, USA.
³ Geriatric Research Education and Clinical Center, William S. Middleton Memorial Veterans Hospital, Madison, WI 53705, USA.
⁴ Department of Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA.
⁵ School of Nursing, University of Wisconsin-Madison, Madison, WI 53705, USA.
⁶ Department of Anesthesiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53705, USA.
⁷ Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53705, USA.

Abstract

Objective: Detecting cognitive decline in presymptomatic Alzheimer's disease (AD) and early mild cognitive impairment (MCI) is challenging, but important for treatments targeting AD-related neurodegeneration. The current study aimed to investigate the utility and performance of internally developed robust norms and standard norms in identifying cognitive impairment in late middle-age (baseline age range = 36-68; M = 54).

Method: Robust norms were developed for neuropsychological measures based on longitudinally confirmed cognitively normal (CN) participants (n= 476). Seven hundred and seventy-nine participants enriched for AD risk were classified as psychometric MCI (pMCI) or CN based on standard and robust norms and "single-test" versus "multi-test" criteria.

Results: Prevalence of pMCI ranged from 3% to 49% depending on the classification scheme used. Those classified as pMCI using robust norms exhibited greater subjective cognitive complaints, diagnostic stability, and mild clinical symptoms at follow-up.

Conclusions: Results suggest that identifying early clinically relevant cognitive decline in late middle-age is feasible using robust norms and multi-test criteria.

Keywords: Alzheimer's disease; Dementia; Elderly/Geriatrics/Aging; Learning and Memory; Mild cognitive impairment; Norms/normative studies.

Abstract

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