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Neuropsychological Test Performance and Cognitive Reserve in Healthy Aging and the Alzheimer's Disease Spectrum: A Theoretically Driven Factor Analysis

Published online by Cambridge University Press:  08 October 2012

Meghan B. Mitchell ,
Lynn W. Shaughnessy ,
Steven D. Shirk ,
Frances M. Yang  and
Alireza Atri
Meghan B. Mitchell*
Affiliation:
Geriatric Research Education and Clinical Center, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts Harvard Medical School, Boston, Massachusetts
Lynn W. Shaughnessy
Affiliation:
Harvard Medical School, Boston, Massachusetts Department of Psychiatry, Massachusetts Mental Health Center, Boston, Massachusetts Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston, Massachusetts
Steven D. Shirk
Affiliation:
Geriatric Research Education and Clinical Center, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts
Frances M. Yang
Affiliation:
Harvard Medical School, Boston, Massachusetts Institute for Aging Research, Hebrew Senior Life, Boston, Massachusetts Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
Alireza Atri
Affiliation:
Geriatric Research Education and Clinical Center, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, Massachusetts Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts Harvard Medical School, Boston, Massachusetts
*
Correspondence and reprint requests to: Meghan Mitchell, 200 Springs Road, 182b, Edith Nourse Rogers Memorial Veterans Hospital, Bedford, MA 01730. E-mail: [email protected]
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Abstract

Accurate measurement of cognitive function is critical for understanding the disease course of Alzheimer's disease (AD). Detecting cognitive change over time can be confounded by level of premorbid intellectual function or cognitive reserve and lead to under- or over-diagnosis of cognitive impairment and AD. Statistical models of cognitive performance that include cognitive reserve can improve sensitivity to change and clinical efficacy. We used confirmatory factor analysis to test a four-factor model composed of memory/language, processing speed/executive function, attention, and cognitive reserve factors in a group of cognitively healthy older adults and a group of participants along the spectrum of amnestic mild cognitive impairment to AD (aMCI-AD). The model showed excellent fit for the control group (χ2 = 100; df = 78; CFI = .962; RMSEA = .049) and adequate fit for the aMCI-AD group (χ2 = 1750; df = 78; CFI = .932; RMSEA = .085). Although strict invariance criteria were not met, invariance testing to determine if factor structures are similar across groups yielded acceptable absolute model fits and provide evidence in support of configural, metric, and scalar invariance. These results provide further support for the construct validity of cognitive reserve in healthy and memory impaired older adults. (JINS, 2012, 18, 1–10)

Keywords

Mild cognitive impairmentBrain reserveExecutive functionMemory functionDementiaCognition
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 18 , Issue 6 , November 2012 , pp. 1071 - 1080
Copyright
Copyright © The International Neuropsychological Society 2012

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