A method for assessing clinically relevant individual cognitive change in older adult populations

J Gerontol B Psychol Sci Soc Sci. 1999 Mar;54(2):P116-24. doi: 10.1093/geronb/54b.2.p116.

Abstract

The evaluation of individual cognitive change has relied heavily upon the raw change score, defined simply as the difference between follow-up and baseline scores. However, raw changes scores are susceptible to the confounding effects of both regression-to-the-mean and practice effect. The clinical relevance of raw change scores for the older adult is also obscured by normal, age-related cognitive change. The present study illustrates the use of a standardized regression-based (SRB) methodology to generate an alternative to the raw change score; the SRB change score. SRB change scores provide a standardized alternative to the raw change score, allowing the clinician to evaluate the magnitude of change on one or more variables along a common metric that controls for practice effect, regression-to-the-mean, and normal cognitive decline. Case data illustrate how SRB change scores can identify clinically relevant cognitive change in the individual older adult patient.

Publication types

  • Case Reports

MeSH terms

  • Aged / physiology*
  • Attention
  • Cognition / physiology*
  • Cognition Disorders / diagnosis*
  • Cognition Disorders / etiology
  • Confounding Factors, Epidemiologic
  • Female
  • Follow-Up Studies
  • Geriatric Assessment*
  • Humans
  • Language
  • Male
  • Memory
  • Middle Aged
  • Neuropsychological Tests*
  • Psychometrics
  • Regression Analysis
  • Reproducibility of Results
  • Severity of Illness Index