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American Journal of Epidemiology Advance Access originally published online on November 14, 2006
American Journal of Epidemiology 2007 165(3):344-350; doi:10.1093/aje/kwk017
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American Journal of Epidemiology Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

PRACTICE OF EPIDEMIOLOGY

Sensitivity of Four Psychometric Tests to Measure Cognitive Changes in Brain Aging-Population–based Studies

Cécile Proust-Lima1,2, Hélène Amieva2,3, Jean-François Dartigues2,3 and Hélène Jacqmin-Gadda1,2

1 INSERM E0338, Bordeaux, France
2 Université Victor Segalen Bordeaux 2, Bordeaux, France
3 INSERM U593, Bordeaux, France

Correspondence to Cécile Proust-Lima, INSERM E0338, Institut de Santé Publique, d'Epidémiologie et de Développement, Université de Bordeaux 2, 146 rue Léo Saignat, 33076 Bordeaux Cedex, France (e-mail: cecile.proust{at}isped.u-bordeaux2.fr).

Choosing the measure of cognition in an epidemiologic study investigating cognitive changes over time is a challenging question. A powerful measure must be able to detect small cognitive changes in all the range of cognition observed in the target population. This work aims at comparing the sensitivity to detect cognitive changes in the observed range of cognition of four widely used psychometric tests in an aging-population–based study through a nonlinear latent process model, assuming that the psychometric tests are nonlinear noisy transformations of their common factor. With data from the French prospective cohort study PAQUID (1989–2001), the authors found that the Mini-Mental State Examination and the Benton Visual Retention Test exhibited a better sensitivity to cognitive changes in low levels of cognition, while the Digit Symbol Substitution Test was more sensitive to changes in high levels of cognition. In contrast, the Isaacs Set Test shortened at 15 seconds appeared to be sensitive to small changes in all the range of cognition and, thus, represents an appropriate measure of cognition in population-based studies including both highly normal and severely impaired subjects.

aging; cognition; dementia; epidemiologic methods; neuropsychological tests

Abbreviations: BVRT, Benton Visual Retention Test; DSST, Digit Symbol Substitution Test; IQR, interquartile range; IST15, Isaacs Set Test shortened at 15 seconds; MMSE, Mini-Mental State Examination


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