Basic and Applied Memory Research: Practical Applications - Vol. 2

By Douglas J. Herrmann; Cathy McEvoy et al. | Go to book overview

processes that are impaired is needed to analyze and understand the mechanisms of cognitive impairment.


Impairment Can Be Detected Earlier, With Greater Sensitivity

Detection of impairment by deviation from expected performance is more appropriate and sensitive than detection of impairment by deviation from the mean. Impairment cannot be detected by deviation from the mean until performance has fallen significantly below the mean. Deviation from the mean cannot detect impairment when performance has declined but still is in the normal range. Deviation from expected performance can detect impairment when performance has declined but still is in the normal range. Deviation from expected performance shown by correlated testing allows earlier detection of milder impairment that may be more responsive to treatment.


The Relationship of Correlated Test Scores May Be Affected Less by Cohort Effects

Age differences on a single cognitive test may be confounded by cohort effects. However, if cohort effects influence control and experimental tests to the same degree, then the relationship between control and experimental tests should be relatively free of cohort effects. Because the control and experimental tests are very similar and are correlated, it is plausible that both may be affected by the same cohort effects to approximately the same extent. When that is the case, cohort effects on the relationship between control and experimental tests may be less than cohort effects on either test alone. Attenuation of cohort effects would not be expected when two correlated tests are not similar. When correlated tests are as similar as control and experimental tests, cohort effects on the relationship between control and experimental tests may be less than cohort effects on either test alone.


CONCLUSIONS

Acquired cognitive impairment can only be detected by detecting cognitive change. A single test cannot show change, but correlated testing under correlated control and experimental conditions can detect cognitive change (impairment). The regression of experimental performance on control performance by unimpaired subjects can predict expected performance on the experimental test from performance on the control test. Experimental performance that deviates significantly from expected performance shows

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