MCI Status, Amyloid and Tau Biomarkers, and Composite Cognitive Impairment Scores are Associated with Cogstate Performance in the Wisconsin Registry for Alzheimer's Prevention

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Alzheimer's & Dementia

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Background: CogState is a computerized cognitive battery spanning domains of memory, executive function, and speed and processing. CogState, designed to be robust to education level and efficient for repeated administration with minimal practice effects, holds potential for detecting early cognitive deficits that may prove to be due to preclinical Alzheimer’s disease (AD). This project aimed to provide convergent and construct validity for CogState in detecting preclinical AD during late-middle-age.

Methods: 279 late-middle-aged participants from the Wisconsin Registry for Alzheimer’s Prevention (mean age 63±7 years; 69% female; 37% APOE4+) completed a traditional paper-based neuropsychological battery and a CogState battery consisting of seven tests approximately six years post-baseline. A composite cognitive impairment score (CCI) was calculated using eight neuropsychological tests acquired longitudinally and was estimated at age 50 to remove confounding age effects; higher CCI indicates lower cognitive performance. Mild Cognitive Impairment (MCI) status (n=36) was determined by consensus using clinical and/or pyschometric criteria. A subset underwent cerebrospinal fluid (CSF) collection (n=36) and PET-PiB imaging (n=46). To determine clinical relevance of CogState, MCI and normal controls were compared by ANCOVA on select CogState variables controlling for age, literacy, gender, APOE4, AD family history, self-rated computer familiarity, and depression. To determine whether biomarkers (CSF Aβ42/Aβ40, CSF total-tau/Aβ42, global PiB burden) or CCI predict CogState performance, we ran multiple regression models controlling for age, sex, literacy, and computer familiarity.

Results: MCI participants performed significantly worse (p

Conclusions: MCI status, biomarkers for amyloid and tau, and CCI all predict performance on the CogState variables assessed in this study of late-middle-aged adults. CogState performance at a single time point may be an important indicator of preclinical AD processes.



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