Longitudinal Assessment of Cognitive Decline: Distinguishing Features and Trends in Cognitive Challenge Test among Older Adults with Mild Cognitive Impairment and Amyloid PET Status

• Published in: The American journal of geriatric psychiatry 2024-04, Vol.32 (4), p.S86-S86
• Main Authors: Ortiz, Juliana, Correa, Rebecca, Bosworth, Brooke, Gallardo, Liz, Crenshaw, Kirsten Horne, Ortega, Alexandra, Georgiou, Mike, Sfakianaki, Efrosyni, Loewenstein, David, Curiel, Rosie
• Format: Article
• Language: English
• ISSN: 1064-7481; 1545-7214
• DOI: 10.1016/j.jagp.2024.01.166

The Loewenstein-Acevedo Scales of Semantic Interference and Learning (LASSI-L) is a sensitive measure of early cognitive impairment. It is unclear how performance over time on this cognitive challenge test (CCT) differentiates older adults who are cognitively unimpaired (CU) and amyloid PET negative (A-), from those with amnestic Mild Cognitive Impairment (aMCI) who are either A- or amyloid PET positive (A+) over long periods of time. 94 participants with a minimum of three LASSI-L assessments administered annually (baseline visit, and 2 annual follow-ups) were evaluated. 63 participants were diagnosed with aMCI (27 A+ and 36 A-) at baseline. All 31 CU participants were PET A- during the initial evaluation. The average length of the last follow-up period was 39.05 (SD=12.1) months with a maximum span of 71.4 months after the initial visit. Results showed a main group effect, but a lack of a time effect. Cued B1 and Cued B2 semantic intrusions (related to difficulties with self-monitoring and inhibitory control) and failure to recover from proactive semantic interference (frPSI; Cued B2 recall), were significantly impaired in aMCI A+ when compared to both aMCI A- counterparts and CU A- controls. In addition, a significant Group X Time Interaction for Cued A2 recall (maximum learning) showed higher scores for CU participants while the aMCI A+ evidenced decreased scores across subsequent follow-up visits. Semantic intrusion errors appear to be a distinguishing feature of aMCI A+ participants after adjustment for global mental status and demographic factors up to an average of 39 months after initial evaluation. Moreover, initial learning showed a modest and inconsistent increase among cognitively unimpaired participants but a decrease in aMCI A+ scores over time.