Abstract
Objective: Neuropsychologists have difficulty detecting cognitive decline in high-functioning older adults because greater neurological change must occur before cognitive performances are low enough to indicate decline or impairment. For high-functioning older adults, early neurological changes may correspond with subjective cognitive concerns and an absence of high scores. This study compared high- functioning older adults with and without subjective cognitive concerns, hypothesizing those with cognitive concerns would have fewer high scores on neuropsychological testing and lower frontoparietal network volume, thickness, and connectivity.
Method: Participants had high estimated premorbid functioning (e.g., estimated intelligence ≥75th percentile or college-educated) and were divided based on subjective cognitive concerns. Participants with cognitive concerns (n = 35; 74.0 ± 9.6 years old, 62.9% female, 94.3% White) and without cognitive concerns (n = 33; 71.2 ± 7.1 years old, 75.8% female, 100% White) completed a neuropsychological battery of memory and executive function tests and underwent structural and resting-state magnetic resonance imaging, calculating frontoparietal network volume, thickness, and connectivity.
Results: Participants with and without cognitive concerns had comparable numbers of low test scores (≤16th percentile), p = .103, d = .40. Participants with cognitive concerns had fewer high scores (≥75th percentile), p = .004, d = .71, and lower mean frontoparietal network volumes (left: p = .004, d = .74; right: p = .011, d = .66) and cortical thickness (left: p = .010, d = .66; right: p = .033, d = .54), but did not differ in network connectivity. Conclusions: Among high-functioning older adults, subjective cognitive decline may correspond with an absence of high scores on neuropsychological testing and underlying changes in the frontoparietal network that would not be detected by a traditional focus on low cognitive test scores.
Document Type
Article
Publication Date
2024
Digital Object Identifier (DOI)
https://doi.org/10.1017/S1355617723000607
Funding Information
This research was funded by the National Institute on Aging (NIA) of the National Institutes of Health (NIH) (#R01-AG026307). This work was also supported, in part, by a Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) grant (#K12-DA035150) from the National Institute on Drug Abuse (NIDA) of the NIH and the University of Kentucky Alzheimer’s Disease Research Center funded by the National Institute on Aging (#P30AG072946). The authors have no competing interests or conflicts of interest to report.
Repository Citation
Karr, Justin E.; Hakun, Jonathan G.; Elbich, Daniel B.; Pinheiro, Cristina N.; and Schmitt, Frederick A., "Detecting cognitive decline in high-functioning older adults: The relationship between subjective cognitive concerns, frequency of high neuropsychological test scores, and the frontoparietal control network" (2024). Neurology Faculty Publications. 100.
https://uknowledge.uky.edu/neurology_facpub/100
Included in
Neurology Commons, Other Neuroscience and Neurobiology Commons, Other Psychiatry and Psychology Commons
Notes/Citation Information
Copyright © INS. Published by Cambridge University Press 2023. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:// creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.