ASSOCIATIONS OF STATUS AND CHANGE MEASURES OF NEUROPSYCHOLOGICAL FUNCTION WITH PATHOLOGICAL-CHANGES IN ELDERLY, ORIGINALLY NONDEMENTED SUBJECTS

Objective: To describe the association between status and change of ne uropsychological function and postmortem neuropathologic findings in s ubjects with Alzheimer's disease, vascular dementia, normal aging, and pathologic aging. Design: Volunteer cohort study. Setting: Volunteers were interviewed and tested in outpatient-clinical research offices. Participants: Nondemented, healthy, community-residing subjects, initi ally between 75 and 85 years of age, who participated in the Bronx Agi ng Study and had at least 2 years of neuropsychological data and quant itative neuropathologic examinations. Main Outcome Measures: Initial s ummary neuropsychological score, rate of change score. Results: Summar y neuropsychological scores at baseline in subjects who subsequently d eveloped pathologically confirmed Alzheimer's disease or vascular deme ntia were 0.8 z units lower than those of subjects classified in the n ormal or pathologic aging subgroups (P<.05). Subjects with Alzheimer's disease showed more neuropsychological change over time than subjects in the normal or pathologic aging groups (P<.001). Normal subjects an d subjects with pathologic aging did not differ in baseline scores or rate of change. Level of education was strongly associated with initia l neuropsychological scores (P<.004), but not with change scores. Conc lusions: Among elderly, initially nondemented subjects who were follow ed up until death, subjects with pathologically confirmed Alzheimer's disease or vascular dementia had lower neuropsychological scores at in itial evaluation than normal subjects or subjects with pathologic agin g. Subjects with Alzheimer's disease had a more rapid rate of decline than normal subjects or subjects with pathologic aging.