COGNITIVE TEST-SCORES IN COMMUNITY-BASED OLDER ADULTS WITH AND WITHOUT DEMENTIA

In an epidemiological survey of a rural, largely blue-collar, communit y, 1,363 randomly selected adults, aged 65 + years, were administered a cognitive screening battery (including in part the CERAD neuropsycho logical tests): Mini-Mental State Examination; Word List Learning, Rec all, and Recognition; Story, Immediate and Delayed Recall; Boston Nami ng Test; Verbal Fluency; Temporal Orientation; Constructional Praxis; Draw a Clock; and Trailmaking. Cognitively impaired subjects and cogni tively intact controls underwent independent standardized diagnostic a ssessments and were rated on Clinical Dementia Rating (CDR) scale. Ove rall, subjects at higher CDR levels (more severe dementia) had worse s cores on all tests; showing that standard neuropsychological tests are valid for characterizing the cognitive impairments seen in dementia, even in community settings. However, non-demented scores on the CERAD tests in this community-based sample were lower than reported from CER AD's pooled healthy controls from Alzheimer's Disease Centers (ADCs) n ationwide. Thus, 'normal' scores from specialty dementia clinics, wher e there may be a selection bias, may differ from normative scores from rural and/or less-educated populations. Patients from such population s may be functionally intact despite low test scores. Community-based studies are required to complement specialty clinic-based studies of d ementia and cognitive functioning.