Introduction: Generational changes warrant recalibrating normative cognitive measures to detect changes indicative of dementia risk within each generation.
Methods: We performed linear regressions to compare eight neuropsychological (NP) tests among three-generation cohorts at baseline in Framingham Heart Study (FHS, n = 4787) and conducted Cox regressions to investigate the relationships of NP tests with generation-specific dementia risk.
Results: The FHS second and third generations performed better than the first generation for seven NP tests (0.14-0.81 standard deviation improvement, P ≤ .001) while the second and third generations performed similarly for six of eight NP tests (P > .05). One standard deviation better performance was associated with a higher reduction in incident dementia risk in the second than the first generation (35% vs. 24%, P interaction = .02) for the similarities test.
Discussion: Our findings suggest cohort-based norms are needed for cognitive assessment for the diagnosis of cognitive impairment and dementia.
Keywords: Alzheimer's disease; cognitive function; dementia; neuropsychological test; norms.
© 2023 The Authors. Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association.