Journals of Gerontology Series B: Psychological Sciences and Social Sciences, Vol 54, Issue 2 P116-P124, Copyright © 1999 by The Gerontological Society of America

ARTICLES

A method for assessing clinically relevant individual cognitive change in older adult populations

SM Sawrie, DC Marson, AL Boothe and LE Harrell
Department of Neurology, University of Alabama at Birmingham, USA. [email protected]

The evaluation of individual cognitive change has relied heavily upon the raw change score, defined simply as the difference between follow- up and baseline scores. However, raw changes scores are susceptible to the confounding effects of both regression-to-the-mean and practice effect. The clinical relevance of raw change scores for the older adult is also obscured by normal, age-related cognitive change. The present study illustrates the use of a standardized regression-based (SRB) methodology to generate an alternative to the raw change score; the SRB change score. SRB change scores provide a standardized alternative to the raw change score, allowing the clinician to evaluate the magnitude of change on one or more variables along a common metric that controls for practice effect, regression-to-the-mean, and normal cognitive decline. Case data illustrate how SRB change scores can identify clinically relevant cognitive change in the individual older adult patient.

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