Browsing by Subject "Word List Learning"

Objectives – Ageing is progressing worldwide. Cognitive decline and dementia are highly associated with age and have significant economic impacts. Alzheimer's disease (AD) is the major cause of dementia. In Finland the 'baby boomer' generation (born 1945-1949) shall already during the 2020s increase the amount of the very old substantially. The CERAD (The Consortium to Establish a Registry for Alzheimer's Disease) neuropsychological battery (nb) is used as an evaluation tool for dementia. In Finland, CERAD-nb was introduced in 1999 and has been used in primary health care as a screening instrument to detect memory deficits. The continuum would benefit of updated clinical dementia/MCI assessment tools, norms and methodologies for the larger scale cognitive screening as the amount of the very old is soon growing remarkably. The main focus of this study is the overall performance of general population on selected CERAD-nb variables and how it fits to previously established Finnish cut-off scores. Materials and Methods – The study data is derived from the Finnish nationwide Health 2011 health examination survey (Health 2011), which was carried out in 2011. The study population consisted of a sample (n=4544) of Finnish subjects aged from 30 to 100 years belonging to either the lowest, middle or highest education class. Because of health-related factors possibly affecting cognitive performance, medical exclusion criteria were used and due to the high prevalence of dementia at older age, a cognitive status-screening test was used for subjects aged 55 and over. The final sample size was 4174 subjects. A weighted variable was used and thus the statistical analyses (weighted n=3389) prepared are estimations of population quantities. The sample underwent a CERAD-nb investigation for variables Verbal Fluency Animal Category (VFA), Word List Memory (WLM), Word List Recall (WLR) and Word List Savings (WLS) as a part of a wider Health 2011 examination procedure. Results – The total effect size of demographic variables was largest and clearest in WLM (30%) and WLR (27%) and the independent effect size of age (11% in both) was noticeable, as well. The results showed a continuous downward slope by advancing age steps: in the age groups 30-54 years, 55-64 years, 65-74 years and ≥75 years in WLM, in age groups 30-49, 50-54 years, 55-64 years, 65-74 years and ≥75 years in WLR, in age groups 30-49 years, 50-69 years, 70-74 years and ≥75 years in VFA, and finally the mildest effect in WLS in the group ≥55 with only age groups of 55-74 years and ≥75 years showing a decline. Education had the largest independent effect (5%) in VFA and WLM. The highest education class differed (p < .001) from other education classes for all variables. Gender had only a mild effect, largest in WLM (3%) and women mainly performing better. In total 25% (854 subjects) fell below the previously established cut-off scores. To the group <55 years belonged 26% (221 subjects) of those and 74% (633 subjects) to the group ≥75, of which 59% were in the lowest education class, 52% men and 32% were 75 years and over. Conclusions – Significant differences in performance between the age and education groups and minor differences between genders are found. Proposals for new normative scores for VFA, WLM, WLR and WLS are presented in Appendices. Indications of differences in the education-age-gender synergetic effect are found in affected variables for performance falling below the previously established cut-off scores. Most importantly, a clear indication for need of an update of the national normative and cut-off scores of the whole CERAD-nb for the age 55 is found.