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Practice effects persist over two decades of cognitive testing: Implications for longitudinal research
Jeremy A Elman1,2, Erik Buchholz1,2, Rouhui Chen3
1Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
Medrxiv : the Preprint Server for Health Sciences
|June 30, 2025
Summary
Practice effects (PEs) from repeated cognitive testing persist for decades. Accounting for PEs in longitudinal studies improves detection of cognitive decline and mild cognitive impairment (MCI).
Area of Science:
- Neuroscience
- Cognitive Psychology
- Gerontology
Background:
- Repeated cognitive testing can lead to practice effects (PEs), artificially inflating scores.
- The persistence of PEs across multiple long-term assessments is not well understood.
Purpose of the Study:
- To investigate the persistence of PEs across multiple assessments from midlife to old age.
- To determine the impact of PEs on cognitive trajectories and mild cognitive impairment (MCI) prevalence.
Main Methods:
- Analysis of data from 1,608 men in the Vietnam Era Twin Study of Aging (VETSA).
- Neuropsychological assessment with 30 measures across 4 waves (~6-year intervals) spanning up to 20 years.
- Used age-matched replacement participants to estimate PEs and compared cognitive trajectories using unadjusted vs. PE-adjusted scores.
Main Results:
- Significant PEs were observed in 7-12 out of 30 tests across follow-ups, particularly in episodic memory and visuospatial domains.
- Adjusting for PEs revealed improved detection of cognitive decline.
- PE adjustment led to up to 20% higher MCI prevalence.
Conclusions:
- Practice effects are persistent phenomena across multiple assessments and decades.
- Accounting for PEs is crucial for accurate interpretation of cognitive changes in longitudinal aging studies.
Keywords:
cognitive changelongitudinal testingmild cognitive impairmentpractice effectsrepeat testingserial testingMore Related Videos
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