Development of amyloid-negative neuropsychological norms using GAMLSS

Recent research has suggested increased sensitivity of Alzheimer's disease (AD)-negative neuropsychological norms; concurrently, generalized additive models for location, scale, and shape (GAMLSS) have emerged as a promising alternative to traditional norming approaches. Here, we developed amyloid β-negative (Aβ-) next-generation norms (NGN) for a comprehensive neuropsychological battery using GAMLSS.

We included N = 987 cognitively normal (CN) individuals from a Spanish multicenter study with extensive neuropsychological data and cerebrospinal fluid AD biomarker assessment. NGN were developed using GAMLSS based on the performance of n = 774 Aβ- CN individuals aged 30-90 years.

Age-, education-, and sex-adjusted z-scores were obtained for 14 measures covering the main cognitive domains (memory, language, attention/executive, and visuospatial functions). A user-friendly calculator for the z-scores was made available in an open-access ShinyApp to facilitate their application.

NGN may improve the detection of objective cognitive impairment in clinical and research settings.

Brain amyloid β (Aβ) is associated with poorer performance in cognitively normal individuals.We provide GAMLSS-based Aβ-negative norms for 14 neuropsychological measures.Age, education, and often sex significantly influence cognitive performance.An online calculator for the demographically adjusted z-scores is freely available.