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A Metadata Extraction Approach for Clinical Case Reports to Enable Advanced Understanding of Biomedical Concepts
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Clinical Manifestations.

Laiss Bertola1, Isabela M Bensenor2, Paulo A Lotufo3

  • 1University of Sao Paulo Medical School, Sao Paulo, Sao Paulo, Brazil.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

Increased cognitive variability, a measure of score dispersion, may signal early cognitive impairment in older adults. This study found higher intraindividual cognitive variability at baseline predicted a lower risk of cognitive impairment eight years later.

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Area of Science:

  • Neuroscience
  • Cognitive Psychology
  • Epidemiology

Background:

  • Neuropsychological assessments traditionally focus on average performance.
  • Increased intraindividual cognitive variability (IICV) in middle-aged and older adults can indicate early cognitive impairment, even in cognitively normal individuals.
  • IICV, or score dispersion, is linked to a higher risk of dementia.

Purpose of the Study:

  • To determine if baseline IICV predicts cognitive impairment over an eight-year period.
  • To investigate the association between cognitive variability and future cognitive decline.

Main Methods:

  • Analysis of data from 9,914 participants in the prospective ELSA-Brasil cohort study.
  • Measurement of IICV using the coefficient of variation (CoV), adjusted for global cognitive ability.
  • Logistic regression models, controlling for sociodemographic and clinical factors, were used to assess the odds of cognitive impairment at Wave 3.

Main Results:

  • A total of 13% of participants were diagnosed with cognitive impairment after eight years.
  • Higher baseline CoV scores were associated with a decreased odds of developing cognitive impairment (OR 0.94 per unit increase).
  • A small percentage (2.4%) exhibited atypical IICV at baseline.

Conclusions:

  • Elevated IICV at baseline is associated with a reduced risk of cognitive impairment over eight years.
  • Cognitive dispersion, measured by IICV, may serve as a valuable biomarker for identifying individuals at risk for preclinical cognitive impairment.
  • Neuropsychological assessments should consider cognitive variability alongside mean-level performance.