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Clinical Manifestations.

Andrew M Kiselica1, Sidonia Compton2, Shayne S-H Lin3

  • 1University of Georgia, Athens, GA, USA.

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

Cognitive dispersion measures show promise in identifying Lewy body disease and Alzheimer's disease biomarkers. While normed scores are sensitive to disease, their test-retest reliability in healthy older adults is limited.

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Area of Science:

  • Neuroscience
  • Cognitive Psychology
  • Gerontology

Background:

  • Cognitive dispersion, or within-person variability in neuropsychological test performance, is sensitive to cognitive impairment severity.
  • Dispersion measures predict disease progression in Alzheimer's disease (AD).
  • Lack of implementation tools has limited the clinical use of cognitive dispersion.

Purpose of the Study:

  • To develop normed score calculation methods for cognitive dispersion measures.
  • To assess the stability and test-retest reliability of these normed scores.
  • To examine the relationship between cognitive dispersion scores and Alzheimer's disease biomarkers.

Main Methods:

  • Developed demographically adjusted, regression-based normed scores for cognitive dispersion using data from 4,283 cognitively unimpaired older adults.
  • Assessed differentiation of Lewy body disease from cognitive impairment using receiver operating characteristic curves.
  • Evaluated mean level stability, test-retest reliability, and relationships with AD biomarkers (amyloid, tau, neurodegeneration) in relevant cohorts.

Main Results:

  • Normative tables and an Excel calculator for normed cognitive dispersion scores were created.
  • Cognitive dispersion scores accurately differentiated Lewy body disease from cognitively unimpaired individuals (AUC range: .81-.88).
  • Scores showed high stability (drm range: -.06-.01) but low test-retest reliability (r range: .35-.51) in unimpaired individuals. Increasing AD biomarker burden correlated with increased cognitive dispersion in impaired individuals.

Conclusions:

  • Normed cognitive dispersion scores demonstrate potential for clinical application, particularly in differentiating specific neurodegenerative diseases.
  • While test-retest reliability may be a limitation in cognitively unimpaired populations, dispersion scores show sensitivity to disease-related changes.
  • These findings support the utility of cognitive dispersion in understanding disease heterogeneity and progression in neurodegenerative disorders.