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Published on: September 20, 2018
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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
Summary
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.
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.
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