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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.

Jeremy A Elman1,2, Erik Buchholz1,3, Rouhui Chen4

  • 1University of California San Diego, La Jolla, CA, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 26, 2025
PubMed
Summary
This summary is machine-generated.

Practice effects (PEs) persist for years in cognitive testing, even with long intervals. Adjusting for PEs in longitudinal studies is crucial for accurate MCI detection and diagnosis.

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Area of Science:

  • Neuroscience
  • Gerontology
  • Cognitive Psychology

Background:

  • Repeated cognitive testing can lead to practice effects (PEs), influencing performance over time.
  • Adjusting for PEs is important for accurate detection of mild cognitive impairment (MCI) and validity of Alzheimer's biomarker concordance.
  • The persistence of PEs across multiple long-term follow-ups, alongside age-related decline, requires further investigation.

Purpose of the Study:

  • To examine the persistence of practice effects (PEs) across 17 years in a nonclinical sample from midlife to old age.
  • To assess the impact of PE adjustment on cognitive scores and mild cognitive impairment (MCI) prevalence over time.
  • To determine the extent to which PEs influence longitudinal cognitive assessments in aging.

Main Methods:

  • Utilized data from the Vietnam Era Twin Study of Aging (VETSA) with 1,608 male participants across 4 waves (ages 56-73).
  • Estimated PEs for 30 tests using generalized estimating equations, comparing returnees to attrition replacements at each wave.
  • Calculated unadjusted and PE-adjusted cognitive scores for multiple domains and compared MCI prevalence before and after PE adjustment.

Main Results:

  • Significant PEs were observed for numerous cognitive tests across all follow-up waves, particularly in episodic and visual memory.
  • PE-adjusted cognitive scores were consistently lower than unadjusted scores, except for fluency.
  • MCI prevalence increased by up to 20% after PE adjustment, indicating earlier detection.

Conclusions:

  • Practice effects (PEs) are persistent across multiple decades and long testing intervals.
  • Even minor PEs can significantly impact cognitive scores, leading to earlier identification of mild cognitive impairment (MCI).
  • Accounting for PEs in longitudinal studies is essential for accurate diagnosis, improved clinical trial efficiency, and reduced costs.