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Clinical Manifestations.

Joshua M Garcia1, Leslie S Gaynor2,3, Adam M Staffaroni4

  • 1University of Houston, Houston, TX, USA.

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

Different scoring methods for global cognition yield similar results when tracking cognitive aging. These composites correlate well with cognitive function and brain structure, aiding in understanding cognitive decline.

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Area of Science:

  • Neuroscience
  • Cognitive Psychology
  • Gerontology

Background:

  • Global cognitive metrics are vital for tracking cognitive aging.
  • No consensus exists on the optimal definition or measurement of global cognition.
  • This study aimed to compare global cognition scoring methods against validity indicators.

Purpose of the Study:

  • To compare various scoring methods for global cognition.
  • To assess the validity of these methods using indicators of cognition, functioning, and neuroimaging.
  • To determine the most effective approach for measuring global cognitive function.

Main Methods:

  • Harmonized factor scores from memory, executive function, language, and visuospatial domains were used.
  • Scoring methods included mean z-scoring, confirmatory factor analysis (CFA), principal component analysis (PCA), and Mini-Mental Status Examination (MMSE) composite weighting.
  • Validity indicators included the Clinical Dementia Rating Scale Sum of Boxes (CDR-SB), MMSE, and neuroimaging metrics (brain volume, ventricular volume, frontal lobe volume, medial temporal lobe volume).
  • Receiver operating characteristic (ROC) curves assessed the detection of cognitive impairment.

Main Results:

  • Cognitive composites were highly intercorrelated and showed strong correlations with cognition/functioning measures (CDR-SB, MMSE).
  • All composites effectively detected cognitive impairment (AUCs=0.84-0.88).
  • Composites demonstrated strong and similar correlations with most neuroimaging metrics, generally outperforming standalone measures, with medial temporal lobe and ventricular volumes showing the strongest associations.

Conclusions:

  • Global cognitive composites, regardless of scoring method, show consistent relationships with cognitive/functioning indicators and structural neuroimaging.
  • The MMSEComposite method exhibited the strongest association with CDR but a weaker link to frontal lobe volume.
  • Cognitive composites offer a more robust association with structural neuroimaging compared to individual cognitive measures.