BHA‐CS: A novel cognitive composite for Alzheimer's disease and related disorders
Elena Tsoy, Sabrina J. Erlhoff, Collette A. Goode, Karen A. Dorsman, Suchanan Kanjanapong, Cutter A. Lindbergh, Renaud La Joie, Amelia Strom, Gil D. Rabinovici, Serggio Lanata, Bruce L. Miller, Sarah Tomaszewski Farias, Joel H. Kramer, Katherine P. Rankin, Katherine L. Possin
Abstract
INTRODUCTION: Composite scores based on psychometrically rigorous cognitive assessments are well suited for early diagnosis and disease monitoring. METHODS: We developed and cross-validated the Brain Health Assessment-Cognitive Score (BHA-CS), based on a brief computerized battery, in 451 cognitively normal (CN) and 399 cognitively impaired (mild cognitive impairment [MCI] or dementia) older adults. We investigated its long-term reliability and reliable change indices at longitudinal follow-up (N = 340), and the association with amyloid beta (Aβ) burden in the CN subgroup with Aβ positron emission tomography (N = 119). RESULTS: The BHA-CS was accurate at detecting cognitive impairment and exhibited excellent long-term stability. Reliable decline over one year was detected in 75% of participants with dementia, 44% with MCI, and 3% of CN. Among CN, the Aβ-positive group showed worse longitudinal performance on the BHA-CS compared to the Aβ-negative group. DISCUSSION: The BHA-CS is sensitive to cognitive decline in preclinical and prodromal neurodegenerative disease.