BHA-CS: A novel cognitive composite for Alzheimer's disease and related disorders

Alzheimer's & Dementia : Diagnosis, Assessment & Disease Monitoring

Alzheimers Dement (Amst). 2020 Jun 21;12(1):e12042. doi: 10.1002/dad2.12042. eCollection 2020.

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.

Keywords: Alzheimer disease; computerized cognitive assessment; dementia; early detection; neuropsychology; psychometrics.

PMID: 32582835 | DOI: 10.1002/dad2.12042