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Introduction and method

The first section of the article introduces the reader to the subject content and basis for the research. Jason Hassenstab et al. seek to demonstrate the possibility of using practice effects for the diagnosis of Stage III preclinical Alzheimer’s disease. The occurrence of dementia tends to increase as people advance in years. Any risk or diagnosis involving dementia involves examination of the cognitive function. Testing individuals frequently using the same machines will cause familiarity. If the same instruments are used more than once in cognitive tests, then the patients’ scores will continue to increase with usage. This means that if the patients do not make any gains in their performance, then there is a problem with their cognitive function.  

The authors are cautious in their observations, and they note that patients suffering from progressive dementia disorders can fail to have any progressive gains. This may indicate that the patient’s cognitive performance is stable or it may reflect a consequence of their disease. However, for some patients, lack of practice effects is a more serious sign of their cognitive decline. This is especially the case with patients suffering from amnestic mild cognitive impairment. Such precautions are important when using practice effects to determine the presence of a disease. They indicate the importance of focusing on other underlying issues that the patients might have. They also compel the diagnosing physicians to undertake a deeper analysis of the patient since some conditions can have the same symptoms.

The researchers worked with participants who were part of longitudinal studies. The use of longitudinal studies in research is important for careful analysis of cause and effect. They also enable the researchers to compare data over the period of study. Use of the studies makes it easier to observe and understand the participants and the subject in question. The use of the studies was particularly important in this case because the researchers were dealing with aging and dementia. The authors’ exclusion and inclusion criteria singles out the specific participants they wanted in the study. They wanted to work with individuals who did not have cognitive impairments. Most of the participants in the study were white and college educated. The methods section in the research is important in determining whether the research can be applied in all situations. It is important for the researchers to consider how they can ensure that their research is applicable, especially when they are dealing with cases such as dementia. It is probable that the work from the research might not benefit all older people suffering from, or who are at the risk of, developing Alzheimer’s.

The researchers conducted both clinical and neuropsychological assessments. The CDR scale was used by a certified person in the healthcare center. The inclusion of professionals such as nurse and physicians was important because of the familiarity they have with the measurements and with patients. The researchers gave the participants adequate time to complete their neuropsychological assessment, which was done by trained psychometricians. There were many factors to consider during measurements and it was important for the researchers to get as much information as they could.

The research is detailed concerning the statistical analysis employed. There were many factors to be considered during measurements and this made the analysis significant. Some of the demographic measurements used included age, gender, and level of education. Using the right statistical analysis tools is important as it helps in better interpretation of the results obtained from the research. The tools used for analysis included linear mixed-effects models and subdistribution hazards model.

 Results and discussion Conclusion

The researchers have discussed the results and put it in a table format, which makes it easy to read and analyze. Many researchers find it necessary to tabulate the results as this makes it easier to comprehend. Based on the results from the study, the researchers were able to determine that global cognition and episodic memory are both important for showing practice effects. They were also able to highlight the importance and significance of practice effects, especially when dealing with older patients. Some people are able to mask cognitive decline. They only realize that they may have cognitive impairment later. At this time, it becomes more challenging to handle the condition. The results are significant especially for people dealing with progressive diseases and other cognitive conditions.

The discussion section restates the purpose of the research and proceeds to analyze the results. This section is important in explaining the results and in enabling the researchers to find practical application for their studies. It is a significant section for readers. The use of longitudinal study enabled the researchers to access the participants’ previous information and data, which were necessary for clear result analysis. According to data from the longitudinal studies, some of the patients had been reviewed annually. These patients had shown improvement of their episodic memory and this was important in reducing the risk of the disease progression to symptomatic AD. This indicates that the absence of practice effects is an indication of Stage III preclinical Alzheimer’s. It is important for researchers to consider whether there have been other test administrations, which they could use for research. However, they cannot depend on the information they get from the previous studies because they can get false results. Depending on such tests could lead to inaccurate measurements and conclusions and this will affect the validity and reliability of the research.

The research concludes by identifying the limitations present in the study. They note that the measurements used are not sensitive to cognition domains. This limitation prevented the researchers to include important factors such as processing speed and attention control, both of which are cognitive processes. The authors note that the demographics of their participants may have acted as a limitation. They suggest the importance of conducting further research which would involve a more diverse demographic and determining whether the research would yield the same results. Additionally, the authors note that their research may not be generalized because they only measured the practice effects on annual intervals. This would not be applicable in a clinical setting. Other researchers intending to advance the information from the study would have to find participants whose practice effects are also annual. Since it would be hard to find other participants in the same situation, the researchers would have to begin a longitudinal study on their own. The researchers limited their model on the first three assessments, and this might have affected their results

Reference

Hassenstab, J., Ruvolo, D., Jasielee, M., Xiong, C., Grant, E., & Morris, C. J. (2015). Absence of practice effects in preclinical Alzheimer’s Disease. Neuropsychology, 29(6), 940-948