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Estimated pre-morbid IQ effects on cognitive and functional outcomes in Alzheimer disease a longitudinal study in a treated cohort.doc

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Estimated pre-morbid IQ effects on cognitive and functional outcomes in Alzheimer disease a longitudinal study in a treated cohort

BMC Psychiatry BioMedCentral Research article Open Access Estimated pre-morbid IQ effects on cognitive and functional outcomes in Alzheimer disease: a longitudinal study in a treated cohort John M Starr*1 and Jane Lonie2 Address: 1Geriatric Medicine unit, University of Edinburgh, Craigleith Road, Edinburgh, UK and 2Lothian Memory Treatment Service, NHS Lothian, Royal Edinburgh Hospital, Edinburgh, UK Email: John M Starr* - jstarr@staffmail.ed.ac.uk; Jane Lonie - Jane.Lonie@lpct.scot.nhs.uk * Corresponding author Published: 21 April 2008 Received: 23 July 2007 Accepted: 21 April 2008 BMC Psychiatry 2008, 8:27 doi:10.1186/1471-244X-8-27 This article is available from: /1471-244X/8/27 ? 2008 Starr and Lonie; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Background: Cognitive reserve is thought to influence the degree of neuropathology needed for diagnosis of Alzheimer disease (AD). Cognitive reserve can be operationally defined as the hypothesized capacity of the mature adult brain to sustain the effects of disease or injury without manifesting clinical symptoms of AD, but sufficient to cause clinical dementia in an individual possessing less cognitive reserve. Its effect on the subsequent course of AD is less clear. Pre- morbid IQ is a useful measure of cognitive reserve. Methods: We studied 659 consecutive patients with AD at a tertiary referral memory clinic. Patients were assessed on six cognitive tests at baseline. Activities of Daily Living (ADL) were measured on the Instrumental Activities of Daily Living (IADL) scale and Physical Self-Maintenance Scale (PSMS). The National Adult Reading Test (NART) was used to estimate pre-morbid IQ. Patients w