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65/100

✓ Peer-reviewed alzhub usefulness score 65 out of 100. Getting a diagnosis

Topic: Amyloid, tau and blood-test diagnosis

In the Baltimore Longitudinal Study of Aging (BLSA), we examined the temporal unfolding of declining performance on tests of episodic memory (Free Recall on the Free and Cued Selective Reminding Test), executive function (Category Fluency, Letter Fluency, and Trails), and Verbal Intelligence (Nelson, 1982; American Version of the Nelson Adult Reading Test [AMNART]) before the diagnosis of dementia in 92 subjects with incident Alzheimer's disease (AD) followed for up to 15 years before diagnosis. To examine the preclinical onset of cognitive decline, we aligned subjects at the time of initial AD diagnosis and examined the cognitive course preceding diagnosis. We found that declines in performance on tests of episodic memory accelerated 7 years before diagnosis. Declining performance on tests of executive function accelerated 2-3 years before diagnosis, and verbal intelligence declined in close proximity to diagnosis. This cognitive profile is compatible with pathologic data suggesting that structures which mediate memory are affected earlier than frontal structures during the preclinical onset of AD. It also supports the view that VIQ as estimated by the AMNART does not decline during the preclinical onset of AD.

Key findings

We found that declines in performance on tests of episodic memory accelerated 7 years before diagnosis.
This cognitive profile is compatible with pathologic data suggesting that structures which mediate memory are affected earlier than frontal structures during the preclinical onset of AD.

Why it matters

Looking back over up to 15 years of test results from 92 people in the Baltimore Longitudinal Study of Aging who went on to be diagnosed with Alzheimer's disease, researchers found that memory-test decline sped up about 7 years before diagnosis, decline on executive-function tests sped up 2–3 years before, and verbal intelligence (estimated by a reading test) declined only close to diagnosis. The authors say this order fits with memory-related brain regions being affected before frontal ones. Because people were lined up by a diagnosis they had already received, this describes group patterns before diagnosis. It does not predict who will develop Alzheimer's and does not test any treatment.

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Study details

Study designlongitudinal study
Participants92
Evidence strengthModerate

Limitations

This analysis is based on a relatively small group (92 people who developed AD) from one long-running study (the Baltimore Longitudinal Study of Aging), and relies on retrospectively aligning people's data to their eventual diagnosis date.

How this study scored 65/100

Published in a peer-reviewed journal, and it is a longitudinal study following the same people over time. Scored zero for effect reported and randomised / blinded because the record does not state it.

Component	Points	Why
Journal tier	7 / 10	Tier 3 — peer-reviewed journal (Journal of the International Neuropsychological Society : JINS)
Journal's citation record	2 / 4	Journal of the International Neuropsychological Society: journal h-index 176 (OpenAlex, 2026-10-29)
Study design	7 / 12	A longitudinal study following the same people over time
Strength of evidence	3 / 5	Rated “moderate” in our summary
Peer-review validation	10 / 10	Peer-reviewed. Published as an article in a named peer-reviewed journal.
How recent	1 / 5	2008 — within 20 year(s) of the newest study here
Sample size	1 / 4	92 participants
Effect reported	0 / 3	No effect size reported — scores zero (not stated in the record — scored 0)
Studied in people	3 / 3	Studied in people (participant count stated)
Randomised / blinded	0 / 2	No randomisation or blinding stated — scores zero (not stated in the record — scored 0)
Times cited	6 / 7	Cited 425 times (OpenAlex, 2026-10-10)
Citations per year	4 / 5	21.2 citations a year over 20 year(s) since 2008
Impact for its field and year	4 / 6	Cited 12.8× the average for papers of its field and year (OpenAlex FWCI)
Cited by studies here	4 / 6	Cited by 33 other studies in this library
Still being cited	3 / 4	Cited 69 times in 2024–2026 (2026 still in progress; OpenAlex)
Senior author's track record	3 / 4	Last-listed author Claudia H. Kawas: h-index 85 (OpenAlex, whole career)
Institution's track record	3 / 3	National Institutes of Health: institution h-index 2,723 (OpenAlex)
Multi-centre collaboration	2 / 3	OpenAlex lists 5 institution(s) in 1 country
Indexed in PubMed	2 / 2	Indexed in PubMed (PMID 18282324)
Free to read	0 / 2	Behind a paywall — scores zero
Total	65 / 100	—

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Read the original

Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).

Cite this study APA, Vancouver, BibTeX · download .bib or .ris

Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.

APA 7th

Grober, E., Hall, C. B., Lipton, R. B., Zonderman, A. B., Resnick, S. M., & Kawas, C. (2008). Memory impairment, executive dysfunction, and intellectual decline in preclinical Alzheimer's disease. Journal of the International Neuropsychological Society : JINS. https://doi.org/10.1017/s1355617708080302

Vancouver

Grober E, Hall CB, Lipton RB, Zonderman AB, Resnick SM, Kawas C. Memory impairment, executive dysfunction, and intellectual decline in preclinical Alzheimer's disease. Journal of the International Neuropsychological Society : JINS. 2008. doi:10.1017/s1355617708080302. PMID: 18282324.

BibTeX

@article{grober2008-18282324,
  author  = {Grober, E. and Hall, C. B. and Lipton, R. B. and Zonderman, A. B. and Resnick, S. M. and Kawas, C.},
  title   = {{Memory impairment, executive dysfunction, and intellectual decline in preclinical Alzheimer's disease}},
  journal = {Journal of the International Neuropsychological Society : JINS},
  year    = {2008},
  doi     = {10.1017/s1355617708080302},
  pmid    = {18282324},
  url     = {https://doi.org/10.1017/s1355617708080302}
}

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