A Neuropsychological Perspective on Defining Cognitive Impairment in the Clinical Study of Alzheimer's Disease: Towards a More Continuous Approach

Roos J. Jutten, Louisa Thompson*, Sietske A. M. Sikkes, Paul Maruff, José Luis Molinuevo, Henrik Zetterberg, Jessica Alber, David Faust, Serge Gauthier, Michael Gold, John Harrison, Athene K. W. Lee, Peter J. Snyder

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review


The global fight against Alzheimer's disease (AD) poses unique challenges for the field of neuropsychology. Along with the increased focus on early detection of AD pathophysiology, characterizing the earliest clinical stage of the disease has become a priority. We believe this is an important time for neuropsychology to consider how our approach to the characterization of cognitive impairment can be improved to detect subtle cognitive changes during early-stage AD. The present article aims to provide a critical examination of how we define and measure cognitive status in the context of aging and AD. First, we discuss pitfalls of current methods for defining cognitive impairment within the context of research shifting to earlier (pre)symptomatic disease stages. Next, we introduce a shift towards a more continuous approach for identifying early markers of cognitive decline and characterizing progression and discuss how this may be facilitated by novel assessment approaches. Finally, we summarize potential implications and challenges of characterizing cognitive status using a continuous approach.
Original languageEnglish
Pages (from-to)511-524
Number of pages14
JournalJournal of Alzheimer's Disease
Issue number2
Publication statusPublished - 2022

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