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Peer-reviewedCC BY 4.0Frontiers in Aging Neuroscience

Beyond retest gains: episodic memory practice effects and longitudinal cognitive trajectories in cognitively healthy adults

  • Simon Fankhauser1,2,3
  • Gabriele Cattaneo1,3,4
  • Gemma Albi-Villuendas1,3,4
  • Javier Solana-Sánchez1,3,4
  • Álvaro Pascual-Leone5,6
  • David Bartrés-Faz2,7
7 affiliations
  1. 1Guttmann Hospital de Neurorehabilitació, Badalona, Spain
  2. 2Departament de Medicina, Facultat de Medicina i Ciències de la Salut, i Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
  3. 3Institut de Recerca Germans Trias i Pujol, Badalona, Spain
  4. 4Institut Universitari de Neurorehabilitació Guttmann adscrit a la Universitat Autònoma de Barcelona, Badalona, Spain
  5. 5Hinda and Arthur Marcus Institute for Aging Research and Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, United States
  6. 6Department of Neurology, Harvard Medical School, Boston, MA, United States
  7. 7Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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Abstract

Background: Practice effects in repeated neuropsychological assessment are usually treated as measurement bias, although they may carry meaningful information. It remains unclear whether individual differences in episodic memory practice effects are associated with cognitive level and longitudinal change beyond generic retest-related gains.

Methods: We analyzed data from 442 cognitively healthy middle-aged and older adults who completed neuropsychological assessments in 2018, 2021, and 2025. Retest-related offsets were modeled explicitly to separate sample-level retest gains from continuous longitudinal change. A baseline-adjusted episodic memory practice effect was derived from change in episodic memory between baseline and first follow-up and included in linear mixed-effects models of global cognition and specific domains, adjusting for age, biological sex, and education.

Results: Retest-related gains were significant at both follow-up waves. After accounting for these offsets, greater episodic memory practice effect was associated with higher global cognitive performance and more favorable longitudinal change. In a robustness analysis using a non-memory global composite, the association with cognitive level remained significant, whereas the association with longitudinal change was attenuated. Domain-specific analyses showed strongest associations for episodic memory, followed by processing speed; reasoning was associated with cognitive level but not change, with no significant associations for attention/working memory or cognitive flexibility.

Conclusion: Episodic memory practice effects appear to carry meaningful information beyond generic retest-related gains. Explicitly modeling retest effects while preserving interindividual differences in practice-related improvement may refine the characterization of longitudinal cognitive trajectories and help identify subtle early differences in cognitive resilience and vulnerability.

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Cite

BibTeXRIS
BibTeX
@article{fankhauser2026beyond,
  title = {{Beyond retest gains: episodic memory practice effects and longitudinal cognitive trajectories in cognitively healthy adults}},
  author = {Simon Fankhauser and Gabriele Cattaneo and Gemma Albi-Villuendas and Javier Solana-Sánchez and Álvaro Pascual-Leone and David Bartrés-Faz},
  journal = {Frontiers in Aging Neuroscience},
  year = {2026},
  month = oct,
  doi = {10.3389/fnagi.2026.1933991},
  url = {https://doi.org/10.3389/fnagi.2026.1933991},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Beyond retest gains: episodic memory practice effects and longitudinal cognitive trajectories in cognitively healthy adults
AU  - Simon Fankhauser
AU  - Gabriele Cattaneo
AU  - Gemma Albi-Villuendas
AU  - Javier Solana-Sánchez
AU  - Álvaro Pascual-Leone
AU  - David Bartrés-Faz
PY  - 2026
DA  - 2026/10/12
JO  - Frontiers in Aging Neuroscience
DO  - 10.3389/fnagi.2026.1933991
UR  - https://doi.org/10.3389/fnagi.2026.1933991
AB  - Background: Practice effects in repeated neuropsychological assessment are usually treated as measurement bias, although they may carry meaningful information. It remains unclear whether individual differences in episodic memory practice effects are associated with cognitive level and longitudinal change beyond generic retest-related gains.  Methods: We analyzed data from 442 cognitively healthy middle-aged and older adults who completed neuropsychological assessments in 2018, 2021, and 2025. Retest-related offsets were modeled explicitly to separate sample-level retest gains from continuous longitudinal change. A baseline-adjusted episodic memory practice effect was derived from change in episodic memory between baseline and first follow-up and included in linear mixed-effects models of global cognition and specific domains, adjusting for age, biological sex, and education.  Results: Retest-related gains were significant at both follow-up waves. After accounting for these offsets, greater episodic memory practice effect was associated with higher global cognitive performance and more favorable longitudinal change. In a robustness analysis using a non-memory global composite, the association with cognitive level remained significant, whereas the association with longitudinal change was attenuated. Domain-specific analyses showed strongest associations for episodic memory, followed by processing speed; reasoning was associated with cognitive level but not change, with no significant associations for attention/working memory or cognitive flexibility.  Conclusion: Episodic memory practice effects appear to carry meaningful information beyond generic retest-related gains. Explicitly modeling retest effects while preserving interindividual differences in practice-related improvement may refine the characterization of longitudinal cognitive trajectories and help identify subtle early differences in cognitive resilience and vulnerability.
SN  - 1663-4365
ER  -