Measurement precision matters: Accounting for uncertainty alters estimated memory trajectories across the cognitive spectrum
7 affiliations
- 1Department of Psychiatry and Behavioral Sciences University of Washington Seattle Washington USA
- 2VA Puget Sound Health Care System, GRECC Seattle Washington USA
- 3Bordeaux Population Health Research Center University of Bordeaux, Inserm Bordeaux France
- 4Department of Medicine University of Washington Seattle Washington USA
- 5Department of Neurology Boston University Chobanian & Avedisian School of Medicine Boston Massachusetts USA
- 6Indiana Alzheimer's Disease Research Center and Center for Neuroimaging Indiana University School of Medicine Indianapolis Indiana USA
- 7Department of Medical and Molecular Genetics, Department of Radiology and Imaging Sciences Indiana University School of Medicine Indianapolis Indiana USA
Abstract
INTRODUCTION: Harmonized cognitive composites are widely used to study longitudinal cognitive decline. Although harmonization places scores on a common latent scale, measurement precision varies across visits, age, and diagnosis, but is typically ignored in longitudinal models.
METHODS: We analyzed harmonized memory scores and time‐varying standard errors from the National Alzheimer's Coordinating Center Uniform Data Set. We compared a naïve mixed‐effects model that did not incorporate measurement uncertainty with two precision‐aware models: a frequentist precision‐weighted and a Bayesian measurement‐error model. Comparisons were based on estimated age of memory impairment.
RESULTS: Accounting for measurement precision produced age‐dependent differences in estimated memory trajectories. Naïve models predicted higher memory scores at older ages in cognitively normal and mildly impaired participants but lower scores in Alzheimer's dementia (AD). Precision‐aware models estimated threshold crossing 1.5–3 years earlier than the naïve model.
DISCUSSION: Incorporating visit‐specific measurement precision alters estimated cognitive trajectories and the timing of clinically interpretable memory impairment.
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BibTeX
@article{trittschuh2026measurement,
title = {{Measurement precision matters: Accounting for uncertainty alters estimated memory trajectories across the cognitive spectrum}},
author = {Emily H. Trittschuh and Phoebe Scollard and Paul K. Crane and Seo‐Eun Choi and Jesse Mez and Andrew J. Saykin and Laura E. Gibbons and Shubhabrata Mukherjee},
journal = {Alzheimer's \& Dementia},
year = {2026},
month = nov,
doi = {10.1002/alz.71976},
url = {https://doi.org/10.1002/alz.71976},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Measurement precision matters: Accounting for uncertainty alters estimated memory trajectories across the cognitive spectrum
AU - Emily H. Trittschuh
AU - Phoebe Scollard
AU - Paul K. Crane
AU - Seo‐Eun Choi
AU - Jesse Mez
AU - Andrew J. Saykin
AU - Laura E. Gibbons
AU - Shubhabrata Mukherjee
PY - 2026
DA - 2026/11/04
JO - Alzheimer's & Dementia
DO - 10.1002/alz.71976
UR - https://doi.org/10.1002/alz.71976
AB - INTRODUCTION: Harmonized cognitive composites are widely used to study longitudinal cognitive decline. Although harmonization places scores on a common latent scale, measurement precision varies across visits, age, and diagnosis, but is typically ignored in longitudinal models. METHODS: We analyzed harmonized memory scores and time‐varying standard errors from the National Alzheimer's Coordinating Center Uniform Data Set. We compared a naïve mixed‐effects model that did not incorporate measurement uncertainty with two precision‐aware models: a frequentist precision‐weighted and a Bayesian measurement‐error model. Comparisons were based on estimated age of memory impairment. RESULTS: Accounting for measurement precision produced age‐dependent differences in estimated memory trajectories. Naïve models predicted higher memory scores at older ages in cognitively normal and mildly impaired participants but lower scores in Alzheimer's dementia (AD). Precision‐aware models estimated threshold crossing 1.5–3 years earlier than the naïve model. DISCUSSION: Incorporating visit‐specific measurement precision alters estimated cognitive trajectories and the timing of clinically interpretable memory impairment.
SN - 1552-5260
SN - 1552-5279
ER -