Establishing cognitive baseline in three generations: Framingham Heart Study

Abstract Introduction Generational changes warrant recalibrating normative cognitive measures to detect changes indicative of dementia risk within each generation. Methods We performed linear regressions to compare eight neuropsychological (NP) tests among three‐generation cohorts at baseline in Framingham Heart Study (FHS, n = 4787) and conducted Cox regressions to investigate the relationships of NP tests with generation‐specific dementia risk. Results The FHS second and third generations performed better than the first generation for seven NP tests (0.14–0.81 standard deviation improvement, P ≤ .001) while the second and third generations performed similarly for six of eight NP tests (P > .05). One standard deviation better performance was associated with a higher reduction in incident dementia risk in the second than the first generation (35% vs. 24%, Pinteraction = .02) for the similarities test. Discussion Our findings suggest cohort‐based norms are needed for cognitive assessment for the diagnosis of cognitive impairment and dementia.