Differential associations of cognitive screeners with biological, psychological, and cognitive factors in high-risk older adults.

BackgroundDementia rates have accelerated in recent decades, yet our ability to screen for and predict who is at risk remains limited. The Montreal Cognitive Assessment (MoCA) and the Alzheimer's Disease Assessment Scale-Cog-13 item (ADAS-Cog-13) are common screeners that provide insight into early dementia progression. However, how these tools relate to biomarkers and psychological predictors before formal diagnosis is unclear.ObjectiveThis study examines associations between biological and psychological factors with MoCA and ADAS-Cog-13 scores to guide clinicians in selecting the most informative screener for specific dementia risk profiles.MethodsZero-order correlations and Classification and Regression Trees were conducted using data from the ADNI-DOD database, comprising high-risk veterans without baseline dementia.ResultsMoCA scores were primarily associated with biomarker predictors and depression, whereas ADAS-Cog-13 scores were primarily associated with post-traumatic stress disorder diagnoses.ConclusionsCognitive screeners tailored to brief psychological and medical histories may improve early detection of cognitive decline and Alzheimer's disease.