Intra-individual reaction time variability in mild cognitive impairment and Alzheimer's disease: gender, processing load and speed factors

Abstract

Compared to cognitively healthy ageing (CH), intra-individual variability in reaction time (IIV(RT)), a behavioural marker of neurological integrity, is commonly reported to increase in both Alzheimer's disease (AD) and mild cognitive impairment (MCI). It varies in MCI with respect to whether it represents the pro-dromal stages of dementia or not; being greatest in those most likely to convert. Abnormal IIV(RT) in MCI therefore represents a potential measure of underlying functional integrity that may serve to differentiate MCI from CH and to help identify those patients for whom MCI is the result of a progressive pathological process. As the clinical approach to MCI is increasingly stratified with respect to gender, we investigated whether this factor could influence study outcome. The influence of RTSPEED and processing load upon IIV(RT) was also examined. Under low processing load conditions, IIV(RT) was significantly increased in both MCI and AD compared to CH. However, correcting for an individual's processing speed abolished this effect in MCI but not in AD, indicating that the increased IIV(RT) in MCI and AD may result from different factors. In MCI but not in CH, IIV(RT) was significantly greater for females. Increasing task processing load by adding distracting information, although increasing overall IIV(RT), failed to improve the differentiation between CH and both MCI and AD, and in MCI resulted in a reduction in the influence of gender upon study outcome. The outcome of studies investigating IIV(RT) in MCI and AD compared to CH therefore appear influenced by the gender of the participants, by task-related processing load and processing speed.

Figure 1. Representation of the stimuli used for (a) the target plus distracter condition and (b) the target alone condition.

Figure 2. Box plot of IIV_RT (msec) based on individual IQR values for the cognitively healthy older adult controls (Old) and patients with aMCI ⁺(MCI).

Figure 3. Box plot of the RT_SPEED (msec) for the cognitively healthy older adult controls (Old) and patients with aMCI⁺ (MCI).