Lower practice effects as a marker of cognitive performance and dementia risk: A literature review

Roos J. Jutten*, Evan Grandoit, Nancy S. Foldi, Sietske A.M. Sikkes, Richard N. Jones, Seo Eun Choi, Melissa L. Lamar, Diana K.N. Louden, Joanne Rich, Douglas Tommet, Paul K. Crane, Laura A. Rabin

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review


Background: Practice effects (PEs) are improvements in performance after repeated exposure to test materials, and typically viewed as a source of bias in repeated cognitive assessments. We aimed to determine whether characterizing PEs could also provide a useful marker of early cognitive decline. Methods: We conducted a systematic review of the literature, searching PsycInfo (Ebsco) and PubMed databases for articles studying PEs in aging and dementia populations. Articles published between 1920 and 2019 were included. Result: We identified 259 articles, of which 27 studied PEs as markers of cognitive performance. These studies consistently showed that smaller, less-robust PEs were associated with current diagnostic status and/or future cognitive decline. In addition, lower PEs were associated with Alzheimer's disease risk factors and neurodegeneration biomarkers. Conclusion: PEs provide a potentially useful marker of cognitive decline, and could prove valuable as part of a cost-effective strategy to select individuals who are at-risk for dementia for future interventions.

Original languageEnglish
Article numbere12055
Pages (from-to)1-12
Number of pages12
JournalAlzheimer's and Dementia: Diagnosis, Assessment and Disease Monitoring
Early online date9 Jul 2020
Publication statusPublished - 2020


  • Alzheimer's disease
  • cognition
  • learning effects
  • practice effects
  • retest effects


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