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


This work was supported by National Institutes of Health (NIH) grant R01AG029672 (Paul K. Crane, PI) and by funding from NIH‐National Institute of General Medicine SC3.GM122662 (Nancy S. Foldi, PI).

FundersFunder number
NIH-National Institute of General Medicine SC3.GM122662
NIH‐National Institute of General Medicine SC3.GM122662
National Institutes of HealthR01AG029672


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


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