OBJECTIVE
Better performance due to repeated testing can bias long-term trajectories of cognitive aging and correlates of change. We examined whether retest effects differ as a function of individual differences pertinent to cognitive aging: race/ethnicity, age, sex, language, years of education, and dementia risk factors including APOE ε4 status, baseline cognitive performance, and cardiovascular risk.
METHOD
We used data from the Washington Heights-Inwood Columbia Aging Project, a community-based cohort of older adults (n=4,073). We modeled cognitive change and retest effects in summary factors for general cognitive performance, memory, executive functioning, and language using multilevel models. Retest effects were parameterized in two ways, as improvement between the first and subsequent testings, and as the square root of the number of prior testings. We evaluated whether the retest effect differed by individual characteristics.
RESULTS
The mean retest effect for general cognitive performance was 0.60 standard deviations (95%CI: 0.46, 0.74), and was similar for memory, executive functioning, and language. Retest effects were greater for participants in the lowest quartile of cognitive performance, consistent with regression to the mean. Retest did not differ by other characteristics.
CONCLUSIONS
Retest effects are large in this community-based sample, but do not vary by demographic or dementia-related characteristics. Differential retest effects may not limit the generalizability of inferences across different groups in longitudinal research.