A clinical cognitive examination was performed in 1196 individuals (557 men, 639 women; response rate 99.4%). The examination was conducted by a psychiatric nurse, a psychiatrist, or a medical doctor, with a total duration of approximately 25 min. The examination comprised tests of word fluency (animals), naming 12 objects, copying five figures, finger agnosia, orientation, selective attention, understanding proverbs, ideational apraxia, memory (remembering 12 objects, word memory list, two last prime ministers), ability to follow instructions. Cognitive function was rated in accordance with a Swedish version of the Mini-Mental State Examination (MMSE) [30 (link)], the Gottfries Bråne Steen-scale (GBS) [31 (link)], as well as global ratings. Specific assessments relevant for dementia diagnosis, such as recent and remote memory, semantic memory, concentration, apraxia, spoken language, language comprehension, word finding difficulties, and other intellectual functions were performed, as well as assessments with the Clinical Dementia Rating scale (CDR) [32 (link)], and Alzheimer’s Disease Assessment Scale-Cognitive (ADAS-COG) [33 (link)]. Dementia was diagnosed following the Diagnostic and Statistical Manual of Mental Disorders DSM III-R [34 ] criteria as closely as possible using information from the clinical cognition examination and information from key informants (see below). We also assessed the neurocognitive domains described in DSM-5 (complex attention, executive function, learning and memory, language, perceptual-motor, and social cognition) [29 ].
A more detailed psychometric cognitive examination that included questions about subjective memory as well as testing of multiple cognitive domains was performed in 1173 individuals (547 men, 626 women; response rate 97.5%). The examination was conducted by research staff members, all trained by a psychologist, with a total duration of approximately 60 min. The subjective part included questions concerning participant’s everyday memory, experiences of memory decline, satisfaction with own memory, everyday memory problems, memory training, and engagement in cognitively demanding recreational activities, such as chess, bridge, crossword-puzzles, and reading habits. The cognitive test battery included several cognitive measurements intended to cover a broad range of different cognitive abilities. Memory in Reality (MIR) [35 ], Supra-span memory test (BUS II) [36 (link)], and Thurstone’s Picture Memory [37 ] measured memory abilities. Digit Span Forward and Backward test [38 ] measured short term memory and executive functioning. Figure Identification—Psif [39 ] measured mental speed, and Figure Logic (SRB 2) [39 ] measured inductive reasoning. Controlled Oral Word Association—FAS (COWA-FAS) [40 ] measured verbal fluency and Block Design (Koh’s Block Test) [38 ] measured spatial ability. The Clock Test [41 (link)] was originally developed for dementia screening and measured a wide range of cognitive abilities including executive functioning [42 (link)]. Most of the tests are part of the Dureman and Sälde (1959) psychometric test battery [43 ] that was widely used in Sweden at the start of the H70 study 1971–72.
A more detailed psychometric cognitive examination that included questions about subjective memory as well as testing of multiple cognitive domains was performed in 1173 individuals (547 men, 626 women; response rate 97.5%). The examination was conducted by research staff members, all trained by a psychologist, with a total duration of approximately 60 min. The subjective part included questions concerning participant’s everyday memory, experiences of memory decline, satisfaction with own memory, everyday memory problems, memory training, and engagement in cognitively demanding recreational activities, such as chess, bridge, crossword-puzzles, and reading habits. The cognitive test battery included several cognitive measurements intended to cover a broad range of different cognitive abilities. Memory in Reality (MIR) [35 ], Supra-span memory test (BUS II) [36 (link)], and Thurstone’s Picture Memory [37 ] measured memory abilities. Digit Span Forward and Backward test [38 ] measured short term memory and executive functioning. Figure Identification—Psif [39 ] measured mental speed, and Figure Logic (SRB 2) [39 ] measured inductive reasoning. Controlled Oral Word Association—FAS (COWA-FAS) [40 ] measured verbal fluency and Block Design (Koh’s Block Test) [38 ] measured spatial ability. The Clock Test [41 (link)] was originally developed for dementia screening and measured a wide range of cognitive abilities including executive functioning [42 (link)]. Most of the tests are part of the Dureman and Sälde (1959) psychometric test battery [43 ] that was widely used in Sweden at the start of the H70 study 1971–72.
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