Detecting cognitive decline in presymptomatic Alzheimer's disease (AD) and early mild cognitive impairment (MCI) is challenging, but important for treatments targeting AD-related neurodegeneration. The current study aimed to investigate the utility and performance of internally developed robust norms and standard norms in identifying cognitive impairment in late middle-age (baseline age range = 36–68; M = 54).


Robust norms were developed for neuropsychological measures based on longitudinally confirmed cognitively normal (CN) participants (n= 476). Seven hundred and seventy-nine participants enriched for AD risk were classified as psychometric MCI (pMCI) or CN based on standard and robust norms and “single-test” versus “multi-test” criteria.


Prevalence of pMCI ranged from 3% to 49% depending on the classification scheme used. Those classified as pMCI using robust norms exhibited greater subjective cognitive complaints, diagnostic stability, and mild clinical symptoms at follow-up.


Results suggest that identifying early clinically relevant cognitive decline in late middle-age is feasible using robust norms and multi-test criteria.

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