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BHA-CS: A novel cognitive composite for Alzheimer's disease and related disorders.

  • Author(s): Tsoy, Elena
  • Erlhoff, Sabrina J
  • Goode, Collette A
  • Dorsman, Karen A
  • Kanjanapong, Suchanan
  • Lindbergh, Cutter A
  • La Joie, Renaud
  • Strom, Amelia
  • Rabinovici, Gil D
  • Lanata, Serggio C
  • Miller, Bruce L
  • Tomaszewski Farias, Sarah E
  • Kramer, Joel H
  • Rankin, Katherine P
  • Possin, Katherine L
  • et al.


Composite scores based on psychometrically rigorous cognitive assessments are well suited for early diagnosis and disease monitoring.


We developed and cross-validated the Brain Health Assessment-Cognitive Score (BHA-CS), based on a brief computerized battery, in 451 cognitively normal (CN) and 399 cognitively impaired (mild cognitive impairment [MCI] or dementia) older adults. We investigated its long-term reliability and reliable change indices at longitudinal follow-up (N = 340), and the association with amyloid beta (Aβ) burden in the CN subgroup with Aβ positron emission tomography (N = 119).


The BHA-CS was accurate at detecting cognitive impairment and exhibited excellent long-term stability. Reliable decline over one year was detected in 75% of participants with dementia, 44% with MCI, and 3% of CN. Among CN, the Aβ-positive group showed worse longitudinal performance on the BHA-CS compared to the Aβ-negative group.


The BHA-CS is sensitive to cognitive decline in preclinical and prodromal neurodegenerative disease.

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