Establishing cognitive baseline in three generations: Framingham Heart Study

INTRODUCTION: Generational changes warrant recalibrating normative cognitive measures to detect changes indicative of dementia risk within each generation. METHODS: We performed linear regressions to compare eight neuropsychological (NP) tests among three‐generation cohorts at baseline in Framingham Heart Study (FHS, n = 4787) and conducted Cox regressions to investigate the relationships of NP tests with generation‐specific dementia risk. RESULTS: The FHS second and third generations performed better than the first generation for seven NP tests (0.14–0.81 standard deviation improvement, P ≤ .001) while the second and third generations performed similarly for six of eight NP tests (P > .05). One standard deviation better performance was associated with a higher reduction in incident dementia risk in the second than the first generation (35% vs. 24%, P (interaction) = .02) for the similarities test. DISCUSSION: Our findings suggest cohort‐based norms are needed for cognitive assessment for the diagnosis of cognitive impairment and dementia.