Examining the role of participant and study partner report in widely-used classification approaches of mild cognitive impairment in demographically-diverse community dwelling individuals: results from the Einstein aging study
ObjectiveThe role of subjective cognitive concerns (SCC) as a diagnostic criterion for MCI remains uncertain and limits the development of a universally (or widely)-accepted MCI definition. The optimal MCI definition should define an at-risk state and accurately predict the development of incident d...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-11-01
|
| Series: | Frontiers in Aging Neuroscience |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fnagi.2023.1221768/full |
| _version_ | 1797490139916664832 |
|---|---|
| author | Katherine H. Chang Katherine H. Chang Cuiling Wang Cuiling Wang Caroline O. Nester Caroline O. Nester Mindy J. Katz Desiree A. Byrd Desiree A. Byrd Richard B. Lipton Richard B. Lipton Richard B. Lipton Laura A. Rabin Laura A. Rabin Laura A. Rabin Laura A. Rabin |
| author_facet | Katherine H. Chang Katherine H. Chang Cuiling Wang Cuiling Wang Caroline O. Nester Caroline O. Nester Mindy J. Katz Desiree A. Byrd Desiree A. Byrd Richard B. Lipton Richard B. Lipton Richard B. Lipton Laura A. Rabin Laura A. Rabin Laura A. Rabin Laura A. Rabin |
| author_sort | Katherine H. Chang |
| collection | DOAJ |
| description | ObjectiveThe role of subjective cognitive concerns (SCC) as a diagnostic criterion for MCI remains uncertain and limits the development of a universally (or widely)-accepted MCI definition. The optimal MCI definition should define an at-risk state and accurately predict the development of incident dementia. Questions remain about operationalization of definitions of self- and informant-reported SCCs and their individual and joint associations with incident dementia.MethodsThe present study included Einstein Aging Study participants who were non-Hispanic White or Black, free of dementia at enrollment, had follow-up, and completed neuropsychological tests and self-reported SCC at enrollment to determine MCI status. Informant-reported SCC at baseline were assessed via the CERAD clinical history questionnaire. Self-reported SCC were measured using the CERAD, items from the EAS Health Self-Assessment, and the single memory item from the Geriatric Depression Scale. Cox proportional hazards models examined the association of different operationalizations of SCC with Petersen and Jak/Bondi MCI definitions on the risk of dementia, further controlling for age, sex, education, and race/ethnicity. Time-dependent sensitivity and specificity at specific time points for each definition, and Youden’s index were calculated as an accuracy measure. Cox proportional hazards models were also used to evaluate the associations of combinations of self- and informant-reported SCC with the risk of incident dementia.Results91% of the sample endorsed at least one SCC. Youden’s index showed that not including SCC in either Jak/Bondi or Petersen classifications had the best balance between sensitivity and specificity across follow-up. A subset of individuals with informants, on average, had a lower proportion of non-Hispanic Blacks and 94% endorsed at least one self-reported SCC. Both informant-reported and self-reported SCC were significantly associated with incident dementia.ConclusionOur findings suggest that the SCC criterion may not improve the predictive validity for dementia when included in widely-employed definitions of MCI. Consistent with some prior research, informant-reported SCC was more related to risk of incident dementia than self-reported SCC. Given that requiring informant report as a diagnostic criterion may unintentionally exclude health disparate groups, additional consideration is needed to determine how best to utilize informant-report in MCI diagnosis. |
| first_indexed | 2024-03-10T00:26:43Z |
| format | Article |
| id | doaj.art-77fd7a36e6ff4eadbaa1811c0b58f477 |
| institution | Directory Open Access Journal |
| issn | 1663-4365 |
| language | English |
| last_indexed | 2024-03-10T00:26:43Z |
| publishDate | 2023-11-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Aging Neuroscience |
| spelling | doaj.art-77fd7a36e6ff4eadbaa1811c0b58f4772023-11-23T15:32:23ZengFrontiers Media S.A.Frontiers in Aging Neuroscience1663-43652023-11-011510.3389/fnagi.2023.12217681221768Examining the role of participant and study partner report in widely-used classification approaches of mild cognitive impairment in demographically-diverse community dwelling individuals: results from the Einstein aging studyKatherine H. Chang0Katherine H. Chang1Cuiling Wang2Cuiling Wang3Caroline O. Nester4Caroline O. Nester5Mindy J. Katz6Desiree A. Byrd7Desiree A. Byrd8Richard B. Lipton9Richard B. Lipton10Richard B. Lipton11Laura A. Rabin12Laura A. Rabin13Laura A. Rabin14Laura A. Rabin15Department of Psychology, Queens College, City University of New York (CUNY), Queens, NY, United StatesDepartment of Psychology, The Graduate Center, City University of New York (CUNY), New York, NY, United StatesDepartment of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United StatesSaul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United StatesDepartment of Psychology, Queens College, City University of New York (CUNY), Queens, NY, United StatesDepartment of Psychology, The Graduate Center, City University of New York (CUNY), New York, NY, United StatesSaul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United StatesDepartment of Psychology, Queens College, City University of New York (CUNY), Queens, NY, United StatesDepartment of Psychology, The Graduate Center, City University of New York (CUNY), New York, NY, United StatesDepartment of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United StatesSaul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United StatesDepartment of Psychiatry and Behavioral Medicine, Albert Einstein College of Medicine, Bronx, NY, United StatesDepartment of Psychology, Queens College, City University of New York (CUNY), Queens, NY, United StatesDepartment of Psychology, The Graduate Center, City University of New York (CUNY), New York, NY, United StatesSaul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, United StatesDepartment of Psychology, Brooklyn College, City University of New York (CUNY), Brooklyn, NY, United StatesObjectiveThe role of subjective cognitive concerns (SCC) as a diagnostic criterion for MCI remains uncertain and limits the development of a universally (or widely)-accepted MCI definition. The optimal MCI definition should define an at-risk state and accurately predict the development of incident dementia. Questions remain about operationalization of definitions of self- and informant-reported SCCs and their individual and joint associations with incident dementia.MethodsThe present study included Einstein Aging Study participants who were non-Hispanic White or Black, free of dementia at enrollment, had follow-up, and completed neuropsychological tests and self-reported SCC at enrollment to determine MCI status. Informant-reported SCC at baseline were assessed via the CERAD clinical history questionnaire. Self-reported SCC were measured using the CERAD, items from the EAS Health Self-Assessment, and the single memory item from the Geriatric Depression Scale. Cox proportional hazards models examined the association of different operationalizations of SCC with Petersen and Jak/Bondi MCI definitions on the risk of dementia, further controlling for age, sex, education, and race/ethnicity. Time-dependent sensitivity and specificity at specific time points for each definition, and Youden’s index were calculated as an accuracy measure. Cox proportional hazards models were also used to evaluate the associations of combinations of self- and informant-reported SCC with the risk of incident dementia.Results91% of the sample endorsed at least one SCC. Youden’s index showed that not including SCC in either Jak/Bondi or Petersen classifications had the best balance between sensitivity and specificity across follow-up. A subset of individuals with informants, on average, had a lower proportion of non-Hispanic Blacks and 94% endorsed at least one self-reported SCC. Both informant-reported and self-reported SCC were significantly associated with incident dementia.ConclusionOur findings suggest that the SCC criterion may not improve the predictive validity for dementia when included in widely-employed definitions of MCI. Consistent with some prior research, informant-reported SCC was more related to risk of incident dementia than self-reported SCC. Given that requiring informant report as a diagnostic criterion may unintentionally exclude health disparate groups, additional consideration is needed to determine how best to utilize informant-report in MCI diagnosis.https://www.frontiersin.org/articles/10.3389/fnagi.2023.1221768/fullsubjective cognitive concernsmild cognitive impairmentinformant reportstudy partneraginglongitudinal |
| spellingShingle | Katherine H. Chang Katherine H. Chang Cuiling Wang Cuiling Wang Caroline O. Nester Caroline O. Nester Mindy J. Katz Desiree A. Byrd Desiree A. Byrd Richard B. Lipton Richard B. Lipton Richard B. Lipton Laura A. Rabin Laura A. Rabin Laura A. Rabin Laura A. Rabin Examining the role of participant and study partner report in widely-used classification approaches of mild cognitive impairment in demographically-diverse community dwelling individuals: results from the Einstein aging study Frontiers in Aging Neuroscience subjective cognitive concerns mild cognitive impairment informant report study partner aging longitudinal |
| title | Examining the role of participant and study partner report in widely-used classification approaches of mild cognitive impairment in demographically-diverse community dwelling individuals: results from the Einstein aging study |
| title_full | Examining the role of participant and study partner report in widely-used classification approaches of mild cognitive impairment in demographically-diverse community dwelling individuals: results from the Einstein aging study |
| title_fullStr | Examining the role of participant and study partner report in widely-used classification approaches of mild cognitive impairment in demographically-diverse community dwelling individuals: results from the Einstein aging study |
| title_full_unstemmed | Examining the role of participant and study partner report in widely-used classification approaches of mild cognitive impairment in demographically-diverse community dwelling individuals: results from the Einstein aging study |
| title_short | Examining the role of participant and study partner report in widely-used classification approaches of mild cognitive impairment in demographically-diverse community dwelling individuals: results from the Einstein aging study |
| title_sort | examining the role of participant and study partner report in widely used classification approaches of mild cognitive impairment in demographically diverse community dwelling individuals results from the einstein aging study |
| topic | subjective cognitive concerns mild cognitive impairment informant report study partner aging longitudinal |
| url | https://www.frontiersin.org/articles/10.3389/fnagi.2023.1221768/full |
| work_keys_str_mv | AT katherinehchang examiningtheroleofparticipantandstudypartnerreportinwidelyusedclassificationapproachesofmildcognitiveimpairmentindemographicallydiversecommunitydwellingindividualsresultsfromtheeinsteinagingstudy AT katherinehchang examiningtheroleofparticipantandstudypartnerreportinwidelyusedclassificationapproachesofmildcognitiveimpairmentindemographicallydiversecommunitydwellingindividualsresultsfromtheeinsteinagingstudy AT cuilingwang examiningtheroleofparticipantandstudypartnerreportinwidelyusedclassificationapproachesofmildcognitiveimpairmentindemographicallydiversecommunitydwellingindividualsresultsfromtheeinsteinagingstudy AT cuilingwang examiningtheroleofparticipantandstudypartnerreportinwidelyusedclassificationapproachesofmildcognitiveimpairmentindemographicallydiversecommunitydwellingindividualsresultsfromtheeinsteinagingstudy AT carolineonester examiningtheroleofparticipantandstudypartnerreportinwidelyusedclassificationapproachesofmildcognitiveimpairmentindemographicallydiversecommunitydwellingindividualsresultsfromtheeinsteinagingstudy AT carolineonester examiningtheroleofparticipantandstudypartnerreportinwidelyusedclassificationapproachesofmildcognitiveimpairmentindemographicallydiversecommunitydwellingindividualsresultsfromtheeinsteinagingstudy AT mindyjkatz examiningtheroleofparticipantandstudypartnerreportinwidelyusedclassificationapproachesofmildcognitiveimpairmentindemographicallydiversecommunitydwellingindividualsresultsfromtheeinsteinagingstudy AT desireeabyrd examiningtheroleofparticipantandstudypartnerreportinwidelyusedclassificationapproachesofmildcognitiveimpairmentindemographicallydiversecommunitydwellingindividualsresultsfromtheeinsteinagingstudy AT desireeabyrd examiningtheroleofparticipantandstudypartnerreportinwidelyusedclassificationapproachesofmildcognitiveimpairmentindemographicallydiversecommunitydwellingindividualsresultsfromtheeinsteinagingstudy AT richardblipton examiningtheroleofparticipantandstudypartnerreportinwidelyusedclassificationapproachesofmildcognitiveimpairmentindemographicallydiversecommunitydwellingindividualsresultsfromtheeinsteinagingstudy AT richardblipton examiningtheroleofparticipantandstudypartnerreportinwidelyusedclassificationapproachesofmildcognitiveimpairmentindemographicallydiversecommunitydwellingindividualsresultsfromtheeinsteinagingstudy AT richardblipton examiningtheroleofparticipantandstudypartnerreportinwidelyusedclassificationapproachesofmildcognitiveimpairmentindemographicallydiversecommunitydwellingindividualsresultsfromtheeinsteinagingstudy AT lauraarabin examiningtheroleofparticipantandstudypartnerreportinwidelyusedclassificationapproachesofmildcognitiveimpairmentindemographicallydiversecommunitydwellingindividualsresultsfromtheeinsteinagingstudy AT lauraarabin examiningtheroleofparticipantandstudypartnerreportinwidelyusedclassificationapproachesofmildcognitiveimpairmentindemographicallydiversecommunitydwellingindividualsresultsfromtheeinsteinagingstudy AT lauraarabin examiningtheroleofparticipantandstudypartnerreportinwidelyusedclassificationapproachesofmildcognitiveimpairmentindemographicallydiversecommunitydwellingindividualsresultsfromtheeinsteinagingstudy AT lauraarabin examiningtheroleofparticipantandstudypartnerreportinwidelyusedclassificationapproachesofmildcognitiveimpairmentindemographicallydiversecommunitydwellingindividualsresultsfromtheeinsteinagingstudy |