State, trait, and accumulated features of the Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS‐Cog) in mild Alzheimer's disease
Abstract Background The Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS‐Cog) is used to assess decline in memory, language, and praxis in Alzheimer's disease (AD). Methods A latent state–trait model with autoregressive effects was used to determine how much of the ADAS‐Cog it...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-01-01
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| Series: | Alzheimer’s & Dementia: Translational Research & Clinical Interventions |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/trc2.12376 |
| _version_ | 1797857638016352256 |
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| author | Hugo Cogo‐Moreira Saffire H. Krance Che‐Yuan Wu Krista L. Lanctôt Nathan Herrmann Sandra E. Black Bradley J. MacIntosh Jennifer S. Rabin Michael Eid Walter Swardfager for the Alzheimer's Disease Neuroimaging Initiative |
| author_facet | Hugo Cogo‐Moreira Saffire H. Krance Che‐Yuan Wu Krista L. Lanctôt Nathan Herrmann Sandra E. Black Bradley J. MacIntosh Jennifer S. Rabin Michael Eid Walter Swardfager for the Alzheimer's Disease Neuroimaging Initiative |
| author_sort | Hugo Cogo‐Moreira |
| collection | DOAJ |
| description | Abstract Background The Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS‐Cog) is used to assess decline in memory, language, and praxis in Alzheimer's disease (AD). Methods A latent state–trait model with autoregressive effects was used to determine how much of the ADAS‐Cog item measurement was reliable, and of that, how much of the information was occasion specific (state) versus consistent (trait or accumulated from one visit to the next). Results Participants with mild AD (n = 341) were assessed four times over 24 months. Praxis items were generally unreliable as were some memory items. Language items were generally the most reliable, and this increased over time. Only two ADAS‐Cog items showed reliability >0.70 at all four assessments, word recall (memory) and naming (language). Of the reliable information, language items exhibited greater consistency (63.4% to 88.2%) than occasion specificity, and of the consistent information, language items tended to reflect effects of AD progression that accumulated from one visit to the next (35.5% to 45.3%). In contrast, reliable information from praxis items tended to come from trait information. The reliable information in the memory items reflected more consistent than occasion‐specific information, but they varied between items in the relative amounts of trait versus accumulated effects. Conclusions Although the ADAS‐Cog was designed to track cognitive decline, most items were unreliable, and each item captured different amounts of information related to occasion‐specific, trait, and accumulated effects of AD over time. These latent properties complicate the interpretation of trends seen in ordinary statistical analyses of trials and other clinical studies with repeated ADAS‐Cog item measures. Highlights Studies have described unfavorable psychometric properties of the Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS‐Cog), bringing into question its ability to track changes in cognition uniformly over time. There remains a need to estimate how much of the ADAS‐Cog measurement is reliable, of that how much is occasion specific versus consistent, and of the consistent information, how much represents enduring traits versus autoregressive effects (i.e., effects of Alzheimer's disease [AD] progression carried over from one assessment to the next). A latent state–trait model with autoregressive effects in mild AD found most items to be unreliable, and each item to capture different amounts of occasion‐specific, trait, and autoregressive information. Language items, specifically, naming and the memory item word recall, were the most reliable. Psychometric idiosyncrasies of individual items complicate the interpretation of their summed score, biasing ordinary statistical analyses of repeated measures in mild AD. Future studies should consider item trajectories individually. |
| first_indexed | 2024-04-09T20:59:58Z |
| format | Article |
| id | doaj.art-b0c0d8ee46ff4afa90f99ecfd677871f |
| institution | Directory Open Access Journal |
| issn | 2352-8737 |
| language | English |
| last_indexed | 2024-04-09T20:59:58Z |
| publishDate | 2023-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Alzheimer’s & Dementia: Translational Research & Clinical Interventions |
| spelling | doaj.art-b0c0d8ee46ff4afa90f99ecfd677871f2023-03-29T10:44:28ZengWileyAlzheimer’s & Dementia: Translational Research & Clinical Interventions2352-87372023-01-0191n/an/a10.1002/trc2.12376State, trait, and accumulated features of the Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS‐Cog) in mild Alzheimer's diseaseHugo Cogo‐Moreira0Saffire H. Krance1Che‐Yuan Wu2Krista L. Lanctôt3Nathan Herrmann4Sandra E. Black5Bradley J. MacIntosh6Jennifer S. Rabin7Michael Eid8Walter Swardfager9for the Alzheimer's Disease Neuroimaging Initiative10Department of Education ICT and Learning Østfold University College Halden NorwaySchulich School of Medicine and Dentistry University of Western Ontario London Ontario CanadaSandra Black Centre for Brain Resilience and Recovery Sunnybrook Research Institute Toronto Ontario CanadaSandra Black Centre for Brain Resilience and Recovery Sunnybrook Research Institute Toronto Ontario CanadaHurvitz Brain Sciences Program Sunnybrook Research Institute Toronto Ontario CanadaSandra Black Centre for Brain Resilience and Recovery Sunnybrook Research Institute Toronto Ontario CanadaSandra Black Centre for Brain Resilience and Recovery Sunnybrook Research Institute Toronto Ontario CanadaHurvitz Brain Sciences Program Sunnybrook Research Institute Toronto Ontario CanadaDepartment of Education and Psychology Freie Universität Berlin Berlin GermanySandra Black Centre for Brain Resilience and Recovery Sunnybrook Research Institute Toronto Ontario CanadaDepartment of Education ICT and Learning Østfold University College Halden NorwayAbstract Background The Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS‐Cog) is used to assess decline in memory, language, and praxis in Alzheimer's disease (AD). Methods A latent state–trait model with autoregressive effects was used to determine how much of the ADAS‐Cog item measurement was reliable, and of that, how much of the information was occasion specific (state) versus consistent (trait or accumulated from one visit to the next). Results Participants with mild AD (n = 341) were assessed four times over 24 months. Praxis items were generally unreliable as were some memory items. Language items were generally the most reliable, and this increased over time. Only two ADAS‐Cog items showed reliability >0.70 at all four assessments, word recall (memory) and naming (language). Of the reliable information, language items exhibited greater consistency (63.4% to 88.2%) than occasion specificity, and of the consistent information, language items tended to reflect effects of AD progression that accumulated from one visit to the next (35.5% to 45.3%). In contrast, reliable information from praxis items tended to come from trait information. The reliable information in the memory items reflected more consistent than occasion‐specific information, but they varied between items in the relative amounts of trait versus accumulated effects. Conclusions Although the ADAS‐Cog was designed to track cognitive decline, most items were unreliable, and each item captured different amounts of information related to occasion‐specific, trait, and accumulated effects of AD over time. These latent properties complicate the interpretation of trends seen in ordinary statistical analyses of trials and other clinical studies with repeated ADAS‐Cog item measures. Highlights Studies have described unfavorable psychometric properties of the Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS‐Cog), bringing into question its ability to track changes in cognition uniformly over time. There remains a need to estimate how much of the ADAS‐Cog measurement is reliable, of that how much is occasion specific versus consistent, and of the consistent information, how much represents enduring traits versus autoregressive effects (i.e., effects of Alzheimer's disease [AD] progression carried over from one assessment to the next). A latent state–trait model with autoregressive effects in mild AD found most items to be unreliable, and each item to capture different amounts of occasion‐specific, trait, and autoregressive information. Language items, specifically, naming and the memory item word recall, were the most reliable. Psychometric idiosyncrasies of individual items complicate the interpretation of their summed score, biasing ordinary statistical analyses of repeated measures in mild AD. Future studies should consider item trajectories individually.https://doi.org/10.1002/trc2.12376Alzheimer's Disease Assessment Scale Cognitive SubscaleAlzheimer's diseasecognitionlatent state–trait autoregressive modelstructural equation modelling |
| spellingShingle | Hugo Cogo‐Moreira Saffire H. Krance Che‐Yuan Wu Krista L. Lanctôt Nathan Herrmann Sandra E. Black Bradley J. MacIntosh Jennifer S. Rabin Michael Eid Walter Swardfager for the Alzheimer's Disease Neuroimaging Initiative State, trait, and accumulated features of the Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS‐Cog) in mild Alzheimer's disease Alzheimer’s & Dementia: Translational Research & Clinical Interventions Alzheimer's Disease Assessment Scale Cognitive Subscale Alzheimer's disease cognition latent state–trait autoregressive model structural equation modelling |
| title | State, trait, and accumulated features of the Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS‐Cog) in mild Alzheimer's disease |
| title_full | State, trait, and accumulated features of the Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS‐Cog) in mild Alzheimer's disease |
| title_fullStr | State, trait, and accumulated features of the Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS‐Cog) in mild Alzheimer's disease |
| title_full_unstemmed | State, trait, and accumulated features of the Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS‐Cog) in mild Alzheimer's disease |
| title_short | State, trait, and accumulated features of the Alzheimer's Disease Assessment Scale Cognitive Subscale (ADAS‐Cog) in mild Alzheimer's disease |
| title_sort | state trait and accumulated features of the alzheimer s disease assessment scale cognitive subscale adas cog in mild alzheimer s disease |
| topic | Alzheimer's Disease Assessment Scale Cognitive Subscale Alzheimer's disease cognition latent state–trait autoregressive model structural equation modelling |
| url | https://doi.org/10.1002/trc2.12376 |
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