Measuring Subjective Cognitive Decline in Older Adults: Harmonization Between the Cognitive Change Index and the Measurement of Everyday Cognition Instruments

Article type: Research Article

Authors: Wells, Lindsey F.^a | Risacher, Shannon L.^{b; c} | McDonald, Brenna C.^{b; c; d} | Farlow, Martin R.^{c; d} | Brosch, Jared^{c; d} | Gao, Sujuan^{c; e} | Apostolova, Liana G.^{b; c; d} | Saykin, Andrew J.^{b; c; d; *} | for the Alzheimer’s Disease Neuroimaging Initiative¹

Affiliations: [a] Indiana University School of Medicine, Indianapolis, IN, USA | [b] Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA | [c] Indiana Alzheimer’s Disease Research Center, Indiana University School of Medicine, Indianapolis, IN, USA | [d] Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA | [e] Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA

Correspondence: [*] Correspondence to: Dr. Andrew J. Saykin, 355 W. 16th St., Suite 4100, Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN 46202, USA. Tel.: +1 317 963 7501; Fax: +1 317 963 7547; E-mail: asaykin@iupui.edu.

Note: [1] Data used in preparation of this article were obtained from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database (https://adni.loni.usc.edu). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. A complete listing of ADNI investigators can be found at: https://adni.loni.usc.edu/wp-content/uploads/how_to_apply/ADNI_Acknowledgement_List.pdf

Abstract: Background:Self and informant (proxy or study partner) reports of everyday cognitive functioning have been shown to be associated with incipient neurodegenerative disease. The 20-item Cognitive Change Index (CCI) and the 39-item Measurement of Everyday Cognition (ECog) were each developed to characterize early subjective changes in cognitive function. Objective:We examined the relationship between CCI and ECog self and informant-based evaluations to determine content overlap and provide a co-calibration for converting between these widely used instruments. Methods:950 participants (57.1% female, mean age = 71.2 years) from ADNI and the Indiana ADRC with self-based evaluations and 279 participants (60.9% female, mean age = 71.8 years) with informant-based evaluations (Indiana ADRC) were included. Analyzed variables for the CCI and ECog included domain mean scores, memory domain total scores, and total scores for all items. Spearman correlations, regression analyses, and frequency distributions were used to assess the relationship between CCI and ECog. Sex, age, years of education, race/ethnicity, APOE ɛ4 carrier status, and baseline diagnosis were also analyzed as potentially relevant covariates. Results:CCI and ECog total scores were highly correlated for the self (r = 0.795, p < 0.001) and informant-based (r = 0.840, p < 0.001) versions, as expected. Frequency distributions of self and informant total scores were generated and plotted separately. Quadratic regressions for self (r2 = 0.626) and informant (r2 = 0.741) scores were used to create a translation table between the CCI and ECog total scores. Conclusion:Self and informant total scores can be harmonized and translated between the CCI and ECog to facilitate cross-study and longitudinal assessment of perceived cognitive change, an important patient-reported outcome.

Keywords: Alzheimer’s disease, co-calibration, cognitive assessment screening instrument,, cognitive decline,, harmonization, tau proteins, subjective cognitive decline

DOI: 10.3233/JAD-215388

Journal: Journal of Alzheimer's Disease, vol. 87, no. 2, pp. 761-769, 2022