scholarly journals Applying generalizability theory to examine assessments of subjective cognitive complaints: whose reports should we rely on – participant versus informant?

2021 ◽  
pp. 1-11
Author(s):  
Q. C. Truong ◽  
C. Choo ◽  
K. Numbers ◽  
A. G. Merkin ◽  
H. Brodaty ◽  
...  
Keyword(s):  
Predominantly White ◽  
Generalizability Theory ◽  
The Elderly ◽  
Community Dwelling ◽  
Assessment Tools ◽  
Sample Population ◽  
Cognitive Complaints ◽  
Longitudinal Measurement ◽  
Measurement Design ◽  
Subjective Cognitive Complaints

ABSTRACT Objectives: This study aimed to apply the generalizability theory (G-theory) to investigate dynamic and enduring patterns of subjective cognitive complaints (SCC), and reliability of two widely used SCC assessment tools. Design: G-theory was applied to assessment scales using longitudinal measurement design with five assessments spanning 10 years of follow-up. Setting: Community-dwelling older adults aged 70–90 years and their informants, living in Sydney, Australia, participated in the longitudinal Sydney Memory and Ageing Study. Participants: The sample included 232 participants aged 70 years and older, and 232 associated informants. Participants were predominantly White Europeans (97.8%). The sample of informants included 76 males (32.8%), 153 females (65.9%), and their age ranged from 27 to 86 years, with a mean age of 61.3 years (SD = 14.38). Measurements: The Memory Complaint Questionnaire (MAC-Q) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE). Results: The IQCODE demonstrated strong reliability in measuring enduring patterns of SCC with G = 0.86. Marginally acceptable reliability of the 6-item MAC-Q (G = 0.77–0.80) was optimized by removing one item resulting in G = 0.80–0.81. Most items of both assessments were measuring enduring SCC with exception of one dynamic MAC-Q item. The IQCODE significantly predicted global cognition scores and risk of dementia incident across all occasions, while MAC-Q scores were only significant predictors on some occasions. Conclusions: While both informants’ (IQCODE) and self-reported (MAC-Q) SCC scores were generalizable across sample population and occasions, self-reported (MAC-Q) scores may be less accurate in predicting cognitive ability and diagnosis of each individual.

scholarly journals DIRECTIONALITY BETWEEN COGNITION AND DEPRESSIVE SYMPTOMS: A LONGITUDINAL CROSS-LAGGED PANEL ANALYSIS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S166-S166
Author(s):  
Randolph Chan ◽  
Jennifer Y M Tang ◽  
Tianyin Liu ◽  
Gloria H Y Wong
Keyword(s):  
Cognitive Impairment ◽  
Depressive Symptoms ◽  
Older People ◽  
Cognitive Decline ◽  
Cognitive Functioning ◽  
Community Dwelling ◽  
Cognitive Complaints ◽  
Subjective Cognitive Function ◽  
Subjective Cognitive Complaints

Abstract Background and Objectives: The relationship between objective and subjective cognitive function and depressive symptoms is complex and potentially multidirectional. This longitudinal prospective study examined the directionality of their relationship among a community sample of older people with no known diagnosis or treatment for dementia or depression. Research Design and Methods: We examined the temporal relationship between objective cognitive functioning, subjective cognitive complaints, and depressive symptoms in 1,814 community-dwelling older people at baseline and one-year follow-up using regression and two-wave cross-lagged panel analyses, after controlling for demographic and health confounders. Results: Cross-lagged analysis showed that depressive symptoms at follow-up were directly predicted by baseline subjective cognitive complaints, but not baseline objective cognitive functioning. The effect differed across objective cognitive functioning levels. In people with clinically significant cognitive impairment at baseline, objective cognitive decline but not baseline subjective cognitive complaints predicted depressive symptoms. In people with mild objective cognitive impairment at baseline, baseline subjective complaints but not objective cognitive decline predicted depressive symptoms. Discussion and Implications: The effects of objective and subjective cognitive decline on depressive symptoms varied across older people with different levels of cognitive impairment. Awareness and insight of one’s cognitive status may contribute to the development/progression in depressive symptom in people with mild cognitive impairment. Mechanisms unrelated to appraisal may be involved in increased depressive symptoms among older persons with significant objective cognitive impairment.

scholarly journals A Systematic Review of the Guidelines and Delphi Study for the Multifactorial Fall Risk Assessment of Community-Dwelling Elderly

2020 ◽  
Vol 17 (17) ◽  
pp. 6097
Author(s):  
Jieun Kim ◽  
Worlsook Lee ◽  
Seon Heui Lee
Keyword(s):  
Systematic Review ◽  
Risk Assessment ◽  
Delphi Study ◽  
Fall Risk ◽  
Assessment Tool ◽  
The Elderly ◽  
Community Dwelling ◽  
Assessment Tools ◽  
Risk Assessment Tool ◽  
Fall Risk Assessment

As falls are among the most common causes of injury for the elderly, the prevention and early intervention are necessary. Fall assessment tools that include a variety of factors are recommended for preventing falls, but there is a lack of such tools. This study developed a multifactorial fall risk assessment tool based on current guidelines and validated it from the perspective of professionals. We followed the Meta-Analysis of Observational Studies in Epidemiology’s guidelines in this systematic review. We used eight international and five Korean databases to search for appropriate guidelines. Based on the review results, we conducted the Delphi survey in three rounds; one open round and two scoring rounds. About nine experts in five professional areas participated in the Delphi study. We included nine guidelines. After conducting the Delphi study, the final version of the “Multifactorial Fall Risk Assessment tool for Community-Dwelling Older People” (MFA-C) has 36 items in six factors; general characteristics, behavior factors, disease history, medication history, physical function, and environmental factors. The validity of the MFA-C tool was largely supported by various academic fields. It is expected to be beneficial to the elderly in the community when it comes to tailored interventions to prevent falls.

scholarly journals Predictors of financial capacity performance in older adults using the Financial Competence Assessment Inventory

2014 ◽  
Vol 26 (6) ◽  
pp. 921-927 ◽  
Author(s):  
Nancy A. Pachana ◽  
Gerard J. Byrne ◽  
Jill Wilson ◽  
Cheryl Tilse ◽  
Donna M. Pinsker ◽  
...  
Keyword(s):  
Cognitive Decline ◽  
Depression Scale ◽  
Later Life ◽  
The Elderly ◽  
Community Dwelling ◽  
Debt Management ◽  
Assessment Tools ◽  
Competence Assessment ◽  
Financial Capacity ◽  
Capacity Performance

ABSTRACTBackground:Declines in financial capacity in later life may arise from both neurocognitive and/or psychiatric disorders. The influence of socio-demographic, cognitive, health, and psychiatric variables on financial capacity performance was explored.Methods:Seventy-six healthy community-dwelling adults and 25 older patients referred for assessment of financial capacity were assessed on pertinent cognitive, psychiatric, and financial capacity measures, including Addenbrooke's Cognitive Examination – Revised (ACE-R), Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE), Geriatric Depression Scale (GDS), Geriatric Anxiety Inventory (GAI), selected Neuropsychiatric Inventory (NPI) items, Financial Competence Assessment Inventory (FCAI), and Social Vulnerability Scale (SVS).Results:The internal consistency of the debt management subscale of the FCAI was relatively poor in our sample. Financial capacity performance differed between controls and patients. In our sample, performance on the FCAI was predicted by Mini-Mental State Examination, IQCODE, and GAI, but not by ACE-R, GDS, NPI items, or SVS (adjusted R2 = 0.7059).Conclusions:Anxiety but not depression predicted financial capacity performance, possibly reflecting relatively low variance of depressive symptoms in this sample. Current cognitive decline as measured by the informant-rated IQCODE was more highly correlated to financial capacity than either educational attainment or ACE-R scores. Lack of significance of ACE-R data may reflect the instrument's decreased sensitivity to domains relevant to financial capacity, compared with more detailed neuropsychological assessment tools. The FCAI displayed fairly robust psychometric properties apart from the debt management subscale.

Psychosocial and Cognitive Performance Correlates of Subjective Cognitive Complaints in Help-Seeking Versus Non-Help-Seeking Community-Dwelling Adults

2019 ◽  
Vol 33 (2) ◽  
pp. 93-102 ◽  
Author(s):  
Alexander F. Lubitz ◽  
Michael Eid ◽  
Michael Niedeggen
Keyword(s):  
Depressive Symptoms ◽  
Cognitive Performance ◽  
Divided Attention ◽  
Help Seeking ◽  
Community Dwelling ◽  
Cognitive Resources ◽  
Psychosocial Variables ◽  
Cognitive Complaints ◽  
Attention Performance ◽  
Subjective Cognitive Complaints

The clinical use of subjective cognitive complaints (SCCs) has been questioned, especially when considering the influence of depression. Further problems describe the registration of SCCs with a focus on memory and different sample selections, with only few studies that directly compare those who seek help because of SCCs and community-dwelling adults. The present study aimed to (1) evaluate differences in psychosocial variables in help-seeking adults and community-dwelling adults with a lower level of complaints and (2) to further explore the relationship between SCCs and cognitive performance in help-seekers. Fifty-five help-seeking adults (HS) were compared to 55 age-, sex-, and education-matched non-help-seeking adults (NHS). Multiple regression analyses revealed that depressive symptoms were linked to experiencing more SCCs mainly in NHS. Altogether, less variance was explained by psychosocial variables in HS, whereas adding cognitive variables—especially divided attention performance—led to a substantial increase in explained variance. Mediation analysis further revealed a possible mediation of depressive symptoms on SCC by divided attention performance. Taken together, our results underpin the importance of assessing SCCs comprehensively to detect a functional relationship between cognitive performance and complaints, especially in HS. In this group, it is likely that depression precedes problems in divided attention, which in turn lead to SCC. Therefore, future studies should further investigate the link between SCC and cognitive functions which rely on more cognitive resources, as these might be first to be affected by cognitive decline.

scholarly journals A-09 The Relationship Between Subjective Cognitive Complaints, Depression, and Executive Functioning in mTBI Veterans

2020 ◽  
Vol 35 (6) ◽  
pp. 782-782
Author(s):  
T Scott ◽  
J Spellman ◽  
N Walker ◽  
J Rivera ◽  
D Waltzman ◽  
...  
Keyword(s):  
Working Memory ◽  
Executive Functioning ◽  
Principal Component ◽  
Trail Making Test ◽  
Cognitive Complaints ◽  
Adult Intelligence Scale ◽  
Neuropsychological Measures ◽  
Trail Making ◽  
Subjective Complaints ◽  
Subjective Cognitive Complaints

Abstract Objective Among individuals with mild traumatic brain injury (mTBI), those with depression report greater subjective cognitive complaints than those without depression. In mTBI patients with general cognitive complaints, depression may account for poor performance on objective neuropsychological measures. This study seeks to expand this research by examining depression, subjective executive functioning (EF) complaints, and objective EF performance in Veterans with mTBI. Method Fifty-seven Veterans with deployment-related mTBI (12% female; age M = 42.0, SD = 13.6; years education M = 15.0, SD = 1.8) with (n = 29) or without (n = 28) a chart diagnosis of depression. Participants were administered the Behavioral Rating Inventory of Executive Functioning (BRIEF) and objective neuropsychological measures of working memory (i.e., Weschler Adult Intelligence Scale-IV Working Memory Index) and aspects of EF (i.e., Trail Making Test B and Delis-Kaplan Executive Functioning System (D-KEFS) subtests). Results Principal component analysis identified similar domains of EF to the BRIEF, including: task monitoring (Trail Making Test B, D-KEFS Letter Fluency, and D-KEFS Tower Test, eigenvalue = 1.93) and shifting (D-KEFS: Color-Word Interference Conditions 3 and 4, and Category Switching, eigenvalue = 1.24). Individuals with depression had greater subjective EF complaints in each BRIEF domain than non-depressed individuals (p’s ≤ .01). However, subjective complaints in these domains were not related to objective performance (r’s = −0.17,-0.19, p’s > .05). Moreover, depressed and non-depressed individuals performed similarly on all EF measures (p’s > .05). Conclusions mTBI Veterans with depression report more subjective EF complaints than those without depression. The lack of association between subjective complaints and objective EF performance suggests it is important to treat depression in mTBI patients to remedy perceived cognitive deficits.

scholarly journals Differences between the Sexes in the Relationship between Chronic Pain, Fatigue, and QuickDASH among Community-Dwelling Elderly People in Japan

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 630
Author(s):  
Satoshi Shimo ◽  
Yuta Sakamoto ◽  
Takashi Amari ◽  
Masaaki Chino ◽  
Rie Sakamoto ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Elderly People ◽  
Physical Disability ◽  
The Elderly ◽  
Daily Basis ◽  
Community Dwelling ◽  
Negative Effects ◽  
The Relationship ◽  
Elderly Healthcare ◽  
Disability Research

Chronic pain and fatigue have negative effects on the health, ADL, work, and hobbies of the elderly. As the proportion of people 65 years of age and older in the population increases, chronic pain and disability research regarding this group is receiving more consideration. However, little empirical evidence of the association between chronic pain, fatigue, and physical disability between the sexes is available. This study investigated the association between chronic pain, fatigue, and instrumental activities of daily living among community-dwelling elderly people by sex in Japan. Concerning the presence of chronic pain, 61% of males and 78% of females reported chronic pain, indicating that many elderly people living in the community suffer from chronic pain and fatigue on a daily basis. The number of sites of chronic pain was higher in females than in males (p = 0.016), with more chronic pain in the knees (p < 0.001) and upper arms (p = 0.014). Regarding chronic pain, males showed a higher correlation with QuickDASH-DS (rs = 0.433, p = 0.017) and QuickDASH-SM (rs = 0.643, p = 0.018) than females. Furthermore, fatigue also showed a higher correlation with QuickDASH-W (rs = 0.531, p = 0.003) in males than in females. These results indicate that the association between chronic pain, fatigue, and QuickDASH differed between the sexes among community-dwelling elderly people in Japan. A better understanding of the risk factors for elderly chronic pain and fatigue among sexes will facilitate the development of elderly healthcare welfare and policies.

scholarly journals Relationship between Psychological Distress and Prolonged Sedentary Bouts in the Elderly: Four Period Analysis

Healthcare ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 676
Author(s):  
Yutaka Owari
Keyword(s):  
Mental Health ◽  
Psychological Distress ◽  
Structural Equation ◽  
Goodness Of Fit ◽  
Secondary Analysis ◽  
The Elderly ◽  
Sample Population ◽  
Elderly Individuals ◽  
Sedentary Bouts ◽  
Fit Index

Background: Too much sitting is associated with low mental health in elderly individuals. We clarified the relationship between psychological distress and the rate of prolonged sedentary bouts (PSBs) among the elderly over four periods. Methods: In a secondary analysis, a sample population of 68 adults aged 65 years or older in Japan was used. The following proxy variables were used: PSB (mental health) and the Kessler 6 scale; K6 scores (psychological distress). Results: Using the cross-lagged effects models, from “2016 K6” to “2017 PSB” (p = 0.004), from “2017 K6” to “2018 PSB” (p < 0.001), and from “2018 K6” to “2019 PSB” (p = 0.021) were all significant; however, the reverse were not all significant in one period. In four periods, from “2016 PSB” to “2019 K6” (p = 0.025) was significant; however, the reverse was not significant. Fit indices were obtained: χ2 = 7.641 (p = 0.182), goodness of fit index (GFI) = 0.891, comparative fit index (CFI) = 0.901, and root mean square error of approximation (RMSEA) = 0.121 in structural equation modelling. Conclusions: Psychological distress may affect the rate of PSB after one year, and the rate of PSB may affect the rate of psychological distress after three years in elderly individuals.

scholarly journals Cross-Cultural Comparisons of Subjective Cognitive Complaints in a Diverse Primary Care Population

2021 ◽  
pp. 1-11
Author(s):  
Danelly Rodríguez ◽  
Emmeline Ayers ◽  
Erica F. Weiss ◽  
Joe Verghese
Keyword(s):  
Primary Care ◽  
Depressive Symptoms ◽  
Cognitive Function ◽  
African Americans ◽  
Primary Care Clinic ◽  
Depression Scale ◽  
Cognitive Complaints ◽  
Care Clinic ◽  
Primary Care Population ◽  
Subjective Cognitive Complaints

Background: Very few studies have explored the utility of subjective cognitive complaints (SCCs) in primary care settings. Objective: We aim to investigate associations between SCCs (item-level), objective cognitive function (across domains and global), and mood in a diverse primary care population, including subjects with mild cognitive impairment. Methods: We studied 199 (75.9%females; 57.8%Hispanics; 42.2%African Americans) older adults (mean age 72.5 years) with memory concerns at a primary care clinic. A five-item SCC questionnaire, and objective cognitive assessments, including the Montreal Cognitive Assessment (MoCA) and the Geriatric Depression Scale, were administered. Results: Logistic regression analyses showed associations between SCC score and depressive symptoms. A memory-specific (“memory worsening”) SCC predicted scores on the MoCA (p = 0.005) in Hispanics. Conclusion: SCCs are strongly linked to depressive symptoms in African Americans and Hispanics in a primary care setting; a specific type of SCC is related to global cognitive function in Hispanics.

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