scholarly journals Diagnosing Mild Cognitive Impairment Among Racially Diverse Older Adults: Comparison of Consensus, Actuarial, and Statistical Methods

2021 ◽  
pp. 1-18
Author(s):  
Kathryn N. Devlin ◽  
Laura Brennan ◽  
Laura Saad ◽  
Tania Giovannetti ◽  
Roy H. Hamilton ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Statistical Methods ◽  
Latent Class ◽  
Population Based ◽  
Functional Change ◽  
Diagnostic Methods ◽  
Prognostic Indicators ◽  
Racially Diverse

Background: Actuarial and statistical methods have been proposed as alternatives to conventional methods of diagnosing mild cognitive impairment (MCI), with the aim of enhancing diagnostic and prognostic validity, but have not been compared in racially diverse samples. Objective: We compared the agreement of consensus, actuarial, and statistical MCI diagnostic methods, and their relationship to race and prognostic indicators among diverse older adults. Methods: Participants (N = 354; M age = 71; 68% White, 29% Black) were diagnosed with MCI or normal cognition (NC) according to clinical consensus, actuarial neuropsychological criteria (Jak/Bondi), and latent class analysis (LCA). We examined associations with race/ethnicity, longitudinal cognitive and functional change, and incident dementia. Results: MCI rates by consensus, actuarial criteria, and LCA were 44%, 53%, and 41%, respectively. LCA identified three MCI subtypes (memory; memory/language; memory/executive) and two NC classes (low normal; high normal). Diagnostic agreement was substantial, but agreement of the actuarial method with consensus and LCA was weaker than the agreement between consensus and LCA. Among cases classified as MCI by actuarial criteria only, Black participants were over-represented, and outcomes were generally similar to those of NC participants. Consensus diagnoses best predicted longitudinal outcomes overall, whereas actuarial diagnoses best predicted longitudinal functional change among Black participants. Conclusion: Consensus diagnoses optimize specificity in predicting dementia, but among Black older adults, actuarial diagnoses may be more sensitive to early signs of decline. Results highlight the need for cross-cultural validity in MCI diagnosis and should be explored in community- and population-based samples.

scholarly journals Anemia, mild cognitive impairment, and dementia among rural‐dwelling older adults: A population‐based study

2020 ◽  
Vol 16 (S10) ◽  
Author(s):  
Ziying Jiang ◽  
Xiaolei Han ◽  
Yongxiang Wang ◽  
Tingting Hou ◽  
Lin Cong ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Population Based ◽  
Population Based Study

scholarly journals Challenge levels of everyday technologies as perceived over five years by older adults with mild cognitive impairment

2018 ◽  
Vol 30 (10) ◽  
pp. 1447-1454 ◽  
Author(s):  
Annicka Hedman ◽  
Anders Kottorp ◽  
Ove Almkvist ◽  
Louise Nygård
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Functional Decline ◽  
Dropout Rate ◽  
Functional Change ◽  
Functional Markers ◽  
Perceived Ability ◽  
Item Functioning ◽  
Perceived Challenge

ABSTRACTBackground:In clinical practice, efficient and valid functional markers are needed to detect subtle cognitive and functional decline in mild cognitive impairment (MCI). This prospective study explored whether changes in perceived challenge of certain everyday technologies (ETs) can be used to detect signs of functional change in MCI.Methods:Baseline and five-year data from 37 older adults (mean age 67.5 years) with MCI regarding their perceived ability to use ET were used to generate Rasch-based ET item measures reflecting the relative challenge of 46 ETs. Actual differential item functioning in relation to time was analyzed based on these item measures. Data collection took place in 2008–2014.Results:Seven (15%) of the ETs included were perceived to be significantly more challenging to use at year five compared to at baseline, while 39 ETs (85%) were perceived to be equally challenging to use, despite the fact that the participants’ perceived ability to use ET had decreased. Common characteristics among the ETs that became more challenging to use could not be identified. The dropout rate was 43%, which limits the power of the study.Conclusions:Changes in the perceived challenge of ETs seem to capture functional change in persons with cognitive decline. Both easier and more challenging ETs typically used at home and in society need to be addressed to capture this functional change because significant changes occurred among ETs of all challenge levels and within all types of ETs.

Characterizing Global and Regional Brain Structures in Amnestic Mild Cognitive Impairment Among Rural Residents: A Population-Based Study

2021 ◽  
Vol 80 (4) ◽  
pp. 1429-1438
Author(s):  
Yuanjing Li ◽  
Lin Cong ◽  
Tingting Hou ◽  
Liguo Chang ◽  
Chuanchen Zhang ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Brain Structures ◽  
Population Based ◽  
Amnestic Mild Cognitive Impairment ◽  
Population Based Study ◽  
Brain Volumes ◽  
Regional Brain ◽  
Mri Scans

Background: Structural brain magnetic resonance imaging (MRI) scans may provide reliable neuroimaging markers for defining amnestic mild cognitive impairment (aMCI). Objective: We sought to characterize global and regional brain structures of aMCI among rural-dwelling older adults with limited education in China. Methods: This population-based study included 180 participants (aged≥65 years, 42 with aMCI and 138 normal controls) in the Shandong Yanggu Study of Aging and Dementia during 2014–2016. We defined aMCI following the Petersen’s criteria. Global and regional brain volumes were automatically segmented on MRI scans and compared using a region-of-interest approach. Data were analyzed using general linear regression models. Results: Multi-adjusted β-coefficient (95% confidence interval) of brain volumes (cm3) associated with aMCI was –12.07 (–21.49, –2.64) for global grey matter (GM), –18.31 (–28.45, –8.17) for global white matter (WM), 28.17 (12.83, 44.07) for cerebrospinal fluid (CSF), and 2.20 (0.24, 4.16) for white matter hyperintensities (WMH). Furthermore, aMCI was significantly associated with lower GM volumes in bilateral superior temporal gyri, thalamus and right cuneus, and lower WM volumes in lateral areas extending from the frontal to the parietal, temporal, and occipital lobes, as well as right hippocampus (p < 0.05). Conclusion: Brain structure of older adults with aMCI is characterized by reduced global GM and WM volumes, enlarged CSF volume, increased WMH burden, reduced GM volumes in bilateral superior temporal gyri, thalamus, and right cuneus, and widespread reductions of lateral WM volumes.

Sign in / Sign up

Export Citation Format

Share Document