Assessment of Cognition Using Surveys and Neuropsychological Assessment: The Health and Retirement Study and the Aging, Demographics, and Memory Study

TLDR

Cognitive assessment for diagnosing dementia and CIND in large population surveys could be improved by incorporating targeted informant information and additional tests covering other brain functions. This study examines the concordance between a single interview in the Health and Retirement Study and a detailed neuropsychiatric assessment in the Aging, Demographics, and Memory Study. Respondents were classified as demented, cognitively impaired no dementia, or normal in ADAMS, and multinomial logistic regression predicted these diagnoses from HRS cognitive and noncognitive measures, supplemented by additional ADAMS data. The HRS cognitive tests correctly predicted ADAMS diagnoses in 74% of self‑respondents, 86% of proxy respondents with some impairment, and adding a few ADAMS tests increased these accuracies to 84% and 93% respectively.

Abstract

This study examines the similarity of cognitive assessments using 1 interview in a large population study, the Health and Retirement Study (HRS), and a subsample in which a detailed neuropsychiatric assessment has been performed (Aging, Demographics, and Memory Study [ADAMS]). Respondents are diagnosed in ADAMS as demented, cognitively impaired without dementia (CIND), or as having normal cognitive function. Multinomial logistic analysis is used to predict diagnosis using a variety of cognitive and noncognitive measures from the HRS and additional measures and information from ADAMS. The cognitive tests in HRS predict the ADAMS diagnosis in 74% of the sample able to complete the HRS survey on their own. Proxy respondents answer for a large proportion of HRS respondents who are diagnosed as demented in ADAMS. Classification of proxy respondents with some cognitive impairment can be predicted in 86% of the sample. Adding a small number of additional tests from ADAMS can increase each of these percentages to 84% and 93%, respectively. Cognitive assessment appropriate for diagnosis of dementia and CIND in large population surveys could be improved with more targeted information from informants and additional cognitive tests targeting other areas of brain function.