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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Diagnosing Mild Cognitive Impairment Among Racially Diverse Older Adults: Comparison of Consensus, Actuarial, and Statistical Methods
Journal of Alzheimer's disease, v 85(2), pp 627-640
2022
PMID: 34864658
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
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.
We compared the agreement of consensus, actuarial, and statistical MCI diagnostic methods, and their relationship to race and prognostic indicators, among diverse older adults.
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.
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.
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.
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Details
- Title
- Diagnosing Mild Cognitive Impairment Among Racially Diverse Older Adults: Comparison of Consensus, Actuarial, and Statistical Methods
- Creators
- Kathryn N Devlin - Drexel UniversityLaura Brennan - Thomas Jefferson University HospitalLaura Saad - Rutgers, The State University of New JerseyTania Giovannetti - Temple UniversityRoy H Hamilton - University of PennsylvaniaDavid A Wolk - University of PennsylvaniaSharon X Xie - University of PennsylvaniaDawn Mechanic-Hamilton - University of Pennsylvania
- Publication Details
- Journal of Alzheimer's disease, v 85(2), pp 627-640
- Publisher
- IOS Press
- Grant note
- K23 AG065499 / NIA NIH HHS P30 AG010124 / NIA NIH HHS P30 AG072979 / NIA NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Psychological and Brain Sciences (Psychology)
- Web of Science ID
- WOS:000747048000015
- Scopus ID
- 2-s2.0-85123294501
- Other Identifier
- 991019168871404721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Neurosciences