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Using informant reports to detect cognitive decline in mild cognitive impairment

Published online by Cambridge University Press:  03 February 2012

Ruby S. M. Tsang
Affiliation:
Ageing Brain Centre, Brain & Mind Research Institute, University of Sydney, Sydney, NSW, Australia
Keri Diamond
Affiliation:
Ageing Brain Centre, Brain & Mind Research Institute, University of Sydney, Sydney, NSW, Australia
Loren Mowszowski
Affiliation:
Ageing Brain Centre, Brain & Mind Research Institute, University of Sydney, Sydney, NSW, Australia
Simon J. G. Lewis
Affiliation:
Ageing Brain Centre, Brain & Mind Research Institute, University of Sydney, Sydney, NSW, Australia
Sharon L. Naismith*
Affiliation:
Ageing Brain Centre, Brain & Mind Research Institute, University of Sydney, Sydney, NSW, Australia
*
Correspondence should be addressed to: Associate Professor Sharon Naismith, Ageing Brain Centre, Brain & Mind Research Institute, University of Sydney, 94 Mallett St, Camperdown NSW 2050, Australia. Phone: +612 9351 0781; Fax: +612 9351 0855. Email: sharon.naismith@sydney.edu.au.

Abstract

Background: The use of informant rating scales in older adults at risk of dementia may assist with early detection and intervention strategies. This study aims to evaluate whether informants rate greater cognitive change in patients with mild cognitive impairment (MCI) compared to cognitively intact individuals, and to determine the relationship between informant ratings of cognitive change and neuropsychological performance.

Methods: One hundred and nine health-seeking older adults underwent clinical and neuropsychological assessments, and informants completed the Cambridge Behavioral Inventory-Revised (CBI-R). Patients were rated according to MCI criteria, including amnestic and non-amnestic subtypes, or as being cognitively intact. CBI-R ratings were evaluated with respect to MCI diagnosis and neuropsychological performance.

Results: Compared to cognitively intact individuals, informants rated patients with MCI as having significantly more change in overall functioning (p < 0.05) as well as in specific domains of memory and orientation (p < 0.01), everyday skills (p < 0.05), and motivation (p < 0.05), even after controlling for depressive symptom severity. In further analyses, the non-amnestic MCI subgroup only had more informant-rated mood changes compared to the amnestic subgroup. In relation to neuropsychological performance, informant ratings were related to poorer visual memory, verbal learning and memory, language, and psychomotor speed, with correlations ranging from –0.19 to –0.43 (p < 0.05).

Conclusions: These findings indicate that informants are sensitive to subtle early cognitive change in individuals with MCI, and that their ratings are related to objectively measured neuropsychological performance. Thus, the CBI-R may be valuable in assisting early screening and intervention processes.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2012

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References

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington, DC: American Psychiatric Association.Google Scholar
Benton, A., Hamsher, K. and Sivan, A. (1983). Multilingual Aphasia Examination, 3rd edn. Iowa City, IA: AJA Associates.Google Scholar
Brodaty, H. and Pond, , , D. (2005). The GPCOG: a new tool for primary care physicians to detect dementia. Alzheimer's and Dementia, 1, S19. doi: 10.1016/j.jalz.2005.06.096.CrossRefGoogle Scholar
Cummings, J. L. (1993). Frontal-subcortical circuits and human behavior. Archives of Neurology, 50, 873880.CrossRefGoogle ScholarPubMed
Dixon, R. A. and Bäckman, , , L. (eds.) (1995). Compensating for Psychological Deficits and Declines: Managing Losses and Promoting Gains. Mahwah, NJ: L. Erlbaum Associates.Google Scholar
Ferri, C. P. et al. (2005). Global prevalence of dementia: a delphi consensus study. Lancet, 366, 21122117. doi: 10.1016/S0140-6736(05)67889-0.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198. doi: 10.1016/0022-3956(75)90026-6.CrossRefGoogle ScholarPubMed
Gauthier, S. et al. (2006). Mild cognitive impairment. Lancet, 367, 12621270. doi: 10.1016/S0140-6736(06)68542-5.CrossRefGoogle ScholarPubMed
Hamilton, M. (1960). A rating scale for depression. Journal of Neurology, Neurosurgery, and Psychiatry, 23, 5662. doi: 10.1136/jnnp.23.1.56.CrossRefGoogle ScholarPubMed
Hickie, I., Scott, E., Wilhelm, K. and Brodaty, H. (1997). Subcortical hyperintensities on magnetic resonance imaging in patients with severe depression: a longitudinal evaluation. Biological Psychiatry, 42, 367374. doi: 10.1016/S0006-3223(96)00363-0.CrossRefGoogle ScholarPubMed
Kaplan, E. F., Goodglass, H. and Weintraub, S. (1983). The Boston Naming Test. Philadelphia, PA: Lea & Febiger.Google Scholar
Komadina, N. C., Terpening, Z., Huang, Y., Halliday, G. M., Naismith, S. L. and Lewis, S. J. G. (2011). Utility and limitations of Addenbrooke's Cognitive Examination-revised for detecting mild cognitive impairment in Parkinson's disease. Dementia and Geriatric Cognitive Disorders, 31, 349357. doi: 10.1159/000328165.CrossRefGoogle ScholarPubMed
Meyers, J. E. and Meyers, K. R. (1995). Rey Complex Figure Test and Recognition Trial: Professional Manual. Odessa, FL: Psychological Assessment Resources, Inc.Google Scholar
Middleton, L. E. and Yaffe, , , K. (2009). Promising strategies for the prevention of dementia. Archives of Neurology, 66, 12101215. doi: 10.1001/archneurol.2009.201.CrossRefGoogle ScholarPubMed
Naismith, S. L. et al. (2003). Neuropsychological performance in patients with depression is associated with clinical, etiological and genetic risk factors. Journal of Clinical and Experimental Neuropsychology, 25, 866877. doi: 10.1076/jcen.25.6.866.16472.CrossRefGoogle ScholarPubMed
Naismith, S. L., Pereira, M., Shine, J. M. and Lewis, S. J. G. (2011). How well do caregivers detect mild cognitive change in Parkinson's disease? Movement Disorders, 26, 161164. doi: 10.1002/mds.23331.CrossRefGoogle ScholarPubMed
O'Bryant, S. E. et al. (2008). Detecting dementia with the Mini-Mental State Examination in highly educated individuals. Archives of Neurology, 65, 963967. doi: 10.1001/archneur.65.7.963.Google ScholarPubMed
Onyike, C. U. (2006). Cerebrovascular disease and dementia. International Review of Psychiatry, 18, 423431. doi: 10.1080/09540260600935421.CrossRefGoogle ScholarPubMed
Petersen, R. C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256, 183194. doi: 10.1111/j.1365-2796.2004.01388.x.CrossRefGoogle ScholarPubMed
Reisberg, B. et al. (2008). The pre-mild cognitive impairment, subjective cognitive impairment stage of Alzheimer's disease. Alzheimer's and Dementia, 4, S98S108. doi: 10.1016/j.jalz.2007.11.017.CrossRefGoogle ScholarPubMed
Reitan, R. M. (1979). Manual for Administration of Neuropsychological Test Batteries for Adults and Children. Tucson, AZ: Reitan Neuropsychological Laboratory.Google Scholar
Schinka, J. (2010). Use of informants to identify mild cognitive impairment in older adults. Current Psychiatry Reports, 12, 412. doi: 10.1007/s11920-009-0079-9.CrossRefGoogle ScholarPubMed
Schinka, J. A., Raj, A., Loewenstein, D. A., Small, B. J., Duara, R. and Potter, H. (2010). The cognitive change checklist (3CL): cross-validation of a measure of change in everyday cognition. International Journal of Geriatric Psychiatry, 25, 266274. doi: 10.1002/gps.2332.CrossRefGoogle ScholarPubMed
Spreen, O. and Strauss, , , E. (1998). A Compendium of Neuropsychological Tests: Administration, Norms and Commentary. New York: Oxford University Press.Google Scholar
Stern, Y. (2009). Cognitive reserve. Neuropsychologia, 47, 20152028. doi: 10.1016/j.neuropsychologia.2009.03.004.CrossRefGoogle ScholarPubMed
Wear, H. J. et al. (2008). The Cambridge Behavioural Inventory revised. Dementia & Neuropsychologia, 2, 102107.CrossRefGoogle ScholarPubMed
Wechsler, D. (1997a). Manual for the Wechsler Adult Intelligence Scale, 3rd edn. San Antonio, TX: The Psychological Corporation.Google Scholar
Wechsler, D. (1997b). Wechsler Memory Scale. San Antonio, TX: The Psychological Corporation.Google Scholar
Wechsler, D. (2001). Wechsler Test of Adult Reading. San Antonio, TX: Harcourt Assessment.Google Scholar
Wright, C. F., Hall, A., Matthews, F. E. and Brayne, C. (2009). Biomarkers, dementia, and public health. Annals of the New York Academy of Sciences, 1180, 1119. doi: 10.1111/j.1749-6632.2009.04942.x.CrossRefGoogle ScholarPubMed