Published on Wed Sep 29 2021

Measuring Subjective Cognitive Decline in Older Adults: Harmonization between the Cognitive Change Index and the Measurement of Everyday Cognition Instruments

Wells, L. F., Risacher, S. L., McDonald, B. C., Farlow, M. R., Brosch, J., Gao, S., Apostolova, L. G., Saykin, A. J.

The 20-item Cognitive Change Index (CCI) and the 39-item Measurement of Everyday Cognition (ECog) were each developed to characterize early subjective changes in cognitive function. We examined the relationship between CCI and ECog self and informant evaluations to determine content overlap and provide a co-calibration for converting between these widely used instruments.

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Abstract

Background: Self and informant (proxy or study partner) reports of everyday cognitive functioning have been shown to be associated with incipient neurodegenerative disease. The 20-item Cognitive Change Index (CCI) and the 39-item Measurement of Everyday Cognition (ECog) were each developed to characterize early subjective changes in cognitive function. Objective: We examined the relationship between CCI and ECog self and informant evaluations to determine content overlap and provide a co-calibration for converting between these widely used instruments. Methods: 950 participants (57.1% female, mean age=71.2yrs) from ADNI and the Indiana ADRC with self evaluations and 279 participants (60.9% female, mean age=71.8yrs) with informant evaluations (Indiana ADRC) were included. Analyzed variables for the CCI and ECog included domain mean scores, memory domain total scores, and total scores for all items. Pearson correlations, regression analyses, and frequency distributions were used to assess the relationship between CCI and ECog. Sex, years of education, race, APOE {varepsilon}4 carrier status, and baseline diagnosis were also analyzed as potentially relevant covariates. Results: CCI and ECog total scores were highly correlated for the self (r=0.790, p<0.001) and informant (r=0.860, p<0.001) versions. Frequency distributions of total scores were generated and self and informant histograms were plotted separately. Quadratic regressions for self (r2=0.682) and informant (r2=0.863) scores were used to create a translation table between the CCI and ECog total scores. Conclusion: Self and informant total scores can be harmonized and translated between the CCI and ECog to facilitate cross-study and longitudinal assessment of perceived cognitive change, an important patient-reported outcome.