Diagnostic accuracy and differential associations between ratings of functioning and neuropsychological performance in non-Hispanic Black and White older adults
Year: 2021
Type: article
Abstract: Objective We recently demonstrated that relative to consensus-based methods, actuarial methods may improve diagnostic accuracy across the continuum of cognitively normal (CN), mild cognitive impairment (MCI), and dementia in the overall National Alzheimer’s Coordinating Center (NACC) cohort. However, the generalizability and comparative utility of current methods of diagnosing MCI and dementia due to Alzheimer’s disease and related disorders (ADRD) are significantly understudied in non-Hispanic Black (NHB) older adults. Thus, we extended our previous investigation to more specifically explore the utility of consensus-based and actuarial diagnostic methods in NHB older adults.Method: We compared baseline consensus and actuarial diagnostic rates, and associations of ratings of functioning with neuropsychological performance and diagnostic outcomes, in NHB (n = 963) and non-Hispanic White (NHW; n = 4577) older adults in the NACC cohort.Results: 60.0% of the NHB subsample, versus 29.2% of the NHW subsample, included participants who met actuarial criteria for MCI despite being classified as CN or impaired-not-MCI per consensus. Additionally, associations between ratings of functioning and neuropsychological performance were less consistent in NHB participants than in NHW participants.Conclusions: Our results provide evidence of differential degrees of association between reported functioning and neuropsychological performance in NHB and NHW older adults, which may contribute to racial group differences in diagnostic rates, and prompt consideration of the strengths and weaknesses of consensus-based and actuarial diagnostic approaches in assessing neurocognitive functioning in NHB older adults.
Source: The Clinical Neuropsychologist
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: Michigan Alzheimer's Disease Core Center, UC Davis Alzheimer's Disease Core Center, Indiana Alzheimer Disease Center, G1711016037, Wake Forest Alzheimer's Disease Core Center, University of Kentucky Alzheimer's Disease Core Center, Re-visiting Methods for MCI Diagnosis to Improve Biomarker and Trial Findings, Alzheimer's Disease Research Center, National Alzheimer's Coordinating Center, Alzheimer's Disease Research Center, Alzheimer's Disease Core Center, Cleveland Alzheimer's Disease Research Center, The Alzheimer's Disease Research Center at the University of California, Irvine, Stanford Alzheimer's Disease Research Center, Oregon Alzheimer's Disease Center, Rush Alzheimer's Disease Core Center, Alzheimer's Disease Core Center, Alzheimer's Disease Research Center - Overall, University of Kansas Alzheimer's Disease Core Centers, G665855531, G6804111827, Alzheimer's Disease Research Center, Alzheimer Disease Research Center, Yale Alzheimer Disease Research Center, Arizona Alzheimer's Disease Core Center, Johns Hopkins Alzheimer's Disease Research Center, Boston University Alzheimer's Disease Center, Alzheimer's Disease Research Center, Alzheimer's Disease Core Center, Emory Alzheimer's Disease Center, University of Florida - Mt. Sinai Medical Center AD Research Center, A Novel Mobile Health Exercise Intervention in Aging: Brain Perfusion and Cognition, UCSD Shiley-Marcos Alzheimer's Disease Research Center P30, Oregon Alzheimer's Disease Research Center, Subjective Cognitive Decline and Objective Cognitive Trajectories in Older Hispanics/Latinos, Indiana Alzheimer's Disease Research Center, New Approaches to Dementia Heterogeneity, Wisconsin Alzheimer's Disease Research Center, National Alzheimer's Coordinating Center, San Diego Alzheimer's Disease Resource Center for Minority Aging Research (San Diego AD-RCMAR), Alzheimer's Disease Research Center, Massachusetts Alzheimer's Disease Research Center (MADRC), Rush Alzheimer's Disease Research Center, New Approaches to Dementia Heterogeneity
OpenAlex ID: W3197323337