TY - JOUR
T1 - A Novel Method for Establishing Functional Change in Older Adults with Cognitive Impairment
AU - González, David A.
AU - Resch, Zachary J.
AU - Gonzales, Mitzi M.
AU - Soble, Jason R.
N1 - Funding Information:
The NACC database is funded by NIA/NIH Grant U01 AG016976. NACC data are contributed by the NIA-funded ADCs: P30 AG019610 (PI Eric Reiman, MD), P30 AG013846 (PI Neil Kowall, MD), P30 AG062428-01 (PI James Leverenz, MD) P50 AG008702 (PI Scott Small, MD), P50 AG025688 (PI Allan Levey, MD, PhD), P50 AG047266 (PI Todd Golde, MD, PhD), P30 AG010133 (PI Andrew Saykin, PsyD), P50 AG005146 (PI Marilyn Albert, PhD), P30 AG062421-01 (PI Bradley Hyman, MD, PhD), P30 AG062422-01 (PI Ronald Petersen, MD, PhD), P50 AG005138 (PI Mary Sano, PhD), P30 AG008051 (PI Thomas Wisniewski, MD), P30 AG013854 (PI Robert Vassar, PhD), P30 AG008017 (PI Jeffrey Kaye, MD), P30 AG010161 (PI David Bennett, MD), P50 AG047366 (PI Victor Henderson, MD, MS), P30 AG010129 (PI Charles DeCarli, MD), P50 AG016573 (PI Frank LaFerla, PhD), P30 AG062429-01(PI James Brewer, MD, PhD), P50 AG023501 (PI Bruce Miller, MD), P30 AG035982 (PI Russell Swerdlow, MD), P30 AG028383 (PI Linda Van Eldik, PhD), P30 AG053760 (PI Henry Paulson, MD, PhD), P30 AG010124 (PI John Trojanowski, MD, PhD), P50 AG005133 (PI Oscar Lopez, MD), P50 AG005142 (PI Helena Chui, MD), P30 AG012300 (PI Roger Rosenberg, MD), P30 AG049638 (PI Suzanne Craft, PhD), P50 AG005136 (PI Thomas Grabowski, MD), P30 AG062715-01 (PI Sanjay Asthana, MD, FRCP), P50 AG005681 (PI John Morris, MD), P50 AG047270 (PI Stephen Strittmatter, MD, PhD). Other support includes: AG054076, AG0666524 and AG052409 and AG059421.
Publisher Copyright:
© Copyright 2022 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2022/7/1
Y1 - 2022/7/1
N2 - Objective: The aim was to set syndrome stage-specific (eg, cognitively unimpaired, severe dementia) metrics for functional change. Methods: We selected 18,097 individuals who participated in 2 National Alzheimer's Coordinating Center visits between June 2005 and May 2020, with completed collateral rating of functioning on activities of daily living assessed by the Functional Activities Questionnaire. Both distribution-based (ie, regression-based reliable change indices) and anchor-based (ie, typical change associated with advancing a syndromal stage for clinically meaningful difference) methods were applied for individuals classified as: unimpaired cognition, mild cognitive impairment, mild dementia, moderate dementia, or severe dementia. Results: There were marked differences in the distribution of functional ratings depending on their syndromal stage. There were also differences in the functional change associated with advancing across different syndromal stages. These informed stage-specific metrics for reliable change indices and clinically meaningful differences. Conclusions: Our indices provide a hitherto unavailable method that allows clinicians to determine whether observed functional change is reliable or meaningful based on syndromal stage.
AB - Objective: The aim was to set syndrome stage-specific (eg, cognitively unimpaired, severe dementia) metrics for functional change. Methods: We selected 18,097 individuals who participated in 2 National Alzheimer's Coordinating Center visits between June 2005 and May 2020, with completed collateral rating of functioning on activities of daily living assessed by the Functional Activities Questionnaire. Both distribution-based (ie, regression-based reliable change indices) and anchor-based (ie, typical change associated with advancing a syndromal stage for clinically meaningful difference) methods were applied for individuals classified as: unimpaired cognition, mild cognitive impairment, mild dementia, moderate dementia, or severe dementia. Results: There were marked differences in the distribution of functional ratings depending on their syndromal stage. There were also differences in the functional change associated with advancing across different syndromal stages. These informed stage-specific metrics for reliable change indices and clinically meaningful differences. Conclusions: Our indices provide a hitherto unavailable method that allows clinicians to determine whether observed functional change is reliable or meaningful based on syndromal stage.
KW - Functional Activities Questionnaire
KW - activities of daily living
KW - clinically meaningful difference
KW - functional change
KW - reliable change index
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U2 - 10.1097/WAD.0000000000000507
DO - 10.1097/WAD.0000000000000507
M3 - Article
C2 - 35380552
AN - SCOPUS:85129881861
SN - 0893-0341
VL - 36
SP - 238
EP - 243
JO - Alzheimer Disease and Associated Disorders
JF - Alzheimer Disease and Associated Disorders
IS - 3
ER -