Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA.
Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA.
J Alzheimers Dis. 2016;51(4):1145-55. doi: 10.3233/JAD-150729.
The perception of cognitive decline by individuals and those who know them well ("informants") has been inconsistently associated with objective cognitive performance, but strongly associated with depressive symptoms.
We investigated associations of self-report, informant-report, and discrepancy between self- and informant-report of cognitive decline obtained from the Cognitive Change Index (CCI) with cognitive test performance and self-reported depressive symptoms.
267 participants with normal cognition, mild cognitive impairment (MCI), or mild dementia were included from a cohort study and memory clinic. Association of test performance and self-rated depression (Geriatric Depression Scale, GDS) with CCI scores obtained from subjects (CCI-S), their informants (CCI-I), and discrepancy scores between subjects and informants (CCI-D; CCI-S minus CCI-I) were analyzed using correlation and analysis of covariance (ANCOVA) models.
CCI-S and CCI-I scores showed high internal consistency (Cronbach alpha 0.96 and 0.98, respectively). Higher scores on CCI-S and CCI-I, and lower scores on the CCI-D, were associated with lower performance on various cognitive tests in both univariate and in ANCOVA models adjusted for age, gender, and education. Adjustment for GDS slightly weakened the relationships between CCI and test performance but most remained significant.
Self- and informant-report of cognitive decline, as measured by the CCI, show moderately strong relationships with objective test performance independent of age, gender, education, and depressive symptoms. The CCI appears to be a valid cross-sectional measure of self and informant perception of cognitive decline across the continuum of functioning. Studies are needed to address the relationship of CCI scores to longitudinal outcome.
个体及其熟人（“知情人”）对认知能力下降的感知与客观认知表现不一致，但与抑郁症状密切相关。
我们研究了从认知变化指数（CCI）获得的自我报告、知情人报告和自我报告与知情人报告的认知下降之间的差异与认知测试表现和自我报告的抑郁症状之间的关联。
从队列研究和记忆诊所中纳入了 267 名认知正常、轻度认知障碍（MCI）或轻度痴呆的参与者。使用相关性和协方差分析（ANCOVA）模型分析了测试表现和自我评定抑郁（老年抑郁量表，GDS）与受试者获得的 CCI 评分（CCI-S）、他们的知情人（CCI-I）和受试者与知情人之间的差异评分（CCI-D；CCI-S 减去 CCI-I）之间的关联。
CCI-S 和 CCI-I 评分具有较高的内部一致性（Cronbach alpha 分别为 0.96 和 0.98）。CCI-S 和 CCI-I 的评分越高，CCI-D 的评分越低，与各种认知测试的表现越低，在单变量和调整年龄、性别和教育的 ANCOVA 模型中均如此。调整 GDS 后，CCI 与测试表现之间的关系略有减弱，但大多数仍具有统计学意义。
CCI 测量的自我和知情人对认知下降的报告与客观测试表现之间存在中度强的关系，独立于年龄、性别、教育和抑郁症状。CCI 似乎是一种有效的横断面对认知下降的自我和知情人感知的测量工具，适用于整个功能连续体。需要进一步研究 CCI 评分与纵向结果的关系。
