Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
General Internal Medicine, University of Washington, Seattle, Washington, USA.
J Gerontol B Psychol Sci Soc Sci. 2023 Feb 19;78(2):191-200. doi: 10.1093/geronb/gbac135.
Telephone-administered cognitive assessments are a cost-effective and sometimes necessary alternative to face-to-face assessments. There is limited information in large studies concerning mode effects, or differences in cognition attributable to the assessment method, as a potential measurement threat. We evaluated mode effects on cognitive scores using a population-based sample of community-living older adults.
We used data from participants aged 65-79 in the 2014 Health and Retirement Study for whom the interview mode was randomized (n = 6,825). We assessed mode differences in test means, whether mode modifies associations of cognition with criterion variables, and formal measurement invariance testing.
Relative to face-to-face assessment, telephone assessment was associated with higher scores for memory and calculation (0.06 to 0.013 standard deviations [SD]) and lower scores for nonmemory items (-0.09 to -0.01 SD). Cognition was significantly differentially related to instrumental activities of daily living difficulty depending on assessment mode. Measurement invariance testing identified evidence of mode differences in certain tests as a function of mode: adjusting for underlying cognition, the largest mode differences in memory and attention: immediate noun recall, delayed word recall, and serial-7s scores were higher given telephone administration.
Differences by mode of administration are apparent in cognitive measurement in older adults, albeit to a small degree in our study, and most pronounced for tests of memory and attention. The importance of accounting for mode differences ultimately depends on one's research question and study sample: not all associations may be affected by mode differences, and such modification may only be apparent among those with lower cognitive functioning.
电话管理认知评估是一种具有成本效益的替代方法，有时也是必要的替代方法，可替代面对面评估。在大型研究中，关于模式效应或由于评估方法而导致的认知差异的信息有限，因为这是一种潜在的测量威胁。我们使用基于人群的社区居住的老年人样本评估了认知评分的模式效应。
我们使用了 2014 年健康与退休研究中年龄在 65-79 岁的参与者的数据，这些参与者的访谈模式是随机的（n=6825）。我们评估了测试均值的模式差异，评估认知与标准变量之间的关联是否因模式而异，以及正式的测量不变性检验。
与面对面评估相比，电话评估与记忆和计算（0.06 至 0.013 标准差）的分数较高相关，与非记忆项目（-0.09 至-0.01 标准差）的分数较低相关。认知与日常活动的工具性活动困难的关系明显因评估模式而异。测量不变性检验确定了模式差异的证据，因为某些测试的模式存在差异：根据基础认知进行调整后，记忆和注意力的测试模式差异最大：即时名词回忆、延迟单词回忆和连续 7 分的分数在电话管理中更高。
尽管在我们的研究中差异很小，但在老年人的认知测量中，管理方式的差异是明显的，尤其是在记忆和注意力方面。最终是否需要考虑模式差异取决于一个人的研究问题和研究样本：并非所有关联都可能受到模式差异的影响，并且这种变化可能仅在认知功能较低的人群中明显。
