不同国家背景下晚年认知功能的协调统一：来自统一认知评估协议（HCAPs）的结果。
Harmonization of Later-Life Cognitive Function Across National Contexts: Results from the Harmonized Cognitive Assessment Protocols (HCAPs).
作者信息
Gross Alden L, Li Chihua, Briceno Emily M, Rentería Miguel Arce, Jones Richard N, Langa Kenneth M, Manly Jennifer J, Nichols Emma L, Weir David, Wong Rebeca, Berkman Lisa, Lee Jinkook, Kobayashi Lindsay C
出版信息
medRxiv. 2023 Jun 12:2023.06.09.23291217. doi: 10.1101/2023.06.09.23291217.
BACKGROUND
The Harmonized Cognitive Assessment Protocol (HCAP) is an innovative instrument for cross-national comparisons of later-life cognitive function, yet its suitability across diverse populations is unknown. We aimed to harmonize general and domain-specific cognitive scores from HCAPs across six countries, and evaluate precision and criterion validity of the resulting harmonized scores.
METHODS
We statistically harmonized general and domain-specific cognitive function across the six publicly available HCAP partner studies in the United States, England, India, Mexico, China, and South Africa (N=21,141). We used an item banking approach that leveraged common cognitive test items across studies and tests that were unique to studies, as identified by a multidisciplinary expert panel. We generated harmonized factor scores for general and domain- specific cognitive function using serially estimated graded-response item response theory (IRT) models. We evaluated precision of the factor scores using test information plots and criterion validity using age, gender, and educational attainment.
FINDINGS
IRT models of cognitive function in each country fit well. We compared measurement reliability of the harmonized general cognitive function factor across each cohort using test information plots; marginal reliability was high (r> 0·90) for 93% of respondents across six countries. In each country, general cognitive function scores were lower with older ages and higher with greater levels of educational attainment.
INTERPRETATION
We statistically harmonized cognitive function measures across six large, population-based studies of cognitive aging in the US, England, India, Mexico, China, and South Africa. Precision of the estimated scores was excellent. This work provides a foundation for international networks of researchers to make stronger inferences and direct comparisons of cross-national associations of risk factors for cognitive outcomes.
FUNDING
National Institute on Aging (R01 AG070953, R01 AG030153, R01 AG051125, U01 AG058499; U24 AG065182; R01AG051158).
背景
统一认知评估协议（HCAP）是一种用于跨国比较晚年认知功能的创新工具，但其在不同人群中的适用性尚不清楚。我们旨在对六个国家的HCAP中的一般和特定领域认知分数进行统一，并评估所得统一分数的精度和标准效度。
方法
我们对美国、英国、印度、墨西哥、中国和南非的六项公开可用的HCAP合作研究（N = 21141）中的一般和特定领域认知功能进行了统计统一。我们采用了项目库方法，利用跨研究的共同认知测试项目以及多学科专家小组确定的各研究独有的测试项目。我们使用序列估计等级反应项目反应理论（IRT）模型生成一般和特定领域认知功能的统一因子分数。我们使用测试信息图评估因子分数的精度，并使用年龄、性别和教育程度评估标准效度。
结果
每个国家的认知功能IRT模型拟合良好。我们使用测试信息图比较了每个队列中统一的一般认知功能因子的测量可靠性；六个国家93%的受访者的边际可靠性较高（r>0.90）。在每个国家，一般认知功能分数随年龄增长而降低，随教育程度提高而升高。
解读
我们对美国、英国、印度、墨西哥、中国和南非六项基于人群的大型认知老化研究中的认知功能测量进行了统计统一。估计分数的精度非常高。这项工作为研究人员的国际网络提供了一个基础，以便对认知结果的危险因素的跨国关联进行更强有力的推断和直接比较。
资金来源
美国国立衰老研究所（R01 AG070�53、R01 AG０30153、R01 AG051125、U01 AG058499；U24 AG065182；R01AG051158）。
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