Rachel L. Nosheny, Ph.D., Assistant Professor, University of California, San Francisco, Department of Psychiatry, San Francisco VA Medical Center, 4150 Clement Street (114M), San Francisco, CA 94121, Tel: 650-468-0619, Fax: 415-668-2864, email:
J Prev Alzheimers Dis. 2024;11(6):1741-1750. doi: 10.14283/jpad.2024.109.
The Everyday Cognition (ECog) 12-item scale, a functional decline measurement, can distinguish dementia from cognitively unimpaired (CU). Limited data compare ECog-12 performance by raters (self vs. informant) and scoring systems (average numeric vs. categorical grouping) to differentiate cognitive statuses.
To evaluate the performance of ECog-12 in differentiation cognitive statuses.
A cross-sectional diagnostic test study.
Data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) study are analyzed. Participants were aged 55-90 years old divided into subgroups based on diagnostic criteria.
We evaluated ECog-12 performance across different diagnostic groups, such as CU vs cognitive impairment (CI; mild cognitive impairment (MCI), and dementia), and the association between ECog-12 and CI. This procedure was repeated for self- and partner (informant)-reports. Additionally, types of ECog scores were also assessed, where an average ECog score was calculated (continuous numeric) as well as a categorical grouping ("any occasional declined" or "any consistently declined") based on item-level responses to ECog questions.
ECog-12 cut-off scores of 1.36 (self-reported) and 1.45 (partner-reported) distinguish CU from CI with AUC 0.7 and 0.78, respectively. Adding a memory-concern question improved self-reported-ECog AUC to 0.79. Self- and partner-reported "consistently-declined" ECog-12 categorical grouping provided AUC 0.69 and 0.78. The study partner reported ECog-12 showed a greater association with CI than self-reported, with odds ratios of 35.45 and 8.79, respectively.
Study partner-reported ECog scores performed better than self-reported ECog-12 in differentiating cognitive statuses, and a higher study partner reported ECog score was a higher prognostic risk for CI. A memory concern question could enhance self-reported ECog-12 performance. This further emphasizes the need to obtain data from study partners for research and clinical practice.
日常认知（ECog）12 项量表是一种衡量功能下降的方法，可以将痴呆与认知正常（CU）区分开来。目前关于评估者（自我报告与知情者报告）和评分系统（平均数值与分类分组）对 ECog-12 表现的比较数据有限，这些数据可用于区分认知状态。
评估 ECog-12 在区分认知状态方面的性能。
一项横断面诊断测试研究。
分析来自阿尔茨海默病神经影像学倡议（ADNI）研究的数据。参与者年龄在 55-90 岁之间，根据诊断标准分为亚组。
我们评估了 ECog-12 在不同诊断组中的表现，例如 CU 与认知障碍（CI；轻度认知障碍（MCI）和痴呆），以及 ECog-12 与 CI 之间的相关性。这一过程在自我报告和伴侣（知情者）报告中重复进行。此外，还评估了 ECog 评分的类型，包括计算 ECog 的平均得分（连续数值）以及根据 ECog 问题的项目水平回答进行分类分组（“偶尔下降”或“持续下降”）。
ECog-12 的截断值为 1.36（自我报告）和 1.45（伴侣报告），分别用于区分 CU 与 CI，曲线下面积（AUC）分别为 0.7 和 0.78。添加记忆问题可将自我报告的 ECog-AUC 提高至 0.79。自我报告和伴侣报告的“持续下降”ECog-12 分类分组的 AUC 分别为 0.69 和 0.78。与自我报告相比，研究伴侣报告的 ECog-12 与 CI 的相关性更强，优势比分别为 35.45 和 8.79。
研究伴侣报告的 ECog 评分在区分认知状态方面优于自我报告的 ECog-12，且研究伴侣报告的 ECog 评分越高，CI 的预后风险越高。添加记忆问题可提高自我报告的 ECog-12 表现。这进一步强调了在研究和临床实践中需要从研究伴侣那里获取数据。
