Neural correlates of daily function: A pilot study of the white matter retrogenesis hypothesis and three separate performance-based functional assessments

Informant sex/gender moderates associations between reported functioning and memory performance in Mexican American adults

Objective: In neuropsychological evaluations, assessing cognitive functioning is often achieved using objective neuropsychological measures, whereas subjective informant reports are typically obtained to determine manifest daily functioning. Informant reports of participant functioning and their associations with objective participant performance on neuropsychological testing have been shown to vary based on informant characteristics. However, associations among informant characteristics, reported functioning, and neuropsychological performance have not been adequately examined with Mexican American or other Hispanic/Latino samples, despite these populations' disproportionately higher rates of dementia due to Alzheimer's disease and related disorders. Method: We examined associations of informant characteristics with informant reports of participant functioning (assessed via the Functional Activities Questionnaire [FAQ]), and potential moderating effects of these characteristics on associations between reported functioning and participant performance on neuropsychological testing, for Mexican American adult participants in the National Alzheimer's Coordinating Center cohort (n = 294). Results: Female informants reported significantly worse participant functioning compared to male informants (p = .035, r = .126). Moreover, significant associations between reported functioning and memory performance were observed for participants with female informants, but not for those with male informants (p = .024, r = .138). Higher levels of informant education were associated with significantly worse participant functioning (p = .011, r = .151). However, informant education did not moderate associations between reported functioning and neuropsychological performance (ps > .05). Conclusions: Compared to male informants, female informants may provide subjective reports of Mexican American participant functioning that more closely corroborate objective participant performance in memory.

Informant Characteristics Influence Reports of Participant Functioning and their Associations with Neuropsychological Performance in Non-Hispanic Black Adults

OBJECTIVE

Assessing one's functional capacity-in addition to neuropsychological performance-is essential for determining neurocognitive status, and functional assessment is often provided via informant report. Although informant characteristics have been shown to influence reports of participant functioning, the degree to which they moderate relationships between reported functioning and participant performance on neuropsychological testing is unclear. Moreover, associations among informant characteristics, reported functioning, and neuropsychological performance have not been adequately examined with non-Hispanic Black (NHB) samples, despite this population's disproportionately high risk of Alzheimer's disease and related dementias.

METHOD

In this cross-sectional observational study, we examined the influence of informant characteristics on informant reports of participant functioning (assessed via the Functional Activities Questionnaire [FAQ]) and associations between reported functioning and participant performance on neuropsychological testing, among NHB adult participants in the National Alzheimer's Coordinating Center cohort (n = 1024).

RESULTS

Informants who were younger, female, more educated, knew participants longer, or lived with participants reported poorer participant functioning (p < .001). However, younger (vs. older) informants provided reports of functioning that were more predictive of visuoconstructional ability and visual memory, and male (vs. female) informants provided reports of functioning that were more predictive of verbal memory, visuoconstructional ability and visual memory, and language (ps < .001).

CONCLUSIONS

Within the context of neurocognitive evaluations of NHB participants, informant characteristics may influence subjective reports of participants' functioning and the extent to which reported functioning corroborates objective participant performance on neuropsychological testing.

Evidence for the reliability and validity of a Spanish translation of the Medication Management Ability Assessment administered via tele-assessment

We translated the Medication Management Ability Assessment (MMAA) from English to Spanish for use via tele-assessment and examined its reliability and validity. Following International Test Commission Guidelines for Translating and Adapting Tests, we used translation/back-translation and a small focus group (n = 6) to adapt a Spanish version of the MMAA. Eighty-six Spanish-speaking adults completed the adapted MMAA via tele-assessment at baseline and at a two-week follow-up visit. Participants also completed several self-report and performance-based cognitive and functional measures. The internal consistency of the MMAA was excellent (standardized Cronbach's α = 0.90). Performance-based functional assessments (PBFAs) and objective cognition were positively associated with the MMAA at small to medium effect sizes. Self-report measures of daily function and cognition, measures of health literacy, and estimates of premorbid intellectual functioning were not significantly associated with MMAA performance. The test-retest reliability of the MMAA was good (CCC = 0.73, 95% CI [0.62, 0.81]; rs = 0.37, p < 0.001) and demonstrated a small practice effect (Cohen's d = 0.36, p = 0.001). Preliminary evidence for the construct validity of a Spanish-language MMAA administered via tele-assessment further expands the potential clinical utility of PBFAs in culturally diverse, Spanish-speaking populations.