A-101 Correspondence between ABAS-II and VABS-II Composite Scales in a Cohort of Adults with Down Syndrome

Objective: Informant ratings of adaptive functioning are a valuable source of information that can support diagnosis and treatment planning and monitor change. The Adaptive Behavior Assessment System (ABAS-II) and Vineland Adaptive Behavior Scales (VABS-II) are well-known adaptive functioning questionnaires used in clinical practice. This study assessed the correspondence between ABAS-II and VABS-II composite scales in adults with Down Syndrome (DS).

Method: Participants were selected from a cohort of 110 adults with DS involved in a longitudinal study examining Alzheimer’s risk. Participants were selected if they had informant ratings on both the ABAS-II and VABS-II at the same measurement wave (n = 85; M = 41.9 years-old, SD = 10.8; 55.3% female; 96.5% White). Due to non-normality, non-parametric correlations examined convergent validity of the ABAS-II and VABS-II standard scores.

Results: The composite scores of similar constructs from each measure correlated significantly (ps < 0.001) with large effect sizes: ABAS-II Conceptual with VABS-II Communication (rho = 0.53), ABAS-II Social with VABS-II Socialization (rho = 0.83), ABAS-II Practical with VABS-II Daily Living Skills (rho = 0.84), and ABAS-II Global Adaptive Composite (GAC) with VABS-II Adaptive Behavior Composite (ABC) (rho = 0.88). There was 85.2% correspondence between ABAS-II and VABS-II ratings of low adaptive functioning (SS < 70 on the GAC or ABC, respectively), with just 14.8% of participants (n = 12) categorized as low on VABS-II but not ABAS-II.

Conclusion(s): The ABAS-II and VABS-II composites were strongly correlated, capturing similar adaptive domains. However, there was a greater chance of being rated as low functioning on the VABS-II compared to the ABAS-II, which may have diagnostic implications for clinical and research work in DS.

Diabetes mitigates the role of memory complaint in predicting dementia risk: Results from the Prevention of Alzheimer's Disease with Vitamin E and Selenium Study

BACKGROUND

Subjective memory complaints (SMCs) are associated with increased risk of dementia in older adults, but the role of comorbidities in modifying this risk is unknown.

OBJECTIVES

To assess whether comorbidities modify estimated dementia risk based on SMCs.

DESIGN

The Prevention of Alzheimer's Disease with Vitamin E and Selenium Study (PREADVISE) was designed as an ancillary study to the Selenium and Vitamin E Cancer Prevention Trial (SELECT), a randomized, multi-center prostate cancer prevention trial with sites in the Unites States, Puerto Rico, and Canada. In 2009, PREADVISE and SELECT were changed into cohort studies.

SETTING

Secondary analysis of PREADVISE data.

PARTICIPANTS

PREADVISE recruited 7,540 non-demented male volunteers from participating SELECT sites from 2002 to 2009. SMCs, demographics, and comorbidities including hypertension, diabetes, coronary artery bypass graft (CABG), stroke, sleep apnea, and head injury were ascertained by participant interview.

MEASUREMENTS

Cox models were used to investigate whether baseline comorbidities modified hazard ratios (HR) for SMC-associated dementia risk using two methods: (1) we included one interaction term between SMC and a comorbidity in the model at a time, and (2) we included all two-way interactions between SMC and covariates of interest and reduced the model by "backward" selection. SMC was operationalized as any complaint vs. no complaint.

RESULTS

Baseline SMCs were common (23.6%). In the first analyses, with the exception of stroke, presence of self-reported comorbidities was associated with lower estimated HR for dementia based on SMC status (complaint vs. no complaint), but this difference was only significant for diabetes. In the second analysis, the two-way interactions between SMC and race as well as SMC and diabetes were significant. Here, black men without diabetes who reported SMC had the highest estimated dementia risk (HR=5.05, 95% CI 2.55-10.00), while non-black men with diabetes who reported SMC had the lowest estimated risk (HR=0.71, 95% CI 0.35-1.41).

CONCLUSIONS

SMCs were more common among men with comorbidities, but these complaints appeared to be less predictive of dementia risk than those originating from men without comorbidities, suggesting that medical conditions such as diabetes may explain SMCs that are unrelated to an underlying neurodegenerative process.

Factors Associated with Unmet Needs among African-American Dementia Care Providers

Racial and ethnic minorities currently comprise 20% of the U.S. population; in 2050, this figure is expected to rise to 42%. As a result, Alzheimer’s disease (AD), the 5^th leading cause of death for people aged 65 and older, is likely to increase in these groups. Most dementia caregiving for these populations comes from family and friends, especially among families with lower socioeconomic status. A convenience sample of 30 African-American dementia caregivers was interviewed to determine unmet needs. Participants expressed a limited desire for formal services, such as support groups, legal advice, case management, and homemaker services. Instead, commonly expressed needs were daytime respite care and especially a desire for family and social support. Many caregivers expressed a need for other family members to share responsibility in the process; therefore, methods for caregiver support that address multiple family members in care provision may be beneficial for this group.