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Comparing the predictive validity of four MCI definitions for incident dementia in demographically diverse community-dwelling individuals: Results from the Einstein Aging Study (EAS)

Published online by Cambridge University Press:  27 December 2024

Katherine H. Chang Open the ORCID record for Katherine H. Chang [Opens in a new window] ,
Cuiling Wang ,
Jiyue Qin ,
Mindy J. Katz ,
Desiree A. Byrd ,
Richard B. Lipton  and
Laura A. Rabin
Katherine H. Chang*
Affiliation:
Department of Psychology, Queens College, City University of New York (CUNY), Flushing, NY, USA Department of Psychology, The Graduate Center, City University of New York (CUNY), New York, NY, USA Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
Cuiling Wang
Affiliation:
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
Jiyue Qin
Affiliation:
Division of Biostatistics and Bioinformatics, Herbert Wertheim School of Public Health and Human Longevity Science, UC San Diego, La Jolla, CA, USA
Mindy J. Katz
Affiliation:
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
Desiree A. Byrd
Affiliation:
Department of Psychology, Queens College, City University of New York (CUNY), Flushing, NY, USA Department of Psychology, The Graduate Center, City University of New York (CUNY), New York, NY, USA
Richard B. Lipton
Affiliation:
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
Laura A. Rabin
Affiliation:
Department of Psychology, Queens College, City University of New York (CUNY), Flushing, NY, USA Department of Psychology, The Graduate Center, City University of New York (CUNY), New York, NY, USA Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA Department of Psychology, Brooklyn College, City University of New York (CUNY), Brooklyn, NY, USA
*
Corresponding author: Katherine H. Chang; Email: kchang@gradcenter.cuny.edu
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Abstract

Objective:

Research examining (MCI) criteria in diverse and/or health-disparate populations is limited. There is a critical need to investigate the predictive validity for incident dementia of widely used MCI definitions in diverse populations.

Method:

Eligible participants were non-Hispanic White or Black Bronx community residents, free of dementia at enrollment, with at least one annual follow-up visit after baseline. Participants completed annual neurological and neuropsychological evaluations to determine cognitive status. Dementia was defined based on DSM-IV criteria using case conferences. Cox proportional hazard models assessed predictive validity for incident dementia of four specific MCI definitions (Petersen, Jak/Bondi, number of impaired tests, Global Clinical Ratings) at baseline, controlling for age, sex, education, and race/ethnicity. Time-dependent sensitivity and specificity at 2–7 years for each definition, and Youden’s index were calculated as accuracy measures.

Results:

Participants (N = 1073) ranged in age from 70 to 100 (mean = 78.4 ± 5.3) years at baseline. The sample was 62.5% female, and educational achievement averaged 13.9 ± 3.5 years. Most participants identified as White (70.0%), though Black participants were well-represented (30.0%). In general, MCI definitions differed in sensitivity and specificity for incident dementia. However, there were no significant differences in Youden’s index for any definition, across all years of follow-up.

Conclusions:

This work provides an important step toward improving the generalizability of the MCI diagnosis to underrepresented/health-disparate populations. While our findings suggest the studied MCI classifications are comparable, researchers and clinicians may choose to consider one method over another depending on the rationale for evaluation or question of interest.

Keywords

Mild cognitive impairmentcross-cultural neuropsychologycross-cultural issuesdiversitylongitudinalaging
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 31 , Issue 1 , January 2025 , pp. 32 - 41
Copyright
© The Author(s), 2024. Published by Cambridge University Press on behalf of International Neuropsychological Society

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