Abstract
Abstract Objective Evaluate the psychometric characteristics of the Cognitive Difficulties Scale (CDS; McNair & Kahn, 1983), a 39-item Likert-type self-report instrument that requires a fifth-grade reading level. The CDS is a popular instrument that has been shown to predict cognitive decline. Evaluation included an exploratory factor analysis, measures of internal consistency, relation to demographics, criterion validity, and normative table for raw to T score/percentile transformation. Method Participants were 643 consecutive referrals (71% women, mean age 60.6 and education 14.6 years) for a neuropsychological examination in a memory disorders clinic as part of a broader neurodiagnostic workup for cognitive decline. A principal components analysis was conducted followed by varimax rotation (Kaiser). Factor scores were investigated in relation to multiple internal and external criteria. Results Six dimensions of cognitive complaint emerged accounting for 64% of the variance: Attention/Concentration, Fine Motor Skill, Prospective Memory, Speech Problems, Memory for Names, and Temporal Orientation. Factors showed good internal consistencies (alphas > .850). Correlations with Logical Memory, Visual Reproduction, and Digit Span were all nonsignificant. CDS factor scores were highly predictive of MMPI-2 measures of anxiety, depression, and somatic preoccupation. Percentiles and T-scores were derived for the CDS total score and its six component scales. Conclusion The CDS is a multidimensional measure of subjective cognitive complaints that provides clinicians with a psychometrically sound basis for deriving a profile with six subscale scores. The test has substantial clinical utility, and is a potentially useful tool in exploring subjective cognitive decline as a prodrome to dementia.
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