Assessing Cognitive Impairment in People with Dementia Associated Disorders: Self‐Reported Recognitive Impairment Contrasted with Computerized Multi‐Domain Cognitive Testing – Truth be Told

Abstract

AbstractBackgroundDementia associated diseases (DAD) are characterized by progressive impairment of cognition that interferes with an individual’s ability to function independently. Clinically, cognitive impairment (CI) can vary in degree and combination across multiple cognitive domains (CD). Clinician and patient with DAD (PwDAD) recognition of such varied types/degrees of CI might not only be sub‐optimal, but also unable to recognize subtle change and progression. Patient self‐reported outcome measures (PRO) are used to gauge CI or disability progression. Traditional measures (MOCA, MMSE) include a dichotomous outcome measure and routine neuropsychological screening might not be practical. Quantitative and objective screening across multiple CD can be accomplished in routine care with validated, examiner independent, computerized multi‐domain cognitive assessment battery (CAB‐NT, NeuroTrax). NeuroQOL Cognitive Function Short‐Form (CF‐SF) is one validated disease agnostic PRO that can be incorporated to evaluate patient perception of disease impact and change on CI. The relationship of CF‐SF to multi‐domain quantitative CAB has not been explored in PwDAD.MethodRetrospective review of consecutive PwDaD who completed both CF‐SF and CAB‐NT on the same day in the course of routine care. CAB‐NT included 7 cognitive domains: memory (Mem), executive function (Exe), attention (Att), information processing speed (Inf), visual spatial (Vis), verbal function (Ver), motor skills (Mot) as well as a global cognitive summary score (GCS).ResultsLinear regression analysis of relationship was explored with significance (p<0.05). 196 PwDAD, (65% female, average age 73+/‐ 9 years). “Significant” relationships (p<0.05) were identified through regression analysis for the following CD scores: GCS (r2 = 0.03), Exe (r2 = 0.04), Att (r2 = 0.06), and Mot (r2 = 0.04).ConclusionPwDAD self‐perception of their cognitive abilities do not accurately reflect objective CAB performance measures of cognitive function. CF‐SF PRO scores do not reflect cognitive performance across multiple cognitive domains and should not be considered appropriate screening tools to incorporate into routine care to determine when to consider the need for examiner independent measures to accurately monitor disease impact or change. Objective computerized testing measures across multiple cognitive domains provides useful insight and value based information for clinicians to gauge the presence of or change in cognitive impairment.