Cognitive lapses reported by daily digital diary, and not by recall‐based questionnaires, predict future MCI in a demographically diverse cohort of community‐dwelling older adults

Abstract

AbstractBackgroundAlthough cognitive lapses are a daily occurrence for many older adults, widely used self‐reports of cognitive function ask respondents to recollect lapses occurring over months or years. We used daily diaries to capture memory and other cognitive difficulties close in time to their occurrence and determined whether daily reports predicted concurrent and/or new cases of mild cognitive impairment (MCI) in the next year (i.e., at annual follow‐up).MethodIn the Einstein Aging Study, daily digital diary indicators of cognitive lapses were assessed each evening over a two‐week period (82% of diaries completed). Conventional recall‐based indicators were the Cognitive Change Index total score and a single item capturing worsening memory (with/without worry), both assessed at each annual visit. Using time‐dependent lagged models with generalized estimating equations (GEE) to correct for within person correlation, we evaluated the association of current cognitive lapses with the probability of being MCI at the current or next annual visit among those diagnosed with MCI after baseline (n = 31 new cases).ResultIn 307 community‐dwelling participants (Mage = 77.05, SD = 4.95; 67% female, 47% White) who were free of MCI at baseline, higher numbers of daily problems significantly predicted the likelihood of being diagnosed with MCI at the next annual visit (average number of visits = 2.72, range 1‐6 years). For every additional daily cognitive lapse, there was a 5% greater odds of being classified at the next visit (OR = 1.05, 95% CI: 1.01‐1.09). By contrast, conventional indicators did not significantly predict transition to MCI at the next visit (ps = .48 and .62, respectively). However, the single item regarding worsening memory was related to concurrent MCI diagnostic status (p<.01). Sensitivity analyses examining the first 3 days or first 7 days to determine the number of daily reports required to identify new MCI cases indicated that both 3 and 7 days significantly predicted future MCI (OR = 1.34, 95% CI: 1.12‐1.61; OR = 1.07, 95% CI: 1.00‐1.14, respectively).ConclusionA brief daily diary assessment of cognitive lapses predicted new cases of MCI. The combination of daily and conventional methods may represent complementary approaches that offer the optimal approach for capturing self‐perceived cognitive deficits associated with current and future MCI.