English Language Proficiency, Hearing Impairment, and Functional Change in Mild Cognitive Impairment

Abstract

I congratulate Brodaty et al. 1 Brodaty H. Aerts L. Crawford J.D. et al. Operationalizing the diagnostic criteria for mild cognitive impairment: the salience of objective measures in predicting incident dementia. Am J Geriatr Psychiatry. 2017; 25: 485-497 Abstract Full Text Full Text PDF PubMed Scopus (24) Google Scholar for successfully deconstructing the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria for mild cognitive impairment (MCI). This article ranks among the five most important MCI articles in the past year. My comments apply to three issues. First is the exclusion of subjects with non–English-speaking backgrounds in this analysis. The authors explored non–English-speaking backgrounds in a previous article. 2 Low L.F. Harrison F. Kochan N.A. et al. Can mild cognitive impairment be accurately diagnosed in English speakers from linguistic minorities? Results from the Sydney Memory and Ageing Study. Am J Geriatr Psychiatry. 2012; 20: 866-877 Abstract Full Text Full Text PDF PubMed Scopus (14) Google Scholar They suggest that those with non–English-speaking backgrounds must be analyzed separately in studies of incident dementia because of impaired comprehension of test items. Looking at this issue from a root level, neuropsychological tests can be administered at baseline and again a follow-up several years later using the subject as his or her own control to assess incident MCI or incident dementia. English language proficiency is very unlikely to change during this interval except for recent immigrants from non–English-speaking countries. Operationalizing the Diagnostic Criteria for Mild Cognitive Impairment: The Salience of Objective Measures in Predicting Incident DementiaThe American Journal of Geriatric PsychiatryVol. 25Issue 5PreviewMild cognitive impairment (MCI) is considered an intermediate stage between normal aging and dementia. It is diagnosed in the presence of subjective cognitive decline and objective cognitive impairment without significant functional impairment, although there are no standard operationalizations for each of these criteria. The objective of this study is to determine which operationalization of the MCI criteria is most accurate at predicting dementia. Full-Text PDF Response to: English Language Proficiency, Hearing Impairment, and Functional Change in Mild Cognitive ImpairmentThe American Journal of Geriatric PsychiatryVol. 25Issue 11PreviewWe thank Paul J. Regal for his constructive comments on our paper about the operationalization of the diagnostic criteria for mild cognitive impairment (MCI).1 He highlights three issues: The exclusion of participants from a non-English speaking background, the occurrence of hearing impairment, and the interpretation and partitioning of the Bayer-Activities of Daily Living (ADL) score for functional impairment. We would like to take the opportunity to respond to these valuable comments. Full-Text PDF