Self‐reported and informant‐reported assessments of neuropsychological conditions in a Lebanese sample of community‐dwelling older adults in Lebanon

Abstract

AbstractBackgroundAccumulated data highlight a significant role for mental health in influencing and exacerbating the risk, detection, and progression of cognitive decline and aging‐related disorders. In parallel, several findings suggest cultural and contextual differences in the manifestation and recognition of mental health problems. In Lebanon, data on mental and cognitive health and on their assessments are scarce. We examined the agreement between self‐reported and informant‐reported assessments of depressive and anxiety symptoms in a Lebanese community‐based sample of older adults.MethodData come from a Lebanese cohort of older adults (n=502, age=75.5 (SD=7.2); 56.2% women). Depressive and anxiety symptoms were self‐rated using the Geriatric Mental State (GMS) AGECAT and informant‐rated using the Neuropsychiatric Inventory Questionnaire (NPI‐Q). We estimated Cohen’s Kappa and investigated factors related to mismatch in reports using logistic regression models; explanatory factors included participants’ cognitive functioning and participants’ and informants’ demographic and socioeconomic indicators. Data processing is still ongoing to include more participants.ResultPreliminary results showed that 10.6% and 1.6% of participants self‐reported depression and anxiety symptoms and 4.6% and 2% had depression and anxiety symptoms based on informant’s reports, respectively. Cohen’s Kappa was 0.38 for depression and 0.32 for anxiety symptoms; 69.8% and 62.5% of those reporting depressive and anxious symptoms were not reported to have these symptoms by their informants and 30% and 70.4% of informant‐reported depression and anxiety were not reported by participants. Men and participants with higher educational attainment had lower odds of mismatch between self‐ and informant‐reports (OR=0.46 (95% CI=0.24, 0.88) and OR=0.54 (95% CI=0.28, 1.04)); current employment of both participants and informants was associated with lower mismatch (OR=0.19 (95% CI=0.07, 0.54) and OR=0.58 (95% CI=0.32, 1.1). Higher cognitive scores were associated with lower mismatch (OR=0.90 (95% CI=0.81, 0.99).ConclusionResults indicate a weak agreement between self‐reported and informant‐reported neuropsychological symptoms and that the majority of older adults with symptoms were not identified by their informants. More work is needed to improve assessments of neuropsychological symptoms and identify mechanisms underlying discrepancies in assessments in the Lebanese population to better track neurocognitive and health changes at older age.