Maryclare Sacca
Pronouns: she/her
Research Mentor(s): Jonathan Reader
Co-Presenter:
Research Mentor School/College/Department: Michigan Alzheimer’s Disease Research Center / Medicine
Presentation Date: April 20
Presentation Type: Poster
Session: Session 6 – 4:40pm – 5:30 pm
Room: League Ballroom
Authors: MaryClare Sacca, Allyson Gregoire, Jonathan Reader
Presenter: 21
Abstract
Analyzing the bond between co-participant reports of older adults’ daily functioning and their cognitive abilities: Does the relationship to the participant matter? Alzheimer’s or related dementia’s (ADRD) economic impact on the healthcare industry was estimated to be $305 billion in 2020 (Wong, 2020). In addition to fiscal costs, ADRD includes “hidden†costs such as caregiver burden (Deb, Thornton, Sambamoorthi, & Innes, 2017; Wong, 2020). To correctly diagnose cognitively impaired individuals and provide caregivers with support, it is important to provide clinicians with multiple sources of evidence (e.g., cognitive testing, co-participant report) to get a holistic view of the individual’s condition. Additionally, co-participant report of an individual’s functioning may differ depending on the co-participant relationship (Tang, Friedman, Kannaley, Davis, Wilcox, Levkoff, et al., 2018). The current study aims to assess the ability of the Functional Assessment Survey (FAS; Pfeffer, Kurosaki, Harrah, Chance, & Filos, 1982), a co-participant reported survey of participant daily functioning to predict Montreal Cognitive Assessment (MoCA; Nasreddine, Phillips, Bédirian, Charbonneau, Whitehead, Collin, et al., 2005) scores in a sample of individuals from the National Alzheimer’s Coordinating Center (NACC). In addition, this project seeks to see if the relationship between the FAS and MoCA is dependent on the type of coparticipant. Methods Inclusion criteria for the current study were the first visit using version 3 of NACC’s Uniform Data Seta, a completed MoCA, English as primary language, known education level, and a co-participant whose relationship to participant was either spouse/partner/companion or child who completed the FAS. After applying these criteria, the final number of participants remaining for analyses were 6,697 individuals with a variety of cognitive statuses (e.g., ADRD, mild cognitive impairment). Approximately 80% of these participants identified as White/Caucasian and 2,552 (38%) identified males. The overall mean age was 69.3 years (SD = 10.2 years) and the overall mean education years was 16.1 years (SD = 2.6). Participants completed a battery of cognitive tests, including the MoCA, administered by trained research assistants. A total MoCA score was computed by adding the total number of points. Higher scores indicate better cognitive performance. Scores for this sample ranged from 0 to 30 (Mean = 23.13, SD = 5.9). In addition, many participants bring friends or family to also participate in the study on behalf of the participant as their co-participant. These co-participants complete several assessments of the participant’s functioning, including the FAS. Higher values on the FAS indicate more impaired cognitive functioning. FAS Scores for this sample ranged from 0 to 30 (Mean = 3.91, SD = 7.31). Due to a left-skewed distribution of MoCA scores, data transformations were employed. Data were reflected by subtracting all values from 30.5, to create a right-skew, and then a log10 transformation was performed to approximate a normal distribution. To interpret the transformed data from the generalized linear model (stats package in R; Core Team, 2021), results of the regression were multiplied by -1 and exponentiated. Results Results from the linear regression suggest that performance on daily living as reported by co-participants on the FAS significantly predicts individuals’ MoCA score (p < 0.05); every one unit increase in FAS score is associated with a 6.6% decrease in MoCA score. In addition, the effect of FAS modified by co-participant relationship (spouse/partner/companion versus child) revealed a significant interaction effect (p < 0.05). If the co-participant was a child instead of a spouse/partner/companion, for every one unit increase in FAS, MoCA score only decreased by 5.9% as opposed to 6.6%. Education, sex, co-participant relationship, and race significantly predicted MoCA score (all ps < 0.05). Discussion The MoCA and FAS can provide clinicians with different pieces of information in order to better understand an individual’s cognitive health. We found an association between performance on the MoCA and FAS score as well as evidence of effect modification between FAS and co-participant. This reveals both tests are reliable measures of cognitive health. While these results are statistically significant, they may not be clinically significant. A larger, more diverse sample could provide more information. Future studies may also compare different cognitive tests to determine if the same type of association exists as this study uncovered. Presentation link
Biomedical Sciences, Engineering
