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Applying generalizability theory to examine assessments of subjective cognitive complaints: whose reports should we rely on – participant versus informant?

Published online by Cambridge University Press:  13 April 2021

Q. C. Truong ,
C. Choo ,
K. Numbers ,
A. G. Merkin ,
H. Brodaty Open the ORCID record for H. Brodaty [Opens in a new window] ,
N. A. Kochan ,
P. S. Sachdev ,
V. L. Feigin  and
O. N. Medvedev Open the ORCID record for O. N. Medvedev [Opens in a new window]
Q. C. Truong
Affiliation:
School of Psychology, University of Waikato, Hamilton, New Zealand
C. Choo
Affiliation:
School of Psychology, University of Waikato, Hamilton, New Zealand
K. Numbers
Affiliation:
Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
A. G. Merkin
Affiliation:
Auckland University of Technology, Auckland, New Zealand Centre for Precise Psychiatry and Neurosciences, Germany/Switzerland
H. Brodaty
Affiliation:
Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
N. A. Kochan
Affiliation:
Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
P. S. Sachdev
Affiliation:
Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, Australia
V. L. Feigin
Affiliation:
Auckland University of Technology, Auckland, New Zealand
O. N. Medvedev*
Affiliation:
School of Psychology, University of Waikato, Hamilton, New Zealand
*
Correspondence should be addressed to: Oleg N. Medvedev, School of Psychology, University of Waikato, Private Bag 3105, Hamilton 3240, New Zealand. Phone: + 64 7 837 9212. Email: oleg.medvedev@waikato.ac.nz
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Abstract

Objectives:

This study aimed to apply the generalizability theory (G-theory) to investigate dynamic and enduring patterns of subjective cognitive complaints (SCC), and reliability of two widely used SCC assessment tools.

Design:

G-theory was applied to assessment scales using longitudinal measurement design with five assessments spanning 10 years of follow-up.

Setting:

Community-dwelling older adults aged 70–90 years and their informants, living in Sydney, Australia, participated in the longitudinal Sydney Memory and Ageing Study.

Participants:

The sample included 232 participants aged 70 years and older, and 232 associated informants. Participants were predominantly White Europeans (97.8%). The sample of informants included 76 males (32.8%), 153 females (65.9%), and their age ranged from 27 to 86 years, with a mean age of 61.3 years (SD = 14.38).

Measurements:

The Memory Complaint Questionnaire (MAC-Q) and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE).

Results:

The IQCODE demonstrated strong reliability in measuring enduring patterns of SCC with G = 0.86. Marginally acceptable reliability of the 6-item MAC-Q (G = 0.77–0.80) was optimized by removing one item resulting in G = 0.80–0.81. Most items of both assessments were measuring enduring SCC with exception of one dynamic MAC-Q item. The IQCODE significantly predicted global cognition scores and risk of dementia incident across all occasions, while MAC-Q scores were only significant predictors on some occasions.

Conclusions:

While both informants’ (IQCODE) and self-reported (MAC-Q) SCC scores were generalizable across sample population and occasions, self-reported (MAC-Q) scores may be less accurate in predicting cognitive ability and diagnosis of each individual.

Keywords

agingcognitive assessmentdementiamental capacitygeneralizability theorylongitudinal design
Type
Original Research Article
Information
International Psychogeriatrics , Volume 34 , Special Issue 12: Issue Theme: Subjective Cognitive Complaints: What Do They Predict? , December 2022 , pp. 1023 - 1033
Copyright
© International Psychogeriatric Association 2021

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