国家健康与老龄化趋势研究中的认知表现与健康与退休研究的统一认知评估方案的共同校准：对痴呆分类的影响

IF 3.6 2区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Ssm-Population Health Pub Date : 2025-04-03 DOI:10.1016/j.ssmph.2025.101796

Yuan S. Zhang , Alden L. Gross , Ryan J. Dougherty , Lindsay C. Kobayashi , Jennifer A. Schrack , Vicki A. Freedman

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引用次数: 0

摘要

背景：基于大量人群的研究对痴呆症研究至关重要；然而，认知测试和痴呆症分类方法的差异可能导致结果不一致。我们协调了两项具有全国代表性的美国衰老研究的认知数据，以便进行比较。方法研究了2016年国家健康与老龄化趋势研究（NHATS）（n = 5696）和健康与退休研究（HRS）的统一认知评估方案（HCAP）（n = 2731）中年龄≥70岁的个体的数据。我们导出了NHATS认知测试组中一般认知表现的因子评分，这些评分与HRS-HCAP组共同校准，并确定了痴呆的临界点，该临界点返回了每项研究中预期的患病率。我们用曲线下面积分析来评估切点对研究特定痴呆算法的诊断特征。研究特定算法得出了可比的痴呆患病率估计值：NHATS为10.8%，HRS-HCAP为11.1%。共同校准得分显示出相似的分布，具有可接受的可靠性，具有相似的痴呆切点。在这两项研究中，受教育程度较低（与受教育程度较高）和非白人（与非西班牙裔白人）群体的敏感性更高。两项研究中共同校准的痴呆患者年龄和性别分布相似，但在教育水平和种族/民族概况上略有不同。结论snhats和HRS-HCAP均可为美国老年人提供可靠的认知功能测量和痴呆患病率估计。基于每项研究的认知测试电池的共同校准分数为比较美国的研究提供了有效和可行的方法。跨研究更好地协调算法方法可以加强使用协校准方法对美国背景下的差异进行比较研究的机会。

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Co-calibration of cognitive performance in the National Health and Aging Trends Study with the Health and Retirement Study's Harmonized Cognitive Assessment Protocol: Implications for dementia classification

Background

Large population-based studies are crucial for dementia research; yet variation in cognitive tests and dementia classification approaches can lead to inconsistent findings. We harmonized cognitive data from two nationally representative US studies of aging to facilitate comparisons.

Methods

We examined 2016 data for individuals aged ≥70 years from the National Health and Aging Trends Study (NHATS) (n = 5696) and the Harmonized Cognitive Assessment Protocol (HCAP) of the Health and Retirement Study (HRS) (n = 2731). We derived factor scores for general cognitive performance in the NHATS cognitive test battery that were co-calibrated to the HRS-HCAP battery and identified cutpoints for dementia that returned the expected prevalence in each study. We evaluated diagnostic characteristics of the cutpoints against study-specific dementia algorithms with Area Under the Curve analysis.

Results

Study-specific algorithms yielded comparable dementia prevalence estimates: 10.8 % in NHATS and 11.1 % in HRS-HCAP. Co-calibrated scores showed similar distributions and had acceptable reliability, with similar dementia cutpoints. In both studies, sensitivity was higher among lower-educated (vs. higher educated) and non-White (vs. non-Hispanic White) groups. Co-calibrated populations with dementia in both studies had similar age and gender distributions but differed somewhat in education levels and race/ethnicity profiles.

Conclusions

NHATS and HRS-HCAP both provide reliable cognitive function measures and dementia prevalence estimates for older Americans. Co-calibrated scores based on each study's cognitive test battery provide a valid and feasible approach for comparative US research. Better aligned algorithmic approaches across studies could strengthen opportunities for comparative studies of disparities in the US context using the co-calibration approach.

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来源期刊

Ssm-Population Health PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

6.50

自引率

2.10%

发文量

298

审稿时长

101 days

期刊介绍： SSM - Population Health. The new online only, open access, peer reviewed journal in all areas relating Social Science research to population health. SSM - Population Health shares the same Editors-in Chief and general approach to manuscripts as its sister journal, Social Science & Medicine. The journal takes a broad approach to the field especially welcoming interdisciplinary papers from across the Social Sciences and allied areas. SSM - Population Health offers an alternative outlet for work which might not be considered, or is classed as ''out of scope'' elsewhere, and prioritizes fast peer review and publication to the benefit of authors and readers. The journal welcomes all types of paper from traditional primary research articles, replication studies, short communications, methodological studies, instrument validation, opinion pieces, literature reviews, etc. SSM - Population Health also offers the opportunity to publish special issues or sections to reflect current interest and research in topical or developing areas. The journal fully supports authors wanting to present their research in an innovative fashion though the use of multimedia formats.