The association between late-life cognitive test scores and retrospective informant interview data

Marioni, Riccardo E.; Matthews, Fiona E.; Brayne, Carol

doi:10.1017/s1041610210001201

Cited by 12 publications

(9 citation statements)

References 15 publications

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“…Two entire sub-cohorts were used to maintain the unbiased population-representative base of the study (Cambridge and Newcastle), totalling 183 cases Neuropathological lesions were previously assessed in this cohort, including AD-neuropathology using the CERAD protocol [ 23 ] and Braak NFT stage, based on immunohistochemistry and silver staining. Dementia status at death was based on all information available for each study participant, including algorithmic assessment in life (AGECAT), information from death certification and a Retrospective Informant Interview (RINI) developed by CFAS [ 20 , 24 ].…”

Section: Methodsmentioning

confidence: 99%

Epidemiological pathology of Tau in the ageing brain: application of staging for neuropil threads (BrainNet Europe protocol) to the MRC cognitive function and ageing brain study

Wharton

Minett

Drew

et al. 2016

acta neuropathol commun

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IntroductionDeposition of abnormally phosphorylated tau (phospho-tau) occurs in Alzheimer’sdisease but also with brain ageing. The Braak staging scheme focused on neurofibrillary tangles, butabundant p-tau is also present in neuropil threads, and a recent scheme has been proposed by theBrainNet Europe consortium for staging tau pathology based on neuropil threads. We determined therelationship of threads to tangles, and the value of staging for threads in an unselected population-representative ageing brain cohort. We also determined the prevalence of astroglial tau pathologies, and their relationship to neuronal tau. Phospho-tau pathology was determined by immunohistochemistry (AT8 antibody) in the MRC-CFAS neuropathology cohort. Neuropil threads were staged using the BrainNet Europe protocol for tau pathology, and compared with Braak tangle stages. Astroglial tau pathology was assessed in neo-cortical, mesial temporal and subcortical areas.ResultsCases conformed well to the hierarchical neuropil threads staging of the BrainNet Europe protocol and correlated strongly with Braak staging (r=0.84, p < 0.001). Based on the areas under the receiver operator curves (AUC), incorporating either threads or tangle staging significantly improved dementia case identification to a similar degree over age alone (Braak stage X2(1)=10.1, p=0.002; BNE stage X2(1)=9.7, p=0.002). Thorn-shaped astrocytes, present in 40 % of cases, were most common in mesial temporal lobe, then brainstem, and were associated with subpial tau-positive neurites (mesial temporal: X2(1)=61.3, p < 0.001; brainstem: X2(1)=47.9, p < 0.001). Adding thorn astrocytes did not improve dementia prediction (AUC: X2(1)=0.77, p=0.381), but there was a weak relationship between numbers of areas involved and staging for threads or tangles (r=0.17, p=0.023). Neuropil threads develop hierarchically in parallel with neurofibrillary tangles.ConclusionsThe BrainNet Europe staging protocol is straightforward to apply, and offers similar predictive value for dementia to Braak tangle staging. Astroglial tauopathy, particularly thorn shaped astrocyte formation, does not relate to dementia status, but the association with phospho-tau neurites may suggest a pathogenic relationship to neuronal tau pathology.

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Section: Methodsmentioning

confidence: 99%

Epidemiological pathology of Tau in the ageing brain: application of staging for neuropil threads (BrainNet Europe protocol) to the MRC cognitive function and ageing brain study

Wharton

Minett

Drew

et al. 2016

acta neuropathol commun

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“…[32][33] In addition, some studies considered ZIP model as a good model for count outcome data, but these studies did not explore the ZINB model and couldn't compare the goodness of fit between ZIP model and ZINB model. [34][35][36][37][38] The number of sub-health symptoms had a wide range from 0 to 18, which aggravated its over-dispersion, so that both Poisson model and ZIP model fitted badly. In addition, two-fifth of zero counts weakened the goodness of fit of traditional NB model.…”

Section: Results Of Zinb Modelmentioning

confidence: 99%

Study of Zero-Inflated Regression Models in a Large-Scale Population Survey of Sub-Health Status and Its Influencing Factors△

Zhu

Han

2017

Chinese Medical Sciences Journal

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Objective Sub-health status has progressively gained more attention from both medical professionals and the publics. Treating the number of sub-health symptoms as count data rather than dichotomous data helps to completely and accurately analyze findings in sub-healthy population. This study aims to compare the goodness of fit for count outcome models to identify the optimum model for sub-health study.Methods The sample of the study derived from a large-scale population survey on physiological and psychological constants from 2007 to 2011 in 4 provinces and 2 autonomous regions in China. We constructed four count outcome models using SAS: Poisson model, negative binomial (NB) model, zero-inflated Poisson (ZIP) model and zero-inflated negative binomial (ZINB) model. The number of sub-health symptoms was used as the main outcome measure. The alpha dispersion parameter and O test were used to identify over-dispersed data, and Vuong test was used to evaluate the excessive zero count. The goodness of fit of regression models were determined by predictive probability curves and statistics of likelihood ratio test.Results Of all 78 307 respondents, 38.53% reported no sub-health symptoms. The mean number of sub-health symptoms was 2.98, and the standard deviation was 3.72. The statistic O in over-dispersion test was 720.995 (P<0.001); the estimated alpha was 0.618 (95% CI: 0.600-0.636) comparing ZINB model and ZIP model; Vuong test statistic Z was 45.487. These results indicated over-dispersion of the data and excessive zero counts in this sub-health study. ZINB model had the largest log likelihood (-167 519), the smallest Akaike's Information Criterion coefficient (335 112) and the smallest Bayesian information criterion coefficient (335455), indicating its best goodness of fit. The predictive probabilities for most counts in ZINB model fitted the observed counts best. The logit section of ZINB model analysis showed that age, sex, occupation, smoking, alcohol drinking, ethnicity and obesity were determinants for presence of sub-health symptoms; the binomial negative

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“…What emerges from comparisons of the demographic and clinical characteristics of individuals still alive versus those who had died at the time of the first visit (Table 7) is that the failure to include information on deceased elderly would increasingly underestimate with age the prevalence of cognitive and functional disability in the elderly population. Retrospective interviews (on average two years after death) were shown to be sensitive instruments to detect the antemortem presence of dementia and were strongly associated with late-life MMSE scores taken close to death [32,75,76]. In the attempt to limit the attrition bias due to the expected high mortality rate and differential survival rates, a great effort was made at follow-ups to gather complete information also on participants who had died between two subsequent visits.…”

Section: Discussionmentioning

confidence: 99%

A Population-based study of dementia in the oldest old: the Monzino 80-plus Study

et al. 2011

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BackgroundDespite being the fastest growing and the most cognitively impaired age group, the oldest olds are under-represented in clinical research. The purpose of this study was to describe the design, methods, and baseline characteristics of the survey population and investigate possible differences in demographic, cognitive, functional, and behavioral characteristics between oldest old with and without any performance on cognitive tests and between oldest old alive and those deceased prior to the interview.MethodsThe Monzino 80-plus Study is a prospective door-to-door population-based survey among 80 years or older residents in the municipalities in the province of Varese, Italy. Dementia cases were identified with a one-phase design. Trained psychologists interviewed both the subject and a proxy informant. The interview included a comprehensive standardized questionnaire together with an array of rating scales and a multidomain cognitive battery to assess cognitive and functional ability, behavioral disturbances and mood.ResultsInformation was available for 2,139 of the 2,428 registered individuals aged 80 years or older. Main baseline characteristics of the population are reported and discussed. In comparison with those living, elderly persons who had died before the first visit were older, had twice the rate of institutionalization, poorer cognitive performance and competence, and significantly greater instrumental and basic functional disability. The percentage of elderly persons, alive at baseline, without Mini-Mental State Examination rose rather evenly with age. Moreover, they had significantly worse cognitive competence and functional ability, and reported higher prevalences of depressive symptoms and problem behaviors than those with Mini-Mental State Examination.ConclusionsProspective investigation of a large population of oldest old can contribute significantly to understanding the relations between age, cognitive decline, and dementia occurrence. Use of informant-based instruments in surveys in the oldest old is crucial in assessing everyday functioning and changes, especially in participants with no cognitive test performance available. Failure to include information on deceased elderly would underestimate, increasingly with age, the prevalence of cognitive and functional disability in the elderly population.

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The association between late-life cognitive test scores and retrospective informant interview data

Abstract: Cognitive scores from retrospective informant interviews are strongly associated with late-life MMSE scores taken close to death. This suggests that the RInI can be used as a proxy measure of cognition in the period leading up to death.

Cited by 12 publications

References 15 publications

Epidemiological pathology of Tau in the ageing brain: application of staging for neuropil threads (BrainNet Europe protocol) to the MRC cognitive function and ageing brain study

Epidemiological pathology of Tau in the ageing brain: application of staging for neuropil threads (BrainNet Europe protocol) to the MRC cognitive function and ageing brain study

Study of Zero-Inflated Regression Models in a Large-Scale Population Survey of Sub-Health Status and Its Influencing Factors△

A Population-based study of dementia in the oldest old: the Monzino 80-plus Study

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