The Utility of the Cognitive Function Instrument (CFI) to Detect Cognitive Decline in Non-Demented Older Adults

Li, Clara; Neugroschl, Judith; Luo, Xiaodong; Zhu, Carolyn W.; Aisen, Paul S.; Ferris, Steven; Sano, Mary

doi:10.3233/jad-161294

Cited by 54 publications

(47 citation statements)

References 23 publications

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“…The longitudinal ADCS study found the CFI instrument valid in discriminating between a group of older persons with cognitive decline over a period of 4 years and a group with stable cognition [15], and these findings were in line with the results of the study by Li et al [16]. In the current study we have found that the CFI also had power to discriminate between people with dementia and those with either MCI, SCI, or a reference group.…”

Section: Discriminatory Power Of Cfisupporting

confidence: 81%

“…There is currently no cure for dementia, but symptomatic drug treatment is available, and individually tailored dementia et al [16] confirms that subjective change can be reliably assessed by self-report from older adults as well as proxy-report from their study partners, with the CFI. Li et al [16] found that cognitive decline was predicted differentially by CDR level. Self-reported CFI scores provided the best prediction in the group with Clinical Dementia Rating (CDR) 0 points, no cognitive impairment, while proxy-rated CFI predicted best for the CDR 0.5 group, MCI.…”

Section: Introductionmentioning

confidence: 99%

“…The self-rated version has been found to have high discriminating power in the earliest stage of cognitive decline [15,16], the person's own perspectives are important in the diagnostic evaluation, and the self-rating may provide useful information about disagreement between the person and the proxy. We believe that the items of the CFI provide a good opportunity to discuss the core of the concerns when symptoms of cognitive decline are present.…”

Section: Discriminatory Power Of Cfimentioning

confidence: 99%

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The Validity of the Norwegian Version of the Cognitive Function Instrument

Michelet

Engedal

Selbæk

et al. 2018

Dement Geriatr Cogn Disord

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Background/Aims: A timely diagnosis of dementia is important, and the Cognitive Function Instrument (CFI) is a newly developed instrument to screen for cognitive decline. The aim of this study was to evaluate the validity and internal consistency of the Norwegian version of the CFI. Methods: We included 265 participants with dementia, mild cognitive impairment (MCI), subjective cognitive impairment (SCI), and a reference group without subjective or assessed cognitive decline. The participants and their relatives answered the self- and proxy-rated versions of the CFI. Results: The Norwegian CFI had power to discriminate between people with dementia and with MCI, SCI, and the reference group. The proxy version had better power than the self-rated version in our participants (area under the curve [AUC] proxy-rated varying from 0.79 to 0.99, AUC self-rated varying from 0.56 to 0.85). Conclusion: The Norwegian CFI was found to be a useful, valid, and robust instrument.

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Section: Discriminatory Power Of Cfisupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Section: Discriminatory Power Of Cfimentioning

confidence: 99%

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The Validity of the Norwegian Version of the Cognitive Function Instrument

Michelet

Engedal

Selbæk

et al. 2018

Dement Geriatr Cogn Disord

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“…In cross‐sectional analyses, CFI scores have been associated with cognitive impairment and/or worse cognition . In longitudinal studies, baseline CFI scores and change in CFI scores over time predicted cognitive decline . We chose to use the CFI due to its brevity and ease of administration.…”

Section: Discussionmentioning

confidence: 99%

“…The CFI, a validated, 14‐item measure of perceived cognitive and functional change over the past year , was added to the FDNY monitoring questionnaire on 3/1/2018. The CFI was developed to identify early cognitive changes in individuals without clinical impairment, who may eventually progress to dementia; it has been shown to be sensitive to decline in longitudinal studies of older adults . Individuals responded ‘Yes’, ‘Maybe’, or ‘No’ when asked if certain aspects of their cognition and functional abilities had worsened compared to one year ago; responses were scored as 1, 0.5, and 0 points respectively.…”

Section: Methodsmentioning

confidence: 99%

World Trade Center exposure, post‐traumatic stress disorder, and subjective cognitive concerns in a cohort of rescue/recovery workers

Singh

Zeig‐Owens

Hall

et al. 2019

Acta Psychiatr Scand

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Objective To determine whether World Trade Center (WTC)‐exposure intensity and post‐traumatic stress disorder (PTSD) are associated with subjective cognitive change in rescue/recovery workers. Method The population included 7875 rescue/recovery workers who completed a subjective cognition measure, the Cognitive Function Instrument (CFI), between 3/1/2018 and 2/28/2019 during routine monitoring, indicating whether they had experienced cognitive and functional difficulties in the past year. Higher scores indicated greater self‐perceived cognitive change. Probable PTSD, depression, and alcohol abuse were evaluated by validated mental health screeners. Logistic regression assessed the associations of WTC exposure and current PTSD with top‐quartile (≥2) CFI score, and of early post‐9/11 PTSD with top‐quartile CFI in a subpopulation (N = 6440). Models included demographics, smoking, depression, and alcohol abuse as covariates. Results Mean age at CFI completion was 56.7 ± 7.7 (range: 36–81). Participants with high‐intensity WTC exposure had an increased likelihood of top‐quartile CFI score (odds ratio[OR] vs. low exposure: 1.32, 95%CI: 1.07–1.64), controlling for covariates. Current and early PTSD were both associated with top‐quartile CFI (OR: 3.25, 95%CI: 2.53–4.19 and OR: 1.56, 95%CI: 1.26–1.93) respectively. Conclusions High‐intensity WTC exposure was associated with self‐reported cognitive change 17 years later in rescue/recovery workers, as was PTSD. Highly WTC‐exposed subgroups may benefit from additional cognitive evaluation and monitoring of cognition over time.

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PTSD symptoms, depressive symptoms, and subjective cognitive concerns in WTC‐exposed and non‐WTC‐exposed firefighters

Mueller

Singh

Webber

et al. 2021

American J Industrial Med

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Background: Firefighting has been associated with posttraumatic stress disorder (PTSD) and other mental health conditions. We previously found that among Fire Department of the City of New York (FDNY) responders to the World Trade Center (WTC) disaster, higher-intensity WTC-exposure predicted PTSD symptoms, depressive symptoms, and subjective cognitive concerns. The present study aims to compare these symptoms in the FDNY WTC-exposed cohort versus a comparison cohort of non-FDNY, non-WTC-exposed firefighters. Methods:The study population included WTC-exposed male firefighters from FDNY (N = 8466) and non-WTC-exposed male firefighters from Chicago (N = 1195), Philadelphia (N = 770), and San Francisco (N = 650) fire departments who were employed on 9/11/2001 and completed a health questionnaire between 3/1/2018 and 12/31/2020. Current PTSD symptoms, depressive symptoms, and subjective cognitive concerns were assessed via validated screening instruments. Multivariable linear regression analyses stratified by fire department estimated the impact of covariates on each outcome.Results: Adjusted mean PTSD symptom scores ranged from 23.5 ± 0.6 in Chicago firefighters to 25.8 ± 0.2 in FDNY, and adjusted mean depressive symptom scores ranged from 7.3 ± 0.5 in Chicago to 9.4 ± 0.6 in Philadelphia. WTC-exposure was associated with fewer subjective cognitive concerns (β = −0.69 ± 0.05, p < .001) after controlling for covariates. Across cohorts, older age was associated with more cognitive concerns, but fewer PTSD and depressive symptoms.Conclusions: WTC-exposed firefighters had fewer cognitive concerns compared with non-WTC-exposed firefighters. We were unable to estimate associations between WTC exposure and PTSD symptoms or depressive symptoms due to variability between non-WTC-exposed cohorts. Longitudinal follow-up is needed to

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The Utility of the Cognitive Function Instrument (CFI) to Detect Cognitive Decline in Non-Demented Older Adults

Abstract: Cognitive decline was predicted differentially by CDR level with subject CFI scores providing the best prediction for those with CDR 0 while study partner CFI predicted best for those at CDR 0.5.

Cited by 54 publications

References 23 publications

The Validity of the Norwegian Version of the Cognitive Function Instrument

The Validity of the Norwegian Version of the Cognitive Function Instrument

World Trade Center exposure, post‐traumatic stress disorder, and subjective cognitive concerns in a cohort of rescue/recovery workers

PTSD symptoms, depressive symptoms, and subjective cognitive concerns in WTC‐exposed and non‐WTC‐exposed firefighters

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