Journal Article

Development of a subjective cognitive decline questionnaire using item response theory: A pilot study

Jefferson, Angela L, Gifford, Katherine A, Romano, Raymond R, Jones, Richard N, Liu, Dandan

2015

Overview

Abstract Introduction Subjective cognitive decline (SCD) may indicate unhealthy cognitive changes, but no standardized SCD measurement exists. This pilot study aimed to identify reliable SCD questions. Methods A total of 112 cognitively normal (NC; 76 ± 8 years; 63% female), 43 mild cognitive impairment (MCI; 77 ± 7 years; 51% female), and 33 diagnostically ambiguous participants (79 ± 9 years; 58% female) were recruited from a research registry and completed 57 self-report SCD questions. Psychometric methods were used for item reduction. Results Factor analytic models assessed unidimensionality of the latent trait (SCD); 19 items were removed with extreme response distribution or trait-fit. Item response theory (IRT) provided information about question utility; 17 items with low information were dropped. Post hoc simulation using computerized adaptive test (CAT) modeling selected the most commonly used items (n = 9 of 21 items) that represented the latent trait well ( r  = 0.94) and differentiated NC from MCI participants ( F [1, 146] = 8.9, P  = .003). Discussion IRT and CAT modeling identified nine reliable SCD items. This pilot study is a first step toward refining SCD assessment in older adults. Replication of these findings and validation with Alzheimer's disease biomarkers will be an important next step for the creation of a SCD screener.

• Publisher: Elsevier
• Subject: Cognitive & Behavioral Assessment / Computerized adaptive testing / Factor analysis / Item response theory / Mild cognitive impairment / Neurology / Other / Psychometrics / Subjective cognitive decline