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Alzheimer's Association International Conference 2026

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The Relation Between Functional Outcomes And Subjective Cognitive Decline In In Older Adults Within Armcada: A Pilot Study

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The Relation Between Functional Outcomes And Subjective Cognitive Decline In Older Adults Within ARMCADA: A Pilot Study

P-0849

Tatiana Karpouzian-Rogers1, Y. Catherine Han2, Patricia Bucko2, Elizabeth M. Dworak2, Emily H. Ho2*, Berivan Ece, PhD2, LaToya Hall3, 

Richard C. Gershon2, Sandra Weintraub4

 

1Dept of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA, 2Dept of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA, 3Institute of Gerontology, Wayne State University, Detroit, MI, USA, 4Mesulam Institute for Cognitive Neurology and Alzheimer’s Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA    

 

 THE SELECTED FUNCTIONAL OUTCOME MEASURES ARE BRIEF, FEASIBLE, AND HAVE HIGH INTERNAL CONSISTENCY , HIGHLIGHTING THEIR PROMISE AS EARLY INDICATORS OF COGNITIVE DECLINE AND DEMENTIA-RELATED RISK. 

Declines in decision-making (DM) abilities are often observed in older adults along the cognitive aging spectrum, including individuals with Alzheimer's disease and related dementias (ADRD)as well as those with subjective cognitive decline (SCD).
üDeclines in DM may be related to worse functional outcomes (FO). 
The ARMCADA (Advancing Reliable Measurement in Cognitive Aging and Decision-making Ability) initiative aims to develop a multidomain DM battery for adults (45+) that will be sensitive to changes in DM ability, including DM skills related to FO, potentially predicting cognitive decline
The aim of the current pilot study is to assess the feasibility and reliability of FO measures, along with other measures spanning multiple domains of DM, and to compare them with SCD.
A pilot study of n=177 adults aged 40+ were recruited online (55% female), who reported living in rural (15%), suburban (58%), and urban (25%) regions in the US.

Participants completed self-report measures related to functional outcomes and subjective cognitive decline (SCD). 

Feasibility: >98% completion; Reliability:α≥.60  
Worse self-reported functioning and worse SCD, anxiety, depression, and social isolation (WHODAS 2.0 Overall rs≥.55, ps<.001)
Greater perceived participation restrictions and worse SCD, anxiety, depression, and social isolation (P-Scale rs≥.46, ps<.001). 
Increased perceived difficulty using technology and worse SCD, anxiety, depression, and social isolation (rs≥.35, ps<.001) 
However, value placed on driving was not significantly related with SCD or affective states (rs≤|.10|; ps>.05).
The feasibility and internal consistency of the selected FO measures support their candidacy for the final ARMCADA battery. 
Findings from this pilot study will provide the foundation for future investigations exploring interactions between domains and validation in samples with a wide range of cognitive decline.
Additional measures, including performance on an adapted version of the Test of Practical Judgment, will be included in our final battery.

 

1Üstün, T. B., Kostanjsek, N., Chatterji, S., & Rehm, J. (Eds.). (2010). Measuring health and disability: Manual for WHO Disability Assessment Schedule (WHODAS 2.0). World Health Organization.

2 Betz, M. E., Hill, L. L., Fowler, N. R., DiGuiseppi, C., Han, S. D., Johnson, R. L., Meador, L., Omeragic, F., Peterson, R. A., & Matlock, D. D. (2022). "Is it time to stop driving?": A randomized clinical trial of an online decision aid for older drivers. Journal of the American Geriatrics Society, 70(7), 1987–1996. https://doi.org/10.1111/jgs.17791

3 Van Brakel, W. H., Anderson, A. M., Mutatkar, R. K., Bakirtzief, Z., Nicholls, P. G., Raju, M. S., & Das-Pattanayak, R. K. (2006). Participation Scale [Database record]. PsycTESTS. https://doi.org/10.1037/t34802-000

4 Sikkes, S. A. M., Knol, D. L., Pijnenburg, Y. A. L., de Lange-de Klerk, E. S. M., Uitdehaag, B. M. J., & Scheltens, P. (2013). Validation of the Amsterdam IADL Questionnaire©, a new tool to measure instrumental activities of daily living in dementia. Neuroepidemiology, 41(1), 35–41. https://doi.org/10.1159/000346277

5 Cella, D., Riley, W., Stone, A. A., Rothrock, N., Reeve, B. B., Yount, S., Amtmann, D., Choi, S., Cook, K. F., & PROMIS Cooperative Group. (2010). The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005-2008. Journal of Clinical Epidemiology, 63(11), 1179-1194.

6 Tomaszewski Farias, S., Mungas, D., Harvey, D. J., Simmons, A., Reed, B. R., & Decarli, C. (2011). The measurement of everyday cognition: development and validation of a short form of the Everyday Cognition scales. Alzheimer's & dementia : the journal of the Alzheimer's Association, 7(6), 593–601. https://doi.org/10.1016/j.jalz.2011.02.007

7 Vale, F. A. C., Balieiro, A. P., Jr, & Silva-Filho, J. H. (2012). Memory complaint scale (MCS). Proposed tool for active systematic search. Dementia & neuropsychologia, 6(4), 212–218. https://doi.org/10.1590/S1980-57642012DN06040004

This work is supported by NIA grant #1U24AG082022. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

 


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