Rachel L Nosheny1,2, Monica R Camacho2, Chengshi Jin3, John Neuhaus3, Diana Truran2, Derek Flenniken2, Miriam Ashford2, Maria C Carrillo4, Keith N Fargo4, James Hendrix4, Lucy Hanna5, Gil Rabinovici6,7, Paul Maruff8, R Scott Mackin1,2, Michael W Weiner2,7. 1. Department of Psychiatry, University of California San Francisco, San Francisco, California, USA. 2. San Francisco Veteran's Administration Medical Center, San Francisco, California, USA. 3. Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA. 4. Alzheimer's Association, Chicago, Illinois, USA. 5. Department of Biostatistics, Brown University, Providence, Rhode Island, USA. 6. Department of Neurology, University of California San Francisco, San Francisco, California, USA. 7. Department of Radiology & Biomedical Imaging, University of California San Francisco, San Francisco, California, USA. 8. Cogstate, Ltd., Melbourne, VIC, Australia.
Abstract
INTRODUCTION: Assessment of functional status is associated with risk of cognitive decline and diagnosis of dementia, and can be assessed by participants and study partners (SPs). METHODS: In 770 older adults enrolled in the Imaging Dementia-Evidence for Amyloid Scanning (IDEAS) study and the online Brain Health Registry (BHR), we estimated associations between online assessments and clinical variables related to Alzheimer's disease (AD) risk. RESULTS: Worse online learning scores and SP-reported functional decline were associated with higher probability of AD dementia diagnosis and poor in-clinic cognitive assessment, and with higher odds of amyloid beta (Aβ) positivity when combined with participants' report of less decline. SP report of functional decline conferred predictive value independent of online cognitive assessments. Participants underreported decline compared to SPs. DISCUSSION: The results support the validity of online assessments and their greater utilization in healthcare and research settings. Online SP-reported functional decline is an indicator of dementia and AD risk.
INTRODUCTION: Assessment of functional status is associated with risk of cognitive decline and diagnosis of dementia, and can be assessed by participants and study partners (SPs). METHODS: In 770 older adults enrolled in the Imaging Dementia-Evidence for Amyloid Scanning (IDEAS) study and the online Brain Health Registry (BHR), we estimated associations between online assessments and clinical variables related to Alzheimer's disease (AD) risk. RESULTS: Worse online learning scores and SP-reported functional decline were associated with higher probability of AD dementia diagnosis and poor in-clinic cognitive assessment, and with higher odds of amyloid beta (Aβ) positivity when combined with participants' report of less decline. SP report of functional decline conferred predictive value independent of online cognitive assessments. Participants underreported decline compared to SPs. DISCUSSION: The results support the validity of online assessments and their greater utilization in healthcare and research settings. Online SP-reported functional decline is an indicator of dementia and AD risk.
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