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Cultural differences may influence informant reports of cognitive impairment and dementia

African-American family members and other informants are less likely than are their white counterparts to report mild cognitive impairment in people who are cognitively impaired but not demented (CIND), NIA-funded research shows. The finding suggests that cultural differences may influence informant reports of cognitive impairment in non-demented people.

The analysis included 645 older African-American and white participants in the Aging, Demographics, and Memory Study, a subset of the NIA-funded Health and Retirement Study. Researchers compared results of both direct testing of participants and informant reports of participant cognition with clinical diagnoses of cognitive impairment and dementia. Informants completed the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE)—a widely used measure of cognitive decline, while participants were given clinical diagnoses of normal cognition, CIND, or dementia by an expert panel.

Informant reports of higher cognitive decline, as measured by IQCODE scores, were associated with increased odds of dementia in both African Americans and whites. However, higher IQCODE scores were associated with increased odds of CIND diagnosis among whites but not among African Americans. For both African Americans and whites, a higher total score on another test, the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) measure, was associated with lower odds of CIND and dementia.

The results suggest that African-American informants are less inclined than whites are to report mild cognitive changes, the authors explain. More comparative research is needed to establish the cultural validity of measures used to diagnose cognitive impairment, the researchers state.


Potter, G.G., et al. Cognitive performance and informant reports in the diagnosis of cognitive impairment and dementia in African Americans and whites. Alzheimer's & Dementia. 2009. 5:445-53.