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Longitudinal changes in FAQ scores by informant relationship
Author(s) -
Culhane Jessica E.,
Teylan Merilee,
Gauthreaux Kathryn,
Chen YenChi,
Chan Kwun Chuen Gary,
Mock Charles,
Kukull Walter A.
Publication year - 2020
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.036987
Subject(s) - spouse , neurocognitive , psychology , demographics , psychological intervention , clinical psychology , multilevel model , medicine , cognition , psychiatry , demography , machine learning , sociology , anthropology , computer science
Background Informant reports are assumed to reduce bias associated with self‐report of patients’ neurocognitive conditions, aiding clinicians in diagnosis. Prior studies have indicated that bias in informant reports may exist depending on relationship to the participant (spouse vs child). The Functional Assessment Questionnaire (FAQ) is an informant report of subjects’ functional ability in several domains. We investigated whether there are differences in FAQ score by informant relationship. Method We included participants from the National Alzheimer’s Coordinating Center (NACC) Uniform Data Set (UDS) who had at least three visits with the same informant (spouse or child) and completed the FAQ. Using general linear and linear mixed models, we estimated the cross‐sectional difference in FAQ scores by informant relationship as well as the difference in the slope of FAQ scores over time, adjusting for participant and informant demographics, participant cognition, and participant residence type. We also evaluated whether there were differences in objective cognitive test scores over time by informant relationship using the Mini‐Mental State Exam (MMSE). Result Of the 6,815 participants that met inclusion criteria, 77% had a spouse informant. At their initial visit, participants with a spouse informant were more likely to be younger, male, white, more educated, and living at home. In adjusted cross‐sectional analysis, spouse informants reported worse functional ability (higher FAQ score) than child informants (1.12 points, 95% CI: 0.74–1.51). In the adjusted longitudinal model, FAQ score increased 1.34 points per year (95% CI: 1.13– 1.55), and the FAQ score was an additional 0.15 points higher per year (95% CI: 0.02– 0.28) for participants with a spouse informant. However, participants with a spouse informant also had MMSE scores that were worse (0.26 points lower per year) compared to those with a child informant. Conclusion The relationship of the informant to the participant may affect reporting on the FAQ. Cross‐sectionally, spouses of participants report higher FAQ scores (worse functional ability) than children, adjusted for cognition. Spouses also report higher increases in FAQ scores over time compared to children, although this difference may be due to changes in cognitive ability as measured by the MMSE rather than bias.