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[P3–301]: COGNITIVE INTERVIEWING IN THE EVALUATION OF SUBJECTIVE COGNITION ITEMS WITH OLDER ADULTS
Author(s) -
Hill Nikki L.,
Mogle Jacqueline,
Kitko Lisa,
Whitaker Emily,
Corrente Connor
Publication year - 2017
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 - 10.1016/j.jalz.2017.06.1516
Subject(s) - cognitive interview , psychology , cognition , comprehension , clarity , meaning (existential) , interpretation (philosophy) , dementia , interview , cognitive psychology , affect (linguistics) , forgetting , developmental psychology , clinical psychology , medicine , disease , psychotherapist , psychiatry , linguistics , communication , philosophy , biochemistry , chemistry , pathology , political science , law
Background: Prior to cognitive decline identifiable via objective testing, older adults often become aware of subtle changes in memory and thinking that impact daily life. This preclinical period, termed subjective cognitive impairment (SCI), may be a key to early detection of dementia-related decline. However, current measurement of SCI is inconsistent across studies and does not consider the multiple ways older adults interpret and answer such questions. Methods:Cognitive interviewing, a structured approach to analyzing sources of response error when individuals respond to questions, was used to systematically appraise older adults’ interpretation of and response to twenty self-report SCI assessment items commonly used in research. The sample (n1⁄455) included independently-living adults age 60 or over with SCI and without dementia; purposive sampling was used to obtain a range of SCI severity. A cognitive interview guide utilized verbal probing techniques to evaluate comprehension, interpretation, difficulty, and potential alternate wording of each item. Interviews were audio-recorded and transcribed, then coded for problem identification using the Question Appraisal System (QAS-99). Results: The most common problem area identified across SCI items was clarity: problems related to communicating the intent or meaning of the question. Specific problems in this area included vague wording that led to multiple ways of interpreting the question (e.g., lack of specificity in identifying important vs. unimportant instances of forgetting) as well as unspecified reference periods (e.g., differences in interpretation of the time frame “happened recently”). Additionally, some questions were inherently affect-laden even when affective language was not included (e.g., comparing one’s memory to peers) and led to respondent resistance when answering. Conclusions:Identifying problems with current assessment items and individual differences in reporting biases across older adult respondents will help to inform future SCI assessment methods. These findings could also aid in the interpretation of current evidence regarding the associations among SCI and a variety of negative outcomes in older adults.