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Assessing Cognitive Impairment in the Health and Retirement Study Harmonized Cognitive Assessment Protocol Project: Comparing a Diagnostic Algorithm With a Diagnostic Consensus Panel.

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Τίτλος: Assessing Cognitive Impairment in the Health and Retirement Study Harmonized Cognitive Assessment Protocol Project: Comparing a Diagnostic Algorithm With a Diagnostic Consensus Panel.
Συγγραφείς: Farron M; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA., Ryan LH; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA., Manly JJ; Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA., Levine DA; Cognitive Health Sciences Research Program and Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.; Department of Neurology and Stroke Program, University of Michigan, Ann Arbor, MI, USA.; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA., Plassman BL; Department of Psychiatry and Behavioral Science, Duke University School of Medicine, Durham, NC, USA., Giordani BJ; Department of Psychiatry and Michigan Alzheimer's Disease Center, University of Michigan, Ann Arbor, MI, USA., Jones RN; Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, RI, USA.; Department of Neurology, Brown University Warren Alpert Medical School, Providence, RI, USA., Langa KM; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.; Cognitive Health Sciences Research Program and Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
Πηγή: Journal of aging and health [J Aging Health] 2026 Jun; Vol. 38 (5-6), pp. 292-301. Date of Electronic Publication: 2025 Apr 15.
Τύπος έκδοσης: Journal Article; Comparative Study
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: Sage Publications Country of Publication: United States NLM ID: 8912686 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1552-6887 (Electronic) Linking ISSN: 08982643 NLM ISO Abbreviation: J Aging Health Subsets: MEDLINE
Imprint Name(s): Original Publication: [Newbury Park] : Sage Publications, [c1989-
Ιατρικοί όροι (MeSH): Cognitive Dysfunction*/diagnosis , Cognitive Dysfunction*/classification , Dementia*/diagnosis , Algorithms*, Humans ; Aged ; Male ; Female ; Consensus ; Aged, 80 and over ; Retirement ; Neuropsychological Tests ; Middle Aged
Περίληψη: BackgroundAccurate classification of cognitive impairment in population studies is challenging.ObjectiveTo compare the performance of a diagnostic algorithm with a clinical consensus panel.SampleIn 2016, the Health and Retirement Study (HRS) implemented the Harmonized Cognitive Assessment Protocol Project (HRS-HCAP) to streamline cognitive assessments for select HRS participants.MethodsThe Manly-Jones HCAP diagnostic classification was used to classify cognitive status as normal, mild cognitive impairment (MCI), or dementia. For this analysis, a consensus panel of five clinicians reviewed 50 cases with high diagnostic uncertainty, each reviewing 30 cases, blinded to the algorithm's classifications.AnalysisDiagnostic concordance was assessed using unweighted and weighted Cohen's kappa (κ).ResultsUnweighted concordance was 70% (35/50), with discordance mostly among MCI cases. Weighted concordance was 84%. Unweighted κ was 0.56 (95% CI 0.30-0.81) and weighted κ was 0.75 (95% CI 0.49-0.91), indicating moderate to substantial agreement between the two methods.
Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
References: J Alzheimers Dis. 2020;78(1):371-386. (PMID: 32986674)
Alzheimers Dement. 2011 May;7(3):270-9. (PMID: 21514249)
BMC Med. 2015 Jan 06;13:1. (PMID: 25563062)
Ann Intern Med. 2008 Mar 18;148(6):427-34. (PMID: 18347351)
JMIR Ment Health. 2021 May 10;8(5):e27113. (PMID: 33970122)
Int Psychogeriatr. 2004 Sep;16(3):275-93. (PMID: 15559753)
Epidemiology. 2019 Mar;30(2):291-302. (PMID: 30461528)
J Am Geriatr Soc. 2020 Aug;68 Suppl 3:S54-S59. (PMID: 32815604)
J Int Neuropsychol Soc. 2024 Jan;30(1):47-55. (PMID: 37448351)
Neuroepidemiology. 2007;29(1-2):125-32. (PMID: 17975326)
Neuroepidemiology. 2020;54(1):64-74. (PMID: 31563909)
JAMA Neurol. 2022 Dec 1;79(12):1242-1249. (PMID: 36279130)
Front Psychol. 2021 Oct 15;12:679481. (PMID: 34721136)
Neurology. 1993 Nov;43(11):2412-4. (PMID: 8232972)
Alzheimers Dement (Amst). 2023 Apr 04;15(2):e12420. (PMID: 37025188)
Biometrics. 1977 Mar;33(1):159-74. (PMID: 843571)
Alzheimers Dement. 2011 May;7(3):263-9. (PMID: 21514250)
Alzheimers Dement. 2011 Jan;7(1):94-109. (PMID: 21255747)
Int Psychogeriatr. 2024 Mar;36(3):177-187. (PMID: 35844066)
Arch Neurol. 2010 Dec;67(12):1506-12. (PMID: 21149812)
Neuroepidemiology. 2005;25(4):181-91. (PMID: 16103729)
Grant Information: U01 AG009740 United States AG NIA NIH HHS; U01 AG058499 United States AG NIA NIH HHS
Contributed Indexing: Keywords: aging; cognitive impairment; dementia; diagnosis; population-based studies
Entry Date(s): Date Created: 20250416 Date Completed: 20260429 Latest Revision: 20260917
Update Code: 20260917
PubMed Central ID: PMC12509085
DOI: 10.1177/08982643251335370
PMID: 40235076
Βάση Δεδομένων: MEDLINE
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  Data: Assessing Cognitive Impairment in the Health and Retirement Study Harmonized Cognitive Assessment Protocol Project: Comparing a Diagnostic Algorithm With a Diagnostic Consensus Panel.
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  Data: <searchLink fieldCode="AU" term="%22Farron+M%22">Farron M</searchLink>; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.<br /><searchLink fieldCode="AU" term="%22Ryan+LH%22">Ryan LH</searchLink>; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.<br /><searchLink fieldCode="AU" term="%22Manly+JJ%22">Manly JJ</searchLink>; Department of Neurology, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, NY, USA.<br /><searchLink fieldCode="AU" term="%22Levine+DA%22">Levine DA</searchLink>; Cognitive Health Sciences Research Program and Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.; Department of Neurology and Stroke Program, University of Michigan, Ann Arbor, MI, USA.; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.<br /><searchLink fieldCode="AU" term="%22Plassman+BL%22">Plassman BL</searchLink>; Department of Psychiatry and Behavioral Science, Duke University School of Medicine, Durham, NC, USA.<br /><searchLink fieldCode="AU" term="%22Giordani+BJ%22">Giordani BJ</searchLink>; Department of Psychiatry and Michigan Alzheimer's Disease Center, University of Michigan, Ann Arbor, MI, USA.<br /><searchLink fieldCode="AU" term="%22Jones+RN%22">Jones RN</searchLink>; Department of Psychiatry and Human Behavior, Brown University Warren Alpert Medical School, Providence, RI, USA.; Department of Neurology, Brown University Warren Alpert Medical School, Providence, RI, USA.<br /><searchLink fieldCode="AU" term="%22Langa+KM%22">Langa KM</searchLink>; Institute for Social Research, University of Michigan, Ann Arbor, MI, USA.; Cognitive Health Sciences Research Program and Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
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  Data: <i>Publisher: </i><searchLink fieldCode="PB" term="%22Sage+Publications%22">Sage Publications </searchLink><i>Country of Publication: </i>United States <i>NLM ID: </i>8912686 <i>Publication Model: </i>Print-Electronic <i>Cited Medium: </i>Internet <i>ISSN: </i>1552-6887 (Electronic) <i>Linking ISSN: </i><searchLink fieldCode="IS" term="%2208982643%22">08982643 </searchLink><i>NLM ISO Abbreviation: </i>J Aging Health <i>Subsets: </i>MEDLINE
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– Name: Abstract
  Label: Abstract
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  Data: BackgroundAccurate classification of cognitive impairment in population studies is challenging.ObjectiveTo compare the performance of a diagnostic algorithm with a clinical consensus panel.SampleIn 2016, the Health and Retirement Study (HRS) implemented the Harmonized Cognitive Assessment Protocol Project (HRS-HCAP) to streamline cognitive assessments for select HRS participants.MethodsThe Manly-Jones HCAP diagnostic classification was used to classify cognitive status as normal, mild cognitive impairment (MCI), or dementia. For this analysis, a consensus panel of five clinicians reviewed 50 cases with high diagnostic uncertainty, each reviewing 30 cases, blinded to the algorithm's classifications.AnalysisDiagnostic concordance was assessed using unweighted and weighted Cohen's kappa (κ).ResultsUnweighted concordance was 70% (35/50), with discordance mostly among MCI cases. Weighted concordance was 84%. Unweighted κ was 0.56 (95% CI 0.30-0.81) and weighted κ was 0.75 (95% CI 0.49-0.91), indicating moderate to substantial agreement between the two methods.
– Name: Abstract
  Label: Competing Interests
  Group: Ab
  Data: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
– Name: Ref
  Label: References
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  Data: J Alzheimers Dis. 2020;78(1):371-386. (PMID: <searchLink fieldCode="PM" term="%2232986674%22">32986674)</searchLink><br />Alzheimers Dement. 2011 May;7(3):270-9. (PMID: <searchLink fieldCode="PM" term="%2221514249%22">21514249)</searchLink><br />BMC Med. 2015 Jan 06;13:1. (PMID: <searchLink fieldCode="PM" term="%2225563062%22">25563062)</searchLink><br />Ann Intern Med. 2008 Mar 18;148(6):427-34. (PMID: <searchLink fieldCode="PM" term="%2218347351%22">18347351)</searchLink><br />JMIR Ment Health. 2021 May 10;8(5):e27113. (PMID: <searchLink fieldCode="PM" term="%2233970122%22">33970122)</searchLink><br />Int Psychogeriatr. 2004 Sep;16(3):275-93. (PMID: <searchLink fieldCode="PM" term="%2215559753%22">15559753)</searchLink><br />Epidemiology. 2019 Mar;30(2):291-302. (PMID: <searchLink fieldCode="PM" term="%2230461528%22">30461528)</searchLink><br />J Am Geriatr Soc. 2020 Aug;68 Suppl 3:S54-S59. (PMID: <searchLink fieldCode="PM" term="%2232815604%22">32815604)</searchLink><br />J Int Neuropsychol Soc. 2024 Jan;30(1):47-55. (PMID: <searchLink fieldCode="PM" term="%2237448351%22">37448351)</searchLink><br />Neuroepidemiology. 2007;29(1-2):125-32. (PMID: <searchLink fieldCode="PM" term="%2217975326%22">17975326)</searchLink><br />Neuroepidemiology. 2020;54(1):64-74. (PMID: <searchLink fieldCode="PM" term="%2231563909%22">31563909)</searchLink><br />JAMA Neurol. 2022 Dec 1;79(12):1242-1249. (PMID: <searchLink fieldCode="PM" term="%2236279130%22">36279130)</searchLink><br />Front Psychol. 2021 Oct 15;12:679481. (PMID: <searchLink fieldCode="PM" term="%2234721136%22">34721136)</searchLink><br />Neurology. 1993 Nov;43(11):2412-4. (PMID: <searchLink fieldCode="PM" term="%228232972%22">8232972)</searchLink><br />Alzheimers Dement (Amst). 2023 Apr 04;15(2):e12420. (PMID: <searchLink fieldCode="PM" term="%2237025188%22">37025188)</searchLink><br />Biometrics. 1977 Mar;33(1):159-74. (PMID: <searchLink fieldCode="PM" term="%22843571%22">843571)</searchLink><br />Alzheimers Dement. 2011 May;7(3):263-9. (PMID: <searchLink fieldCode="PM" term="%2221514250%22">21514250)</searchLink><br />Alzheimers Dement. 2011 Jan;7(1):94-109. (PMID: <searchLink fieldCode="PM" term="%2221255747%22">21255747)</searchLink><br />Int Psychogeriatr. 2024 Mar;36(3):177-187. (PMID: <searchLink fieldCode="PM" term="%2235844066%22">35844066)</searchLink><br />Arch Neurol. 2010 Dec;67(12):1506-12. (PMID: <searchLink fieldCode="PM" term="%2221149812%22">21149812)</searchLink><br />Neuroepidemiology. 2005;25(4):181-91. (PMID: <searchLink fieldCode="PM" term="%2216103729%22">16103729)</searchLink>
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