Informant Reporting in Mild Cognitive Impairment: Sources of Discrepancy on the Functional Activities Questionnaire

Abstract

Objective:Relative to dementia, little is known about informant bias in mild cognitive impairment (MCI). We investigated the influence of informant demographic and relational characteristics on reports of everyday functioning using the Functional Activities Questionnaire (FAQ).Method:Four thousand two hundred eighty-four MCI participants and their informants from the National Alzheimer’s Coordinating Center Uniform Data Set were included. Informants were stratified according to cohabitation, relationship, visit frequency, race/ethnicity, education, and sex. Informant-rated Mean FAQ score was compared across these groups using univariate general linear model analyses and post hoc tests. Interactions were tested between informant variables. The predictive contribution of informant variables to FAQ score was explored using hierarchical linear regression. Analyses covaried for participant cognition using a cognitive composite score, and for participant age, sex, and depression.Results:After controlling for participant cognition, depression, age, and sex, informant-rated FAQ scores varied significantly across all informant variables (p’s < .005, ηp2’s ≤ .033) except sex and visit frequency. FAQ scores were higher (more impaired) among informants who cohabitate with the participant, among paid caregivers, spouses, and adult children, and among informants with higher levels of education. Scores were lowest (less impaired) among Black/African American informants as compared to all other racial/ethnic groups.Conclusions:Demographic and relational characteristics of informants influence the perception and reporting of instrumental activities of daily living in adults with MCI. As everyday functioning is crucial for differential diagnosis and treatment outcome measurement, it is important to be aware of sources of informant report discrepancies.

Everyday Functioning in a Community-Based Volunteer Population: Differences Between Participant- and Study Partner-Report

“…Previous studies have shown that study partners report a decline in IADL in preclinical AD, even before cognitive problems can be detected by the standard cognitive testing ( Sperling et al, 2011 ; Marshall et al, 2012 , 2017 ; Zoller et al, 2014 ). Due to impairments in awareness in persons with dementia ( Hanseeuw et al, 2020 ), (I)ADL functioning has traditionally been assessed using study partner-report questionnaires ( Loewenstein et al, 2001 ; Howorth and Saper, 2003 ; Wadley et al, 2003 ; Desai et al, 2004 ; Farias et al, 2005 ; Graham et al, 2005 ; Sikkes et al, 2009 ; Hackett et al, 2020 ).…”

Associations Between Self- and Informant-Reported Abilities of Instrumental Activities of Daily Living and Cognitive Functions in Older Adults With Mild Cognitive Impairment

“…Alternatively, the OAs themselves could have had better insight into their own capabilities than the informants. In general, informant- and self-report-based accounts of functional abilities may differ, for example, because the individual may lack insight, or the peer (or the individual) overestimates the problems’ severity due to stress and depression (e.g., Hackett, Mis, Drabick, & Giovannetti, 2020 ; Jorm et al., 1994 ).…”

Everyday functioning in a community-based volunteer population: Differences between participant- and study partner-report

“…Due to impairments in awareness in persons with dementia (5), (I)ADL functioning has traditionally been assessed using study partner-report questionnaires (6)(7)(8)(9)(10)(11)(12)(13)(14). However, it has been suggested that study partner-report may be influenced by study partner depression, anxiety and caregiver burden (15)(16)(17).…”