The Aging, Demographics, and Memory Study: Study Design and Methods

Abstract

Objective: We describe the design and methods of the Aging, Demographics, and Memory Study (ADAMS), a new national study that will provide data on the antecedents, prevalence, outcomes, and costs of dementia and ‘cognitive impairment, not demented’ (CIND) using a unique study design based on the nationally representative Health and Retirement Study (HRS). We also illustrate potential uses of the ADAMS data and provide information to interested researchers on obtaining ADAMS and HRS data. Methods: The ADAMS is the first population-based study of dementia in the United States to include subjects from all regions of the country, while at the same time using a single standardized diagnostic protocol in a community-based sample. A sample of 856 individuals age 70 or older who were participants in the ongoing HRS received an extensive in-home clinical and neuropsychological assessment to determine a diagnosis of normal, CIND, or dementia. Within the CIND and dementia categories, subcategories (e.g. Alzheimer’s disease, vascular dementia) were assigned to denote the etiology of cognitive impairment. Conclusion: Linking the ADAMS dementia clinical assessment data to the wealth of available longitudinal HRS data on health, health care utilization, informal care, and economic resources and behavior, will provide a unique opportunity to study the onset of CIND and dementia in a nationally representative population-based sample, as well as the risk factors, prevalence, outcomes, and costs of CIND and dementia.

The Impact of Disability and Social Determinants of Health on Condition-Specific Readmissions beyond Medicare Risk Adjustments: A Cohort Study

“…Composite scores for ADL difficulty were computed and cut-offs determined a priori to represent no limitations (0), mild/moderate limitations (1-2), and severe limitations (3 or more). The HRS tests cognitive function using well-described methods; [29][30][31][32][33] final models used a binary measure to describe patients as having no cognitive impairment versus any cognitive impairment. Two binary measures related to disability were obtained from the HRS data: whether the patient required nursing home services during the most recent HRS interview, or had used home health care services in the 2 years prior to the interview.…”

Trends in the prevalence and mortality of cognitive impairment in the United States: Is there evidence of a compression of cognitive morbidity?

“…38 The validity of these categories is supported by the clear trends in functional limitations with which they are associated. We assessed the mean number of limitations in instrumental activities of daily living (IADLs; preparing meals, grocery shopping, making phone calls, taking medications, managing money) and found that those in the normal, mild CI, and moderate / severe CI categories had an average of 0.4, 1.1, and 2.5 IADL limitations, respectively (P<.001).…”

Neuropsychological performance in advanced age: Influences of Demographic factors and Apolipoprotein E: Findings from the Cache County Memory Study

“…The neuropsychological battery used in the study has been described in previous work from our group (Breitner et al, 1995) and has been adopted by a growing number of cohort and casecontrol studies of aging and dementia (Steffens et al, 2004;Langa et al, 2005;van der Walt et al, 2005;Plassman et al, 2006;Tschanz et al, 2000Tschanz et al, , 2002Tschanz et al, 2006). A brief description of the measures and the order of test administration follow:…”