title: Cognitive performance and informant reports in the diagnosis of cognitive impairment and dementia in African Americans and whites.
abstract: BACKGROUND
  The diagnosis of cognitive impairment and dementia must reflect an increasingly diverse and aging United States population. This study compared direct testing and informant reports of cognition with clinical diagnoses of cognitive impairment and dementia between African Americans and whites.
  
  
  METHODS
  Participants in the Aging, Demographics, and Memory Study completed in-person dementia evaluations, and were assigned clinical diagnoses (by a consensus panel of dementia experts) of normal; cognitive impairment, not demented (CIND); and dementia. The Consortium to Establish a Registry for Alzheimer's Disease (CERAD) total score and the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) were used to assess cognitive performance and reported cognitive decline.
  
  
  RESULTS
  A higher CERAD total score was associated with lower odds of CIND and dementia, at comparable ratios between African Americans and whites. Higher IQCODE scores were associated with increased odds of dementia in both African Americans and whites. Higher IQCODE scores were associated with increased odds of CIND among whites, but not among African Americans.
  
  
  CONCLUSIONS
  Cultural differences may influence informant reports of prevalent CIND and dementia. Our findings also highlight the need for more comparative research to establish the cultural validity of measures used to diagnose these conditions.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA. guy.potter@duke.edu
authors.forename: Guy G
authors.initials: GG
authors.lastname: Potter
authors.forename: Brenda L
authors.initials: BL
authors.lastname: Plassman
authors.forename: James R
authors.initials: JR
authors.lastname: Burke
authors.forename: Mohammed U
authors.initials: MU
authors.lastname: Kabeto
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Langa
authors.forename: David J
authors.initials: DJ
authors.lastname: Llewellyn
authors.forename: Mary A M
authors.initials: MA
authors.lastname: Rogers
authors.forename: David C
authors.initials: DC
authors.lastname: Steffens
mesh_terms: D000203:Activities of Daily Living; D001741:Black or African American / Q000208:ethnology; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology / Q000706:statistics & numerical data; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology; D015331:Cohort Studies; D003469:Culture; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment; D006306:Health Surveys; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D015588:Observer Variation; D011159:Population Surveillance; D011237:Predictive Value of Tests; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D012042:Registries; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D044465:White People / Q000208:ethnology