title: The Cognitive Change Index as a Measure of Self and Informant Perception of Cognitive Decline: Relation to Neuropsychological Tests.
abstract: BACKGROUND
  The perception of cognitive decline by individuals and those who know them well ("informants") has been inconsistently associated with objective cognitive performance, but strongly associated with depressive symptoms.
  
  
  OBJECTIVE
  We investigated associations of self-report, informant-report, and discrepancy between self- and informant-report of cognitive decline obtained from the Cognitive Change Index (CCI) with cognitive test performance and self-reported depressive symptoms.
  
  
  METHODS
  267 participants with normal cognition, mild cognitive impairment (MCI), or mild dementia were included from a cohort study and memory clinic. Association of test performance and self-rated depression (Geriatric Depression Scale, GDS) with CCI scores obtained from subjects (CCI-S), their informants (CCI-I), and discrepancy scores between subjects and informants (CCI-D; CCI-S minus CCI-I) were analyzed using correlation and analysis of covariance (ANCOVA) models.
  
  
  RESULTS
  CCI-S and CCI-I scores showed high internal consistency (Cronbach alpha 0.96 and 0.98, respectively). Higher scores on CCI-S and CCI-I, and lower scores on the CCI-D, were associated with lower performance on various cognitive tests in both univariate and in ANCOVA models adjusted for age, gender, and education. Adjustment for GDS slightly weakened the relationships between CCI and test performance but most remained significant.
  
  
  CONCLUSIONS
  Self- and informant-report of cognitive decline, as measured by the CCI, show moderately strong relationships with objective test performance independent of age, gender, education, and depressive symptoms. The CCI appears to be a valid cross-sectional measure of self and informant perception of cognitive decline across the continuum of functioning. Studies are needed to address the relationship of CCI scores to longitudinal outcome.
authors.affiliation: Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA.|Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA.|Division of Neurology, Department of Internal Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Chatchawan
authors.initials: C
authors.lastname: Rattanabannakit
authors.affiliation: Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, USA.|Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Shannon L
authors.initials: SL
authors.lastname: Risacher
authors.affiliation: Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA.|Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Sujuan
authors.initials: S
authors.lastname: Gao
authors.affiliation: Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA.|Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Lane
authors.affiliation: Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN, USA.|Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Steven A
authors.initials: SA
authors.lastname: Brown
authors.affiliation: Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA.|Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, USA.|Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Brenna C
authors.initials: BC
authors.lastname: McDonald
authors.affiliation: Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.|Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Frederick W
authors.initials: FW
authors.lastname: Unverzagt
authors.affiliation: Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA.|Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, USA.|Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Liana G
authors.initials: LG
authors.lastname: Apostolova
authors.affiliation: Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA.|Department of Radiology and Imaging Sciences, Center for Neuroimaging, Indiana University School of Medicine, Indianapolis, IN, USA.|Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA.|Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Saykin
authors.affiliation: Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA.|Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Martin R
authors.initials: MR
authors.lastname: Farlow
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology*; D003430:Cross-Sectional Studies; D003704:Dementia / Q000503:physiopathology / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D009483:Neuropsychological Tests; D010465:Perception / Q000502:physiology*; D057566:Self Report
keywords: Alzheimer’s disease; cognitive change index; cognitive performance; subjective cognitive decline; validation