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Differential Item Functioning of the Everyday Cognition (ECog) Scales in Relation to Racial/Ethnic Groups

Published online by Cambridge University Press:  24 January 2020

Teresa Filshtein Open the ORCID record for Teresa Filshtein [Opens in a new window] ,
Michelle Chan ,
Dan Mungas ,
Rachel Whitmer ,
Evan Fletcher ,
Charles DeCarli  and
Sarah Farias
Teresa Filshtein*
Affiliation:
Department of Epidemiology and Biostatistics, University of California, San Francisco, CA94158, USA
Michelle Chan
Affiliation:
Department of Neurology, University of California, Davis, CA95817, USA
Dan Mungas
Affiliation:
Department of Neurology, University of California, Davis, CA95817, USA
Rachel Whitmer
Affiliation:
Department of Public Health Sciences, University of California, Davis, CA95616, USA
Evan Fletcher
Affiliation:
Department of Neurology, University of California, Davis, CA95817, USA
Charles DeCarli
Affiliation:
Department of Neurology, University of California, Davis, CA95817, USA
Sarah Farias
Affiliation:
Department of Neurology, University of California, Davis, CA95817, USA
*
Correspondence and reprint requests to: Teresa Filshtein, Department of Epidemiology and Biostatistics, University of California, UCSF Mission Bay, Mission Hall, 550 16th Street, San Francisco, CA 94158, USA. Phone: +1 860 803 4577. E-mail: [email protected]
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Abstract

Objective:

The Everyday Cognition (ECog) scales measure cognitively based across domains of everyday abilities that are affected early in the course of neurodegenerative disorders such as Alzheimer’s disease. However, the degree to which the ECog may be differentially influenced by ethnic/racial background is unknown. This study evaluates measurement invariance of the ECog across non-Hispanic White (NHW), Black, and Hispanic individuals.

Methods:

Participants included 1177 NHW, 243 Black, and 216 Hispanic older adults from the UC Davis Alzheimer’s Disease Center Cohort who had an ECog. Differential item functioning (DIF) for each ECog domain was evaluated separately for Black and Hispanic participants compared to NHW participants. An iterative multiple group confirmatory factor analysis approach for ordinal scores was used to identify items whose measurement properties differed across groups and to adjust scores for DIF. Adjusted scores were then evaluated to test whether they were more strongly associated with cognitive function (concurrent and longitudinal change in cognition) and brain volumes (measured by brain imaging).

Results:

Varying levels, patterns, and impacts of DIF were found across domains and groups. However, the impact of DIF was relatively small, and DIF effects on scores generally were less than one-half standard error of measurement. There were no meaningful differences in associations with cognition and brain injury between DIF adjusted and unadjusted scores.

Conclusions:

Varying patterns of DIF were observed across the Black and Hispanic participants across select ECog domains. Overall, DIF effects were relatively small and did not change the relationship between the ECog and other indicators of disease.

Keywords

Differential item functioningInstrumental activities of daily livingFunctional abilitiesNeuroimagingExecutive functionEpisodic memoryDementia
Type
Regular Research
Information
Journal of the International Neuropsychological Society , Volume 26 , Issue 5 , May 2020 , pp. 515 - 526
Copyright
Copyright © INS. Published by Cambridge University Press, 2020

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Footnotes

*

These authors contributed equally.

References

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