Hostname: page-component-cd9895bd7-gxg78 Total loading time: 0 Render date: 2024-12-26T15:54:12.498Z Has data issue: false hasContentIssue false
  • English
  • Français

Neuropsychological detection of cognitive impairment: Inter-rater agreement and factors affecting clinical decision-making

Published online by Cambridge University Press:  23 January 2006

HOLLY A. TUOKKO  and
GILLIAN GABRIEL
HOLLY A. TUOKKO
Affiliation:
University of Victoria, Victoria, British Columbia, Canada
GILLIAN GABRIEL
Affiliation:
University of Victoria, Victoria, British Columbia, Canada
Get access Rights & Permissions [Opens in a new window]

Abstract

The agreement between neuropsychologists identifying cognitive impairment (CI) in older adults was examined, as were factors influencing the classification process. Twenty four neuropsychologists in 18 study centers classified cases with or without CI after reviewing neuropsychological findings and other relevant information. All cases were participants in the third wave of the Canadian Study of Health and Aging, a study of CI in later life. For 117 randomly selected cases, a second neuropsychologist reviewed the same material and reclassified the cases. Cases given the same (concordant) or different (discordant) classifications were compared with respect to patient and rater characteristics. The inter-rater agreement was moderate (77.7% agreement, kappa = .49). On all measures of cognitive functioning, the concordant group without impairment obtained a higher mean score than the discordant group, and the discordant group obtained a higher mean score than the concordant group with impairment. For 5 out of 8 cognitive measures, the concordant group with impairment differed from the concordant group without impairment and the discordant group, but the latter two groups did not differ significantly. The findings are comparable to others in the field and highlight the need for neuropsychologists to further clarify procedures for identifying subtle, or mild, forms of cognitive impairment. (JINS, 2006, 12, 72–79.)

Keywords

AgedAged 80 and overClassificationReliabilityCognition disordersClinical psychology
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 12 , Issue 1 , January 2006 , pp. 72 - 79
Copyright
© 2006 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Andresen, E.M., Malmgren, J.A., Carter, W.B., & Patrick, D.L. (1994). Screening for depression in well older adults: Evaluation of a short form of the CES-D. American Journal of Preventive Medicine, 10, 77–84.Google Scholar
Baldereschi, M., Amato, M.P., Nencini, P., Pracucci, G., Lippi, A., Amaducci, L., Gauthier, S., Beatty, L., Quiroga, P., & Klassen, G. (1994). Cross-national interrater agreement on the clinical diagnostic criteria for dementia. WHO-PRA Age-associated Dementia Working group, WHO-program for Research on Aging, Health of Elderly Program. Neurology, 44, 239–242.Google Scholar
Ballantyne, B.T., French, A.K., Heimsoth, S.L., Kachingwe, A.F., Lee, J.B., & Soderberg, G.L. (1995). Influence of examiner experience and gender on interrater reliability of KT-10000 arthrometer measurements. Physical Therapy, 75, 898–906.Google Scholar
Brooks, D. & Thomas, J. (1995). Interrater reliability of auscultation of breath sounds among physical therapists. Physical Therapy, 75, 1082–1088.Google Scholar
Canadian Study of Health and Aging Working Group. (1994). Canadian Study of Health and Aging: Study methods and prevalence of dementia. Canadian Medical Association Journal, 150, 899–913.Google Scholar
Fisher, N.J., Tierney, M.C., & Snow, W.G. (1999). Odd/even short forms of the Boston Naming Test: Preliminary geriatric norms. Clinical Neuropsychologist, 13, 359–364.Google Scholar
Graham, J.E., Rockwood, K., Beattie, B.L., McDowell, I., Eastwood, R., & Gauthier, S. (1996). Standardization of the diagnosis of dementia in the Canadian Study of Health and Aging. Neuroepidemiology, 15, 246–256.Google Scholar
Graham, J.E., Rockwood, K., Beattie, B.L., Eastwood, R., Gauthier, S., Tuokko, H., & McDowell, I. (1997). Prevalence and severity of cognitive impairment with and without dementia in an elderly population. Lancet, 349, 1793–1796.Google Scholar
Hogervorst, E., Barnetson, L., Jobst, K.A., Nagy, Z., Combrinck, M., & Smith, A.D. (2000). Diagnosing dementia: Interrater reliability assessment and accuracy of the NINCDS-ADRDA criteria versus CERAD histopathological criteria for Alzheimer's disease. Dementia and Geriatirc Cognitive Disorders, 11, 107–113.Google Scholar
Jorm, A.F., Rodgers, B., Henderson, A.S., Korten, A.E., Jacomb, P.A., Christensen, H., & Mackinnon, A. (1998). Occupation type as a predictor of cognitive decline and dementia in old age. Age and Ageing, 27, 477–483.Google Scholar
Kukull, W.A., Larson, E.B., Reifler, B.V., Lampe, T.H., Yerby, M., & Hughes, J. (1990). Interrater reliability of Alzhiemer's disease diagnosis. Neurology, 40, 257–260.Google Scholar
Levy, R. (1994). Age-associated cognitive decline. Working Party of the International Psychogeriatric Association in collaboration with the World Health Organization. International Psychogeriatrics, 6, 63–68.Google Scholar
Lopez, O.L., Swihart, A.A., Becker, J.T., Reinmuth, O.M., Reynolds, C.F., Rezek, D.L., & Daly, F.L. (1990). Reliability of the NINCDS-ADRDA clinical criteria for the diagnosis of Alzheimer's disease. Neurology, 40, 1517–1522.Google Scholar
Maruff, P., Collie, A., Darby, D., Weaver-Cargin, J., & Masters, C. (2004). Subtle memory decline over 12 months in mild cognitive impairment. Dementia and Geriatric Cognitive Disorders, 18, 342–348.Google Scholar
O'Connor, D.W., Blessed, G., Cooper, B., Jonker, C., Morris, J.C., Presnell, I.B., Ames, D., Kay, D.W.K., Bickel, H., Schäufele, M., Wind, A., Coats, M., & Berg, L. (1996). Cross-national interrater reliability of dementia diagnosis in the elderly and factors associated with disagreement. Neurology, 47, 1194–1199.Google Scholar
O'Connor, D.W., Pollitt, P.A., & Treasure, F.P. (1991). The influence of education and social class on the diagnosis of dementia in a community population. Psychological Medicine, 21, 219–224.Google Scholar
Petersen, R.C. (2003). Mild cognitive impairment: Aging to Alzheimer's disease. New York: Oxford University Press.
Petersen, R.C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine, 256, 183–194.Google Scholar
Petersen, R.C., Smith, G.E., Waring, S.C., Ivnik, R.J., Tangalos, E.G., & Kokmen, E. (1999). Mild cognitive impairment. Archives of Neurology, 56, 303–308.Google Scholar
Petersen, R.C., Stevens, J.C., Ganguli, M., Tangalos, E.G., Cummings, J.L., & DeKosky, S.T. (2001). Practice parameter: Early detection of dementia: Mild cognitive impairment (an evidence-based review). Report of the Quality Standards Subcommittee of the American Academy of Neurology. Neurology, 56, 1133–1142.Google Scholar
Reitan, R.M. & Wolfson, D. (1996). Relationships of age and education to Wechsler Adult Intelligence Scale IQ values in brain-damaged and non-brain damaged groups. Clinical Neuropsychologist, 10, 293–304.Google Scholar
Ritchie, K., Artero, S., & Touchon, J. (2001). Cognitive classification criteria for mild cognitive impairment: A population-based validation study. Neurology, 56, 37–42.Google Scholar
Ritchie, K. & Touchon, J. (2000). Mild cognitive impairment: Conceptual basis and current nosological status. Lancet, 355, 225–228.Google Scholar
Rosen, W.G. (1980). Verbal fluency in aging and dementia. Journal of Clinical Neuropsychology, 2, 135–146.Google Scholar
Satz, P. & Mogel, S. (1962). An abbreviation of the WAIS for clinical use. Journal of Clinical Psychology, 18, 77–79.Google Scholar
Shapiro, E. & Tate, R.B. (1997). The use and cost of community care services by elders with unimpaired cognitive function, with cognitive impairment/no dementia and with dementia. Canadian Journal on Aging, 16, 665–681.Google Scholar
Solari, A., Cossa, F.M., Denes, F., Gainotti, G., Grossi, D., Nichelli, P., & Filippini, G. (1994). Agreement in clinical diagnosis of dementia: Evaluation of a case series with mild cognitive impairment. Neuroepidemiology, 13, 89–96.Google Scholar
Spreen, O. & Benton, A.L. (1977). Neurosensory Center Comprehensive Examination for Aphasia: Manual of instructions. Victoria, B.C.: University of Victoria.
Steinhausen, H.C. & Erdin, A. (1991). The inter-rater reliability of child and adolescent psychiatric disorders in the ICD-10. Journal of Child Psychology and Psychiatry, 32, 921–928.Google Scholar
Stern, Y., Gurland, B., Tatemichi, T.K., Tang, M.X., Wilder, D., & Mayeux, R. (1994). Influence of education and occupation on the incidence of Alzheimer's disease. Journal of the American Medical Association, 271, 1004–1010.Google Scholar
Stones, M.J., Kozma, A., Hirdes, J., Gold, D., Arbuckle, T., & Kolopack, P. (1996). Short Happiness and Affect Research Protocol (SHARP). Social Indicators Research, 37, 75–91.Google Scholar
Teng, E.L. & Chui, H.C. (1987). The Modified Mini-Mental State (3MS) Examination. Journal of Clinical Psychiatry, 48, 314–318.Google Scholar
Touchon, J. & Ritchie, K. (1999). Prodromal cognitive disorder in Alzheimer's disease. International Journal of Geriatric Psychiatry, 14, 556–563.Google Scholar
Tuokko, H. & Frerichs, R. (2000). Cognitive impairment with no dementia (CIND): Longitudinal studies, the findings, and the issues. The Clinical Neuropsychologist, 14, 504–525.Google Scholar
Tuokko, H., Frerichs, R., Graham, J., Rockwood, K., Kristjansson, B., Fisk, J., Bergman, H., Kozma, A., & McDowell, I. (2003). Five-year follow-up of cognitive impairment with no dementia. Archives of Neurology, 60, 577–582.Google Scholar
Tuokko, H., Kristjansson, E., & Miller, J.A. (1995). Neuropsychological detection of dementia: An overview of the neuropsychological component of the Canadian Study of Health and Aging. Journal of Clinical and Experimental Neuropsychology, 17, 353–373.Google Scholar
Tuokko, H., Vernon-Wilkinson, R., Weir, J., & Beattie, B.L. (1991). Cued recall and early identification of dementia. Journal of Clinical and Experimental Neuropsychology, 13, 871–879.CrossRefGoogle Scholar
Tuokko, H. & Woodward, T.S. (1996). Development and validation of a demographic correction system for neuropsychological measures used in the Canadian Study of Health and Aging. Journal of Clinical and Experimental Neuropsychology, 18, 479–616.Google Scholar
Wechsler, D. (1975). Wechsler Memory Scale. New York: Psychological Corporation.
Wechsler, D. (1981). Wechsler Adult Intelligence Scale–Revised. New York: Psychological Corporation.
White, R.F., James, K.E., Vasterling, J.J., Marans, K., Delaney, R., Krengel, M., & Rose, F. (2002). Interrater reliability of neuropsychological diagnoses: A Department of Veterans Affairs cooperative study. Journal of the International Neuropsychological Society, 8, 555–565.Google Scholar
Wilkinson, G.S. (1993). Wide Range Achievement Test (WRAT-3) administration manual. Wilmington, DE: Wide Range, Inc.