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.)