Analysis of agreement between measures of subjective cognitive impairment and probable dementia in the National Health and Aging Trends Study.

BACKGROUND: Subjective cognitive impairment (SCI) measures in population‐based surveys offer potential for dementia surveillance, yet their validation against established dementia measures is lacking. METHODS: We assessed agreement between SCI and a validated probable dementia algorithm in a random one‐third sample (n = 1936) of participants in the 2012 National Health and Aging Trends Study (NHATS). RESULTS: SCI was more prevalent than probable dementia (12.2% vs 8.4%). Agreement between measures was 90.0% and of substantial strength. Misclassification rates were higher among older and less‐educated subgroups due to higher prevalence of false‐positive misclassification but did not vary by sex or race and ethnicity. DISCUSSION: SCI sensitivity (63.4%) and specificity (92.5%) against dementia were comparable with similar metrics for the NHATS probable dementia measure against the "gold‐standard" Aging, Demographics, and Memory Study–based dementia criteria, implying that population‐based surveys may afford cost‐effective opportunities for dementia surveillance to assess risk and inform policy. Highlights: The prevalence of subjective cognitive impairment (SCI) is generally higher than that of a validated measure of probable dementia, particularly within the youngest age group, females, Whites, and persons with a college or higher degree.Percent agreement between SCI and a validated measure of probable dementia was 90.0% and of substantial strength (prevalence‐ and bias‐adjusted kappa, 0.80). Agreement rates were higher in older and less‐educated subgroups, driven by the higher prevalence of false‐positive disagreement, but did not vary significantly by sex or race and ethnicity.SCI's overall sensitivity and specificity were 63.4% and 92.5%, respectively, against a validated measure of probable dementia, suggesting utility as a low‐cost option for dementia surveillance. Heterogeneity in agreement quality across subpopulations warrants caution in its use for subgroup analyses. [ABSTRACT FROM AUTHOR]

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