Research at the Florida State University College of Medicine has identified a potential low-cost method for predicting whether a person is at risk of developing dementia.
By analyzing data from nearly 13,000 subjects who participated in a long-term study of aging, researchers found that an interviewer’s assessment of a cognitively healthy person’s memory successfully predicted the likelihood of developing dementia over a 15-year period. Their findings will be published in Journal of Alzheimer’s Disease.
“Our findings show that interviewers were able to detect memory deficits in participants that predicted a higher risk of developing dementia over time,” said study author Angelina Sutin, professor of behavioral sciences and social medicine. “Interviewer ratings of memory were particularly important for participants who were among the best performers on objective memory tests.”
The results suggest that interviewer ratings of an individual’s memory performance may be a valuable alternative or adjunct to other detection methods, such as self-report or cognitive testing.
Soutine’s team analyzed 15 years of data involving nearly 13,000 people without cognitive impairment at baseline who participated in the University of Michigan Health and Retirement Study, or HRS, and whose memory was assessed by their interviewer. The ongoing study surveys a representative sample of adults age 50 and older about their health, financial status and well-being every two years until they decide to stay in the study.
Soutine’s sample included participants who were interviewed in 2006 and scored in the normal range of cognitive function at their first interview and had at least one follow-up assessment of cognitive ability between 2008-2020.
Interviewers were trained research assistants working for HRS who conducted the 2-3 hour interviews and rated the item “How much difficulty did the respondent have remembering things you asked him/her about?” from 1 (no difficulty) to 5 (I couldn’t at all).
Interviewer-rated memory was entered as a predictor of incident dementia during the 15-year follow-up period. They found that every 1-point increase in interviewer-rated poor memory (on a scale of 1 to 5) was associated with a 40% increase in the risk of developing dementia at some point during the follow-up period. This association was evident even after accounting for potential factors such as depression and poor hearing. Whether the interview was face-to-face or over the phone did not affect the results.
Notably, the association was even stronger among participants who performed best on objective memory (remembering many words from a long list of words) and subjective memory (how well someone perceived their memory). Both objective and subjective memory have been useful in detecting cognitive deficits preceding the diagnosis of dementia.
Of particular interest, Sutin said, is that the results were consistent even among participants who scored in the top quartile of memory function at baseline. Such performance on an objective memory test usually suggests that the individual has good cognitive function and is not at risk of impairment.
“This simple assessment by an interviewer is predictive of who develops dementia, especially when traditional measures of memory function do not necessarily detect memory deficits,” Soutine said. “And the association is similar across age, sex, race, ethnicity, and education, suggesting that it may be broadly predictable across populations.” Overall, we believe these findings indicate that interviewer-rated memory is a good marker of future dementia among the most cognitively healthy.”
Soutine said the findings support growing evidence about the importance of subjective assessments of memory and extend the relationship to observers who are not necessarily well-versed in the target. Clinicians typically rely on family members to gather information about cognitive function. This study shows that interviewing a stranger can also provide valuable information about future cognitive health.
Based on the findings, a simple interviewer assessment has the long-term power to predict who may develop dementia and may be useful for clinicians in providing effective treatment.
The study was co-authored by Professor Antonio Terraciano and Assistant Professor Martina Lucchetti of Florida State University, Darmrys Aschwanden of the University of Geneva in Switzerland, and Yannick Stéphane of the University of Montpellier in France.
This work was supported by the National Institute on Aging of the National Institutes of Health.