Measurement of Prevalent Versus Incident Dementia Cases in Epidemiologic Studies
Abstract Because dementia is progressive, incident cases are on average milder than prevalent cases, affecting the performance of cognitive tests and questions on functional limitations (i.e., cognition/functional limitation items) used for dementia assessment. Longitudinal studies assess incident c...
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| Veröffentlicht in: | American journal of epidemiology 2023-04, Vol.192 (4), p.520-534 |
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| creator | Nichols, Emma Ng, Derek K James, Bryan D Deal, Jennifer A Gross, Alden L |
| description | Abstract
Because dementia is progressive, incident cases are on average milder than prevalent cases, affecting the performance of cognitive tests and questions on functional limitations (i.e., cognition/functional limitation items) used for dementia assessment. Longitudinal studies assess incident cases, while cross-sectional studies assess prevalent cases, but differences are not typically considered when researchers select items to include in studies. We used longitudinal data from the Religious Orders Study and Memory and Aging Project (ROSMAP) (n = 3,446) collected between 1994 and 2021 to characterize differences in associations between items (cognition: 35 items; functional limitations: 14 items) and incident or prevalent dementia using multinomial regression models with generalized estimating equations, controlling for ROSMAP cohort (Religious Orders Study or Memory and Aging Project), age, sex, race, and education. The association between a given item and incident dementia was significantly weaker than the association between the same item and prevalent dementia for 46 of 49 items. However, there was variability, with larger differences for some items, including naming a pencil (prevalence odds ratio = 0.02 (95% confidence interval: 0.02, 0.03); incidence odds ratio = 0.10 (95% confidence interval: 0.06, 0.17); P for difference |
| doi_str_mv | 10.1093/aje/kwac197 |
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Because dementia is progressive, incident cases are on average milder than prevalent cases, affecting the performance of cognitive tests and questions on functional limitations (i.e., cognition/functional limitation items) used for dementia assessment. Longitudinal studies assess incident cases, while cross-sectional studies assess prevalent cases, but differences are not typically considered when researchers select items to include in studies. We used longitudinal data from the Religious Orders Study and Memory and Aging Project (ROSMAP) (n = 3,446) collected between 1994 and 2021 to characterize differences in associations between items (cognition: 35 items; functional limitations: 14 items) and incident or prevalent dementia using multinomial regression models with generalized estimating equations, controlling for ROSMAP cohort (Religious Orders Study or Memory and Aging Project), age, sex, race, and education. The association between a given item and incident dementia was significantly weaker than the association between the same item and prevalent dementia for 46 of 49 items. However, there was variability, with larger differences for some items, including naming a pencil (prevalence odds ratio = 0.02 (95% confidence interval: 0.02, 0.03); incidence odds ratio = 0.10 (95% confidence interval: 0.06, 0.17); P for difference < 0.001). Important differences exist in the performance of cognition/functional limitation items for measurement of incident versus prevalent dementia. Differences can inform the choice of items for cross-sectional studies of prevalent cases or longitudinal studies of incident cases, leading to reduced misclassification and increased statistical power.</description><identifier>ISSN: 0002-9262</identifier><identifier>ISSN: 1476-6256</identifier><identifier>EISSN: 1476-6256</identifier><identifier>DOI: 10.1093/aje/kwac197</identifier><identifier>PMID: 36372974</identifier><language>eng</language><publisher>United States: Oxford University Press</publisher><subject>Ageing ; Aging ; Aging - psychology ; Cognition ; Cognition & reasoning ; Cognitive ability ; Confidence intervals ; Cross-Sectional Studies ; Dementia ; Dementia - epidemiology ; Dementia disorders ; Epidemiology ; Humans ; Longitudinal Studies ; Memory ; Original Contribution ; Regression analysis ; Regression models ; Religious orders ; Statistical analysis</subject><ispartof>American journal of epidemiology, 2023-04, Vol.192 (4), p.520-534</ispartof><rights>The Author(s) 2022. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. 2022</rights><rights>The Author(s) 2022. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c404t-90d9ae4d6175dfebc90ef67a7940b060bcdc7bbeb6a2afaa931e87ca5ca234173</citedby><cites>FETCH-LOGICAL-c404t-90d9ae4d6175dfebc90ef67a7940b060bcdc7bbeb6a2afaa931e87ca5ca234173</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,1578,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36372974$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nichols, Emma</creatorcontrib><creatorcontrib>Ng, Derek K</creatorcontrib><creatorcontrib>James, Bryan D</creatorcontrib><creatorcontrib>Deal, Jennifer A</creatorcontrib><creatorcontrib>Gross, Alden L</creatorcontrib><title>Measurement of Prevalent Versus Incident Dementia Cases in Epidemiologic Studies</title><title>American journal of epidemiology</title><addtitle>Am J Epidemiol</addtitle><description>Abstract
Because dementia is progressive, incident cases are on average milder than prevalent cases, affecting the performance of cognitive tests and questions on functional limitations (i.e., cognition/functional limitation items) used for dementia assessment. Longitudinal studies assess incident cases, while cross-sectional studies assess prevalent cases, but differences are not typically considered when researchers select items to include in studies. We used longitudinal data from the Religious Orders Study and Memory and Aging Project (ROSMAP) (n = 3,446) collected between 1994 and 2021 to characterize differences in associations between items (cognition: 35 items; functional limitations: 14 items) and incident or prevalent dementia using multinomial regression models with generalized estimating equations, controlling for ROSMAP cohort (Religious Orders Study or Memory and Aging Project), age, sex, race, and education. The association between a given item and incident dementia was significantly weaker than the association between the same item and prevalent dementia for 46 of 49 items. However, there was variability, with larger differences for some items, including naming a pencil (prevalence odds ratio = 0.02 (95% confidence interval: 0.02, 0.03); incidence odds ratio = 0.10 (95% confidence interval: 0.06, 0.17); P for difference < 0.001). Important differences exist in the performance of cognition/functional limitation items for measurement of incident versus prevalent dementia. Differences can inform the choice of items for cross-sectional studies of prevalent cases or longitudinal studies of incident cases, leading to reduced misclassification and increased statistical power.</description><subject>Ageing</subject><subject>Aging</subject><subject>Aging - psychology</subject><subject>Cognition</subject><subject>Cognition & reasoning</subject><subject>Cognitive ability</subject><subject>Confidence intervals</subject><subject>Cross-Sectional Studies</subject><subject>Dementia</subject><subject>Dementia - epidemiology</subject><subject>Dementia disorders</subject><subject>Epidemiology</subject><subject>Humans</subject><subject>Longitudinal Studies</subject><subject>Memory</subject><subject>Original Contribution</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Religious orders</subject><subject>Statistical analysis</subject><issn>0002-9262</issn><issn>1476-6256</issn><issn>1476-6256</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kdFLHDEQxkNR6ql96ntZKIggWyfZ3cQ8iZy2FSwK2r6G2eyszXV3cya3Sv97c94ptQ8-DcP8-Pjm-xj7yOELB10c4owO_zyg5Vq9YxNeKplLUckNNgEAkWshxRbbjnEGwLmu4D3bKmShhFblhF39IIxjoJ6GRebb7CrQPXbL5ReFOMbsfLCuWe6nT4zDbIqRYuaG7GyeLr3znb91NrtejI2juMs2W-wifVjPHfbz69nN9Ht-cfntfHpykdsSykWuodFIZSO5qpqWaquBWqlQ6RJqkFDbxqq6plqiwBZRF5yOlMXKoihKrooddrzSnY91T41N3gJ2Zh5cj-Gv8ejM68vgfptbf284JAMgq6Swv1YI_m6kuDC9i5a6DgfyYzRCpZiSFV4k9PN_6MyPYUj_GXFUprArqJbUwYqywccYqH1xw8EsqzKpKrOuKtGf_n3ghX3uJgF7K8CP8zeVHgHHH58M</recordid><startdate>20230406</startdate><enddate>20230406</enddate><creator>Nichols, Emma</creator><creator>Ng, Derek K</creator><creator>James, Bryan D</creator><creator>Deal, Jennifer A</creator><creator>Gross, Alden L</creator><general>Oxford University Press</general><general>Oxford Publishing Limited (England)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7T2</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20230406</creationdate><title>Measurement of Prevalent Versus Incident Dementia Cases in Epidemiologic Studies</title><author>Nichols, Emma ; Ng, Derek K ; James, Bryan D ; Deal, Jennifer A ; Gross, Alden L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c404t-90d9ae4d6175dfebc90ef67a7940b060bcdc7bbeb6a2afaa931e87ca5ca234173</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Ageing</topic><topic>Aging</topic><topic>Aging - psychology</topic><topic>Cognition</topic><topic>Cognition & reasoning</topic><topic>Cognitive ability</topic><topic>Confidence intervals</topic><topic>Cross-Sectional Studies</topic><topic>Dementia</topic><topic>Dementia - epidemiology</topic><topic>Dementia disorders</topic><topic>Epidemiology</topic><topic>Humans</topic><topic>Longitudinal Studies</topic><topic>Memory</topic><topic>Original Contribution</topic><topic>Regression analysis</topic><topic>Regression models</topic><topic>Religious orders</topic><topic>Statistical analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nichols, Emma</creatorcontrib><creatorcontrib>Ng, Derek K</creatorcontrib><creatorcontrib>James, Bryan D</creatorcontrib><creatorcontrib>Deal, Jennifer A</creatorcontrib><creatorcontrib>Gross, Alden L</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>American journal of epidemiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nichols, Emma</au><au>Ng, Derek K</au><au>James, Bryan D</au><au>Deal, Jennifer A</au><au>Gross, Alden L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Measurement of Prevalent Versus Incident Dementia Cases in Epidemiologic Studies</atitle><jtitle>American journal of epidemiology</jtitle><addtitle>Am J Epidemiol</addtitle><date>2023-04-06</date><risdate>2023</risdate><volume>192</volume><issue>4</issue><spage>520</spage><epage>534</epage><pages>520-534</pages><issn>0002-9262</issn><issn>1476-6256</issn><eissn>1476-6256</eissn><abstract>Abstract
Because dementia is progressive, incident cases are on average milder than prevalent cases, affecting the performance of cognitive tests and questions on functional limitations (i.e., cognition/functional limitation items) used for dementia assessment. Longitudinal studies assess incident cases, while cross-sectional studies assess prevalent cases, but differences are not typically considered when researchers select items to include in studies. We used longitudinal data from the Religious Orders Study and Memory and Aging Project (ROSMAP) (n = 3,446) collected between 1994 and 2021 to characterize differences in associations between items (cognition: 35 items; functional limitations: 14 items) and incident or prevalent dementia using multinomial regression models with generalized estimating equations, controlling for ROSMAP cohort (Religious Orders Study or Memory and Aging Project), age, sex, race, and education. The association between a given item and incident dementia was significantly weaker than the association between the same item and prevalent dementia for 46 of 49 items. However, there was variability, with larger differences for some items, including naming a pencil (prevalence odds ratio = 0.02 (95% confidence interval: 0.02, 0.03); incidence odds ratio = 0.10 (95% confidence interval: 0.06, 0.17); P for difference < 0.001). Important differences exist in the performance of cognition/functional limitation items for measurement of incident versus prevalent dementia. Differences can inform the choice of items for cross-sectional studies of prevalent cases or longitudinal studies of incident cases, leading to reduced misclassification and increased statistical power.</abstract><cop>United States</cop><pub>Oxford University Press</pub><pmid>36372974</pmid><doi>10.1093/aje/kwac197</doi><tpages>15</tpages><oa>free_for_read</oa></addata></record> |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Ageing Aging Aging - psychology Cognition Cognition & reasoning Cognitive ability Confidence intervals Cross-Sectional Studies Dementia Dementia - epidemiology Dementia disorders Epidemiology Humans Longitudinal Studies Memory Original Contribution Regression analysis Regression models Religious orders Statistical analysis |
| title | Measurement of Prevalent Versus Incident Dementia Cases in Epidemiologic Studies |
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