PMID- 38265507
OWN - NLM
STAT- MEDLINE
DCOM- 20240125
LR  - 20240206
IS  - 1720-8319 (Electronic)
IS  - 1594-0667 (Print)
IS  - 1594-0667 (Linking)
VI  - 36
IP  - 1
DP  - 2024 Jan 24
TI  - Clinical importance in Alzheimer's disease: effects of anchor agreement and 
      disease severity.
PG  - 5
LID - 10.1007/s40520-023-02643-0 [doi]
LID - 5
AB  - OBJECTIVES: Methods of evaluating clinically meaningful decline are critical in 
      research on Alzheimer's disease. A common method of quantifying clinically 
      meaningful change is to calculate an anchor-based minimal clinically important 
      difference (MCID) score. In this approach, individuals who report a meaningful 
      change serve as the "anchors", and the mean level of change for this group serves 
      as the MCID. In research on Alzheimer's disease, there are several possible 
      anchors, including patients, knowledgeable observers (e.g., a family member), and 
      clinicians. The goal of this study was to examine the extent to which agreement 
      among anchors impacts MCID estimation and whether this relationship is moderated 
      by cognitive severity status. METHODS: Analyses were completed on a longitudinal 
      sample of 2247 adults, aged 50-103, from the Uniform Data Set. Outcome measures 
      included the Montreal Cognitive Assessment, Clinical Dementia Rating-Sum of 
      Boxes, and Functional Activities Questionnaire. RESULTS: For all of the outcomes, 
      the MCID estimate was significantly higher when meaningful decline was endorsed 
      by all of the anchors compared to when there was disagreement among the anchors. 
      In addition, the MCID estimate was higher with increasing severity of cognitive 
      impairment. Finally, cognitive severity status moderated the influence of 
      agreement among anchors on MCID estimation; as disease severity increased, anchor 
      agreement demonstrated less influence on the MCID. CONCLUSIONS: MCID estimates 
      based on one anchor may underestimate meaningful change, and researchers should 
      consider the viewpoints of multiple anchors in constructing MCIDs, particularly 
      in the early stages of cognitive decline.
CI  - (c) 2024. The Author(s).
FAU - Stojanovic, Marta
AU  - Stojanovic M
AUID- ORCID: 0000-0001-8383-6679
AD  - Department of Psychological and Brain Sciences, Washington University in St. 
      Louis, One Brookings Drive, Box 1125, St. Louis, MO, 63130, USA. 
      martastojanovic@wustl.edu.
FAU - Mikula, Cynthia
AU  - Mikula C
AD  - Institute of Human Nutrition, Columbia University, New York, NY, 10032, USA.
FAU - John, Samantha
AU  - John S
AD  - Department of Brain Health, University of Nevada-Las Vegas, Las Vegas, Nevada, 
      89154, USA.
FAU - Kiselica, Andrew
AU  - Kiselica A
AD  - Department of Health Psychology, University of Missouri-Columbia, Columbia, MO, 
      65211, USA.
LA  - eng
PT  - Journal Article
DEP - 20240124
PL  - Germany
TA  - Aging Clin Exp Res
JT  - Aging clinical and experimental research
JID - 101132995
SB  - IM
MH  - Humans
MH  - Clinical Relevance
MH  - *Alzheimer Disease
MH  - Patient Acuity
MH  - *Cognitive Dysfunction
MH  - Family
PMC - PMC10808396
OTO - NOTNLM
OT  - Alzheimer's disease
OT  - Clinical trials
OT  - Dementia
OT  - Minimal clinically important difference
COIS- The authors have no relevant financial or non-financial interests to disclose.
EDAT- 2024/01/24 12:44
MHDA- 2024/01/25 06:43
PMCR- 2024/01/24
CRDT- 2024/01/24 11:07
PHST- 2023/06/02 00:00 [received]
PHST- 2023/12/14 00:00 [accepted]
PHST- 2024/01/25 06:43 [medline]
PHST- 2024/01/24 12:44 [pubmed]
PHST- 2024/01/24 11:07 [entrez]
PHST- 2024/01/24 00:00 [pmc-release]
AID - 10.1007/s40520-023-02643-0 [pii]
AID - 2643 [pii]
AID - 10.1007/s40520-023-02643-0 [doi]
PST - epublish
SO  - Aging Clin Exp Res. 2024 Jan 24;36(1):5. doi: 10.1007/s40520-023-02643-0.