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Comparative Study
. 2019 Dec;31(12):1709-1719.
doi: 10.1017/S1041610219000693. Epub 2019 Jul 16.

Validation of neuropsychological tests for the China Health and Retirement Longitudinal Study Harmonized Cognitive Assessment Protocol

Qinqin Meng  1 , Huali Wang  2 , John Strauss  3 , Kenneth M Langa  4 , Xinxin Chen  1 , Mingwei Wang  5 , Qiumin Qu  6 , Wei Chen  7 , Weihong Kuang  8 , Nan Zhang  9 , Tao Li  2 , Yafeng Wang  1 , Yaohui Zhao  10
Affiliations
Comparative Study

Validation of neuropsychological tests for the China Health and Retirement Longitudinal Study Harmonized Cognitive Assessment Protocol

Qinqin Meng et al. Int Psychogeriatr. 2019 Dec.

Abstract

Objective: To compare and validate neurocognitive tests in the Harmonized Cognitive Assessment Protocol (HCAP) for the China Health and Retirement Longitudinal Study (CHARLS), and to identify appropriate tests to be administered in future waves of CHARLS.

Methods: We recruited 825 individuals from the CHARLS sample and 766 subjects from hospitals in six provinces and cities in China. All participants were administered the HCAP-neurocognitive tests, and their informants were interviewed regarding the respondents' functional status. Trained clinicians administered the Clinical Dementia Rating scale (CDR) to assess the respondents' cognitive status independently.

Results: The testing protocol took an average of 58 minutes to complete. Refusal rates for tests of general cognition, episodic memory, and language were less than 10%. All neurocognitive test scores significantly correlated with the CDR global score (correlation coefficients ranged from 0.139 to 0.641). The Mini-Mental State Examination (MMSE), the Health and Retirement Study (HRS) - telephone interview for cognitive status (TICS), community screening instrument for dementia (CSI-D) for respondent, episodic memory and language tests each accounted for more than 20% of the variance in global CDR score (p < 0.001) in bivariate tests. In the CHARLS subsample, age and education were associated with neuropsychological performance across most cognitive domains, and with functional status.

Conclusion: A brief set of the CHARLS-HCAP neurocognitive tests are feasible and valid to be used in the CHARLS sample and hospital samples. It could be applied in the future waves of the CHARLS study, and it allows estimating the prevalence of dementia in China through the population-based CHARLS.

Keywords: cognitive testing; dementia; elderly; memory; population.

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Figures

Figure 1.
Figure 1.
The relationship between the MMSE score with the CDR global scores
Figure 2.
Figure 2.
The relationship between the neurocognitive performance of episodic memory (A: word immediate recall; B: word delayed recall), working memory (C: symbol cancellation), executive function (D: backward digit span), language (E: animal naming) and visuospatial function (F: constructional praxis-2) with the CDR global scores.
Figure 3.
Figure 3.
The relationship between the neuropsychological performance of non-memory domains (A: backward digit span; B: trail making test -B; C: number series) with informant-based CSI-D assessment
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