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Related Experiment Video

Updated: Jan 3, 2026

Highlighting and Reducing the Impact of Negative Aging Stereotypes During Older Adults' Cognitive Testing
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Study partner-reported decline identifies cognitive decline and dementia risk.

Rachel L Nosheny1,2, Chengshi Jin3, John Neuhaus3

  • 1Department of Psychiatry, University of California, San Francisco, San Francisco, California.

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Summary

Study partners' reports of functional decline are strong predictors of cognitive decline and dementia risk. This information is crucial for identifying individuals at risk for Alzheimer's disease (AD).

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Area of Science:

  • Neurology
  • Gerontology
  • Cognitive Science

Background:

  • Identifying individuals at risk for cognitive decline, Mild Cognitive Impairment (MCI), and Alzheimer's disease (AD) is a critical unmet need.
  • Functional decline is associated with increased risk and can be assessed by participants and their study partners (SPs).

Purpose of the Study:

  • To test the hypothesis that SP-reported functional decline is an independent predictor of dementia risk and cognitive decline.
  • To evaluate the predictive power of self-reported versus SP-reported functional decline in older adults.

Main Methods:

  • 1048 older adults from the Alzheimer's Disease Neuroimaging Initiative (ADNI) were analyzed.
  • Associations between Everyday Cognition Scale (ECog) scores (self- and SP-reported) and neuropsychological test (NPT) scores, as well as diagnostic conversion to MCI or dementia, were measured.
  • Models included Mini Mental Status Exam (MMSE) and ApoE ε4 genotype (APOE) as covariates.

Main Results:

  • SP-reported ECog was the strongest predictor of cognitive decline across multiple domains and diagnostic conversion.
  • Self-reported ECog showed associations with baseline NPT scores and MCI conversion in participants with biomarker evidence for AD.
  • Models incorporating SP-reported ECog demonstrated significantly stronger predictive power for outcomes.

Conclusions:

  • SP-reported functional decline serves as an independent indicator of cognitive decline and dementia risk.
  • This finding holds true even when controlling for cognitive screening, genetic risk, demographics, and self-reported decline.
  • Greater utilization of SP-reported functional decline is recommended for identifying individuals at risk for dementia due to AD and other causes.