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Future Directions for the HRS Harmonized Cognitive Assessment Protocol.

Jacqueline M Torres1, M Maria Glymour1

  • 1Department of Epidemiology and Biostatistics, UC San Francisco, San Francisco, CA, USA.

Forum for Health Economics & Policy
|March 7, 2022
PubMed
Summary

Population-level research on Alzheimer's disease and related dementias (ADRDs) is crucial. The Harmonized Cognitive Assessment Protocol (HCAP) shows promise, but requires improvements, especially in diversity, to fully understand dementia risk and outcomes.

Keywords:
Alzheimer’s disease and related dementias; measurementU.S. Health and Retirement studyharmonized cognitive assessment protocol

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Area of Science:

  • Gerontology
  • Epidemiology
  • Cognitive Science

Background:

  • Effective treatments for Alzheimer's disease and related dementias (ADRDs) are lacking, necessitating population-level research on modifiable risk factors and outcomes.
  • The Harmonized Cognitive Assessment Protocol (HCAP) was developed to enhance understanding of cognitive impairment and dementia within the U.S. and internationally.
  • The initial HCAP wave confirmed the value of detailed cognitive assessments over brief measures for studying dementia.

Purpose of the Study:

  • To evaluate the effectiveness of the Harmonized Cognitive Assessment Protocol (HCAP) in understanding dementia.
  • To propose recommendations for enhancing future HCAP iterations to improve its utility in ADRD research.
  • To support cross-national comparisons of cognitive impairment and dementia prevalence and determinants.

Main Methods:

  • The study analyzes data from the first wave of the Harmonized Cognitive Assessment Protocol (HCAP), fielded in 2016.
  • It compares the detailed cognitive assessments of HCAP with the brief assessments in the core Health and Retirement Study (HRS) interviews.
  • Recommendations are based on the perceived strengths and limitations of the initial HCAP implementation.

Main Results:

  • The first HCAP wave demonstrated the feasibility and value of in-depth cognitive assessments for dementia research.
  • The current HCAP has limitations, particularly in the representation of diverse populations disproportionately affected by ADRDs.
  • Specific areas for improvement include assessment timing, data validation, item selection, documentation, and caregiver impact measures.

Conclusions:

  • The Harmonized Cognitive Assessment Protocol (HCAP) has significant potential for advancing ADRD research.
  • Implementing proposed recommendations, particularly enhancing diversity and data richness, is crucial for maximizing HCAP's impact.
  • Improvements will strengthen the understanding of dementia risk, outcomes, and facilitate more robust cross-national comparisons.