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Clinical Manifestations.

Federica Cacciamani1,2, Sophie Tezenas du Montcel3

  • 1Qairnel, Paris, France.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 25, 2025
PubMed
Summary
This summary is machine-generated.

Informant accuracy in detecting Alzheimer's disease (AD) changes varies by relationship, sex, age, and education. Children, spouses, and female informants tend to be more accurate, aiding early AD detection.

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Area of Science:

  • Gerontology
  • Neuroscience
  • Clinical Psychology

Background:

  • Informants are crucial for assessing individuals with reduced self-awareness, such as those with Alzheimer's disease (AD).
  • Limited understanding exists regarding which informants are most effective in identifying early AD-related changes.
  • This study investigates informant accuracy in reflecting clinician-assessed cognitive status and factors influencing it.

Purpose of the Study:

  • To determine the alignment between informant-reported functional abilities and clinician-diagnosed cognitive status (cognitively normal vs. mild cognitive impairment).
  • To identify informant characteristics associated with higher accuracy in detecting early cognitive changes.
  • To inform the selection of optimal informants for Alzheimer's disease research and clinical practice.

Main Methods:

  • Utilized baseline data from the NACC database (N=28,559) for analysis.
  • Assessed cognitive status via clinical evaluation and informant-reported daily activities using the Functional Activities Scale (FAS).
  • Employed logistic regression and k-means clustering to quantify informant accuracy and group informants based on characteristics (age, sex, education, relationship, cohabitation).

Main Results:

  • The Functional Activities Scale (FAS) significantly correlated with cognitive status (OR=1.37, p < 0.001).
  • Two informant accuracy clusters were identified: Higher-Accuracy (28.4%) and Lower-Accuracy (71.6%).
  • Children, other relatives, spouses/partners, and paid caregivers demonstrated higher accuracy. Female, older, lower-educated, and cohabiting informants were also more accurate. Men and younger informants were less accurate.

Conclusions:

  • Informant characteristics significantly impact the accuracy of their reports regarding cognitive status.
  • Selecting specific informant profiles (e.g., patient's children, females) can improve early detection of cognitive decline in Alzheimer's disease.
  • Findings emphasize the importance of considering informant background for enhanced accuracy in AD research and clinical settings.