Racial differences in the disparity between clinician and neuropsychological

 
   Lead Investigator:    Amanda Cook Maher
   Institution      :    Emory University
   E-Mail           :    amanda.hollos.cook@emory.edu
   Proposal ID      :    925



   Proposal Description:
   The diagnosis of mild cognitive impairment (MCI) by either clinician judgment     or neuropsychological test performance criteria may be vulnerable to biases       that contribute to inflated diagnosis in African American versus White adults     over the age of 60. For example, the higher prevalence of vascular risk factors   in African Americans compared to Whites or differences in educational             attainment may subtly impact clinician diagnosis and lead to higher rates of      MCI diagnosis in African Americans. This study aims to: (1) create normative      data based on race, education, and age in participants over age 60 who have CDR   and FAQ scores equal to 0 at their Baseline UDS-2 visit. Norms will be created    for composite measures of memory, executive function, language, and attention     (2) investigate whether there is discrepancy between clinician diagnosis of MCI   and neuropsychological test criteria diagnosis of MCI both overall and by MCI     subtype based on the norms established in Aim 1 (3) examine which demographic     and health factors predict clinician-test diagnostic discrepancy within each      race and (4) determine which type of diagnosis (clinician or test-based) at       participants??? Baseline visit best predicts longitudinal cognitive trajectory.   We hypothesize that clinician-test diagnostic discrepancy will be greater for     African American than White older adults, particularly in the domain of           executive MCI, and that this discrepancy will be driven by the presence of        vascular risk factors and educational attainment.