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Browsing by Author "Duarte, Andres"
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Item Reliability and Validity of the Mcdr for Hispanic Older Adults(Oxford University Press, 2023-12-21) Mendoza, Lisandra; Garcia, Patricia; Padron, Dilianna; Duarte, Andres; Marsiske, Michael; Fiala, Jacob; Duara, Ranjan; Rodriguez, Miriam; Neurology, School of MedicineObjective: Effective functional measures can be used among Hispanics to diagnose and evaluate functional dementia progression, especially in the prodromal stages when treatment can be most effective. The current study examined the reliability and validity of the modified version of the modified Clinical Dementia Rating Scale (mCDR) compared to the Alzheimer’s Disease Cooperative Study (ADCS)-MCI-ADL. These are quantitative severity measures of functional impairment in dementing conditions. The mCDR uses an itemized informant-based structured interview with multiple-choice responses and does not include cognitive testing (Duara et al., 2010). Methods: Functional measures were administered to 101 White non-Hispanic Cognitively Normal (CN, n=20) and MCI (n=81) and 159 Hispanic CN (n=32) and MCI (n=127) participants in the patient’s primary language (English or Spanish). Inter-rater reliability and convergent validity for these instruments were examined. Multiple regression analyses were conducted to determine if the administration’s language (English vs. Spanish) moderated the raters’ scores relationships. Results: The results revealed moderate-to-good mCDR inter-rater reliability [β =.73, F (40,40) = 6.24, p < .001], even when controlling for language (β = .72, p < .001; main effect and interaction were not significant). ADCS-MCI-ADL showed moderate-to-good inter-rater reliability [β = .71, F (40,36.6) = 6.34, p < .001] also, when controlling for language (β = .72, p < .001; main effect and interaction were not significant). The mCDR and the ADCS-MCI-ADL were correlated at -.75, suggesting a high convergent validity (56%). Conclusions: The m-CDR is a valid and reliable quantitative functional measure among Hispanic individuals.Item Sensitivity and Specificity of the Mcdr for Mci Diagnosis among Hispanic and White Non-Hispanic Older Adults(Oxford University Press, 2023-12-21) Garcia, Patricia; Mendoza, Lisandra; Duarte, Andres; Padron, Dilianna; Marsiske, Michael; Fiala, Jacob; Duara, Ranjan; Rodriguez, Miriam; Neurology, School of MedicineObjective: Greater functional impairment has been associated with higher rates of progression to dementia. Identifying sensitive functional measures that can detect early ADRD have immediate implications for prognosis, especially among ethnically diverse groups who are disproportionately affected. The modified Clinical Dementia Rating scale (mCDR) is a multiple-choice format assessment that assesses the five domains of the Clinical Dementia Rating scale. The current study aimed to compare sensitivity and specificity of the mCDR between White non-Hispanic (WNH) and Hispanic participants. Methods: The mCDR was administered in the patient’s primary language (English or Spanish) to 101 WNH Cognitively Normal (CN, n=20) and with MCI (n=81) and 159 Hispanic CN (n=32) and MCI (n=127) participants. Sensitivity to MCI diagnosis and Specificity to CN, using the mCDR “mean of means” total score, was quantified via Area under the Curve (AUC) calculated from a Receiver Operating Characteristic analysis. Results: Among WNH participants, the mCDR score demonstrated 78% Sensitivity and 90% Specificity (AUC = .88; CI95%= .81, .94). Among Hispanics, the mCDR showed 61% Sensitivity and 78% specificity (AUC = .73; CI95%= .64, .83). AUC was significantly worse for Hispanic participants. Conclusion: The mCDR is a tool that can be used by a trained psychometrist to facilitate focused answers and reduce administration time when assessing clinical functioning among dementia populations. It demonstrated excellent discrimination between CN and MCI among WNHs and acceptable discrimination among Hispanic individuals. Future research should further examine the utility of this tool for Hispanic older adults in early diagnosis of ADRD.