Article

The Measurement of Everyday Cognition (ECog): Scale Development and Psychometric Properties

Department of Neurology, University of California, CA 95817, USA.
Neuropsychology (Impact Factor: 3.27). 08/2008; 22(4):531-44. DOI: 10.1037/0894-4105.22.4.531
Source: PubMed

ABSTRACT

This article describes the development and validation of an instrument to assess cognitively mediated functional abilities in older adults, Everyday Cognition (ECog). The ECog is an informant-rated questionnaire comprised of multiple subscales. Confirmatory factor analysis (CFA) was used to examine its factor structure. Convergent validity was evaluated by comparing it to established measures of everyday function. External validity was evaluated by comparing ECog results across different clinical groups [cognitively normal, mild cognitive impairment (MCI), dementia]. CFA supported a seven-factor model including one global factor and six domain-specific factors (Everyday Memory, Language, Visuospatial Abilities, Planning, Organization, and Divided attention). The ECog correlated with established measures of functional status and global cognition, but only weakly with age and education. The clinical groups performed differently in each domain. In addition to the global factor, the Everyday Memory factor independently differentiated MCI from Normal, while the Everyday Language domain differentiated Dementia from MCI. Different subtypes of MCI also showed different patterns. Results suggest the ECog shows promise as a useful tool for the measurement of general and domain-specific everyday functions in the elderly.

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Available from: Dan Mungas, Jan 27, 2016
    • "Many questionnaires have been used to demonstrate the existence of functional impairment in the presence of dementia but are insensitive to functional changes occurring early in the spectrum of functional and cognitive decline. Only recently have self-and informant-based questionnaires been developed to capture the mild functional impairments seen in the earlier stages of decline (e.g., ECog, Farias et al., 2008; ADL-PI, Galasko et al., 2006; IADL-C, Schmitter-Edgecombe, Parsey, & Lamb, 2014). Unlike questionnaires, performance-based measures assess functional capacity directly by having an individual enact a task with formal evaluation of performance in an attempt to estimate actual abilities equivalent to those performed in the home environment (Marson & Hebert, 2006; see Moore, Palmer, Patterson, & Jeste, 2007 for a review of performance-based measures). "
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    ABSTRACT: The objective of this meta-analysis was to improve understanding of the heterogeneity in the relationship between cognition and functional status in individuals with mild cognitive impairment (MCI). Demographic, clinical, and methodological moderators were examined. Cognition explained an average of 23% of the variance in functional outcomes. Executive function measures explained the largest amount of variance (37%), whereas global cognitive status and processing speed measures explained the least (20%). Short- and long-delayed memory measures accounted for more variance (35% and 31%) than immediate memory measures (18%), and the relationship between cognition and functional outcomes was stronger when assessed with informant-report (28%) compared with self-report (21%). Demographics, sample characteristics, and type of everyday functioning measures (i.e., questionnaire, performance-based) explained relatively little variance compared with cognition. Executive functioning, particularly measured by Trails B, was a strong predictor of everyday functioning in individuals with MCI. A large proportion of variance remained unexplained by cognition.
    No preview · Article · Jan 2016 · Archives of Clinical Neuropsychology
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    • "Over the past years, there has been some controversy about what type of questions to ask regarding subjective cognitive dysfunction and who is the best judge of that dysfunction. With regard to the type of questions, the MFE-30 assesses current SMI, others ask questions comparing performance to 1 year (SCQ) [45], 2 years (SCD-Q) [46], 5 years (CCI) [12], or 10 years ago (E-Cog) [47]. With regard to the person who might answer the questionnaire, some studies have postulated that informants' perceptions are more highly related to cognitive performance than self-reported complaints [48] [49] [50]. "
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    ABSTRACT: Background: Subjective memory impairment (SMI) refers to subjective awareness of initial memory decline undetectable with existing standardized cognitive tests. The Face Name Associative Memory Exam (FNAME) was created to detect memory deficits in individuals with preclinical Alzheimer's disease (AD). We reported normative data of a Spanish version of FNAME (S-FNAME) in cognitively normal (CN) Spanish-speaking subjects >49. Objective: To determine whether higher SMI [a modification of Memory Failures Everyday (MFE-30)] was related to worse memory performance (S-FNAME) or associated with greater affective symptoms in subjects >49; and whether MFE-30 and FNAME were able to discriminate between CN and mild cognitive impairment (MCI) subjects. Methods: 317 subjects (CN = 196, MCI = 121) were included in the analysis because they attended the annual "Open House Initiative" at Memory Clinic Fundació ACE, were >49 years, literate, received S-FNAME, MFE-30, and Hospital Anxiety and Depression Scale, had Mini-Mental State Exam scores ≥27, and returned to complete a comprehensive diagnostic assessment. Results: MFE-30 scores were associated with affective symptoms but not with S-FNAME performance. S-FNAME scores were related to performance on memory variables of NBACE (neuropsychological battery used in Fundació ACE). Although the MCI group showed significantly higher MFE-30 and worse S-FNAME scores than the CN group, their discriminability values were similar (Sensitivity: 49.6 versus 52.9; Specificity: 85.1 versus 83.6, respectively). Conclusions: SMI was more related to depressive symptoms than to S-FNAME memory performance; and S-FNAME scores were related to other episodic memory test performances, but neither to affective symptoms nor to SMI. MFE-30 and S-FNAME are not optimal for discriminating between CN and MCI groups. Longitudinal follow-up will determine if lower S-FNAME and higher SMI are related to increased risk of AD.
    Full-text · Article · Oct 2015 · Journal of Alzheimer's disease: JAD
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    • "A review of both the SCD and broader cognitive aging literature suggests heterogeneity in important aspects of cognitive self-report measures including mode of administration [34] [35] [36] [37] [38] [39] [40] [41], number of items [42] [43] [44] [45] [46] [47] [48] [49] [50] [51] [52] [53], and response option types [38, 54–59]. Other dimensions on which self-report measures vary are item content and complexity including whether items relate to memory exclusively [57, 60–62] or include additional cognitive domains [50] [63] [64] or noncognitive items [51] [55] [65], whether items tap current cognitive ability or disability/impairment [65] [66] [67] versus intraindividual change [57] [68], and whether items inquire about general versus specific aspects of cognition . In terms of the origin of instruments, while some studies use complete published questionnaires [54–60, 65], others use groups of items from existing measures [69] [70] [71] or develop new items for a specific study [12, 72–77]. "
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    ABSTRACT: Research increasingly suggests that subjective cognitive decline (SCD) in older adults, in the absence of objective cognitive dysfunction or depression, may be a harbinger of non-normative cognitive decline and eventual progression to dementia. Little is known, however, about the key features of self-report measures currently used to assess SCD. The Subjective Cognitive Decline Initiative (SCD-I) Working Group is an international consortium established to develop a conceptual framework and research criteria for SCD (Jessen et al., 2014, Alzheimers Dement 10, 844-852). In the current study we systematically compared cognitive self-report items used by 19 SCD-I Working Group studies, representing 8 countries and 5 languages. We identified 34 self-report measures comprising 640 cognitive self-report items. There was little overlap among measures- approximately 75% of measures were used by only one study. Wide variation existed in response options and item content. Items pertaining to the memory domain predominated, accounting for about 60% of items surveyed, followed by executive function and attention, with 16% and 11% of the items, respectively. Items relating to memory for the names of people and the placement of common objects were represented on the greatest percentage of measures (56% each). Working group members reported that instrument selection decisions were often based on practical considerations beyond the study of SCD specifically, such as availability and brevity of measures. Results document the heterogeneity of approaches across studies to the emerging construct of SCD. We offer preliminary recommendations for instrument selection and future research directions including identifying items and measure formats associated with important clinical outcomes.
    Full-text · Article · Sep 2015 · Journal of Alzheimer's disease: JAD
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Questions & Answers about this publication

  • Russell Jude Chander added an answer in Neuropsychology:
    Can you suggest validated measures for everyday cognitive functioning?

    Not interested in neuropsychology measures and am aware of the Everyday Problems Test

    Russell Jude Chander

    You can consider the Everyday Cognition Scale (ECog). Assesses cognition based subjective ratings on performance in everyday tasks over the past 10 years. These can later be divided and classified into broad cognitive categories. The scale is meant to be informant rated. 

    Farias et al. (2008) is the main reference for the scale. 

    Farias et al. (2011) is the reference for validation of a short form, if that suits you better.

    Edmonds et al. (2014) is a paper that, while kind of decrying subjective scales like this for cognitive impairment, also provides normative data for the ECog as an informant questionnaire and as a self-rated questionnaire, in case self-assessment is more to your needs.

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      [Show abstract] [Hide abstract]
      ABSTRACT: This article describes the development and validation of an instrument to assess cognitively mediated functional abilities in older adults, Everyday Cognition (ECog). The ECog is an informant-rated questionnaire comprised of multiple subscales. Confirmatory factor analysis (CFA) was used to examine its factor structure. Convergent validity was evaluated by comparing it to established measures of everyday function. External validity was evaluated by comparing ECog results across different clinical groups [cognitively normal, mild cognitive impairment (MCI), dementia]. CFA supported a seven-factor model including one global factor and six domain-specific factors (Everyday Memory, Language, Visuospatial Abilities, Planning, Organization, and Divided attention). The ECog correlated with established measures of functional status and global cognition, but only weakly with age and education. The clinical groups performed differently in each domain. In addition to the global factor, the Everyday Memory factor independently differentiated MCI from Normal, while the Everyday Language domain differentiated Dementia from MCI. Different subtypes of MCI also showed different patterns. Results suggest the ECog shows promise as a useful tool for the measurement of general and domain-specific everyday functions in the elderly.
      Full-text · Article · Aug 2008 · Neuropsychology

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