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The Cognitive Difficulties Scale (CDS): Psychometric Characteristics in a Clinical Referral Sample

Published online by Cambridge University Press:  21 October 2020

Carlton S. Gass*
Affiliation:
Memory Disorders Clinic, Tallahassee Memorial Healthcare, Tallahassee, FL, USA
Brooke Patten
Affiliation:
Memory Disorders Clinic, Tallahassee Memorial Healthcare, Tallahassee, FL, USA
Ailyn Penate
Affiliation:
Memory Disorders Clinic, Tallahassee Memorial Healthcare, Tallahassee, FL, USA
Alice Rhodes
Affiliation:
Memory Disorders Clinic, Tallahassee Memorial Healthcare, Tallahassee, FL, USA
*
*Correspondence and reprint requests to: Carlton S. Gass, 2214 Genevieve CT, Tallahassee, FL32312, USA. E-mail: [email protected]

Abstract

Objective:

To evaluate the psychometric characteristics of the Cognitive Difficulties Scale (CDS), a 39-item Likert-type self-report instrument that requires a fifth grade reading level. The CDS is a popular instrument that has been shown to predict cognitive decline in older persons.

Method:

Participants were 512 consecutive outpatient referrals (71% women, mean age 60.6, and education 14.6 years) for a neuropsychological examination in a memory disorders clinic as part of a broader neurodiagnostic workup for cognitive decline. A principal components analysis was followed by a varimax rotation (Kaiser). Factor scores were investigated in relation to multiple internal and external criteria including demographics, Cronbach’s alpha, Digit Span, and Wechsler Memory Scale-IV Logical Memory (LM) and Visual Reproduction (VR), and Minnesota Multiphasic Personality Inventory (MMPI)-2 measures of depression, anxiety, somatic preoccupations, and thought disturbance.

Results:

Six dimensions of cognitive complaint emerged accounting for 64% of the variance: attention/concentration, praxis, prospective memory, speech problems, memory for people’s names, and temporal orientation. The factors showed good internal consistency (alphas > .850). Correlations with Digit Span, LM, and VR were all nonsignificant. CDS scores were associated with MMPI-2 measures of anxiety, depression, somatic preoccupation, and thought disturbance. Percentiles and T-scores were derived for raw scores on the CDS and its six component subscales.

Conclusion:

The CDS is a multidimensional measure of subjective cognitive complaints that provides clinicians with a psychometrically sound basis for deriving a profile with six subscale scores. The test has clinical utility and is a potentially useful tool in research involving age-related cognitive changes and meta-cognition.

Type
Regular Research
Copyright
Copyright © INS. Published by Cambridge University Press, 2020

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References

REFERENCES

Amariglio, R.E., Becker, J.A., Carmasin, J., Wadsworth, L.P., Lorius, N., Sullivan, C., … Rentz, D.M. (2012). Subjective cognitive complaints and amyloid burden in cognitively normal older individuals. Neuropsychologia, 50, 28802886. doi: 10.1016/j.neuropsychologia.2012.08.011 CrossRefGoogle ScholarPubMed
Bessi, V., Mazzeo, S., Padiglioni, S., Piccini, C., Nacmias, B., Sorbi, S., & Bracco, L. (2018). From subjective cognitive decline to Alzheimer’s disease: The predictive role of neuropsychological assessment, personality traits, and cognitive reserve. A 7-year follow-up study. Journal of Alzheimer’s Disease, 63, 113. doi: 10.3233/jad-171180 Google ScholarPubMed
Bowler, R.M., Adams, S.W., Schwarzer, R., Gocheva, V.V., Roels, H.A., Kim, Y., … Lobdell, D.T. (2017). Validity of self-reported concentration and memory problems: Relationship with neuropsychological assessment and depression. Journal of Clinical and Experimental Neuropsychology, 39, 10261036. doi: 10.1080/13803395.2017.1301392 CrossRefGoogle ScholarPubMed
Branca, B., Giordani, B., Lutz, T., & Saper, J.R. (1996). Self-report of cognition and objective test performance in post-traumatic headache. Headache, The Journal of Head and Face Pain, 36, 300306. doi: 10.1046/j.1526-4610.1996.3605300.x CrossRefGoogle Scholar
Brunette, A.M., Holm, K.E., Wamboldt, F.S., Kozora, E., Moser, D.J., Make, B.J., … Hoth, K.F. (2018). Subjective cognitive complaints and neuropsychological performance in former smokers with and without chronic obstructive pulmonary disease, Journal of Clinical and Experimental Neuropsychology, 40, 411422. doi: 10.1080/13803395.2017.1356912 CrossRefGoogle ScholarPubMed
Brzezin´ska, A., Bourke, J., Rivera-Hernández, R., Tsolaki, M., Woz´niak, J., & Kaz´mierski, J. (2020). Depression in dementia or dementia in depression? Systematic review of studies and hypotheses. Current Alzheimer Research, 17, 1628. doi: 10.2174/1567205017666200217104114 CrossRefGoogle Scholar
Buelow, M.T., Tremont, G., Frakey, L.L., Grace, J., & Ott, B.R. (2014). Utility of the cognitive difficulties scale and association with objective test performance. American Journal of Alzheimer’s Disease & Other Dementias, 29, 755761. doi: 10.1177/1533317514539032 CrossRefGoogle ScholarPubMed
Burdick, K., Endick, C., & Goldberg, J. (2005). Assessing cognitive deficits in bipolar disorder: Are self-reports valid? Psychiatry Research, 136. 4350. doi: 10.1016/j.psychres.2004.12.009 CrossRefGoogle ScholarPubMed
Burmester, B., Leathem, J., & Merrick, P. (2016). Subjective cognitive complaints and objective cognitive function in aging: A systematic review and meta-analysis of recent cross-sectional findings. Neuropsychology Review, 26, 376393. doi: 10.1007/s11065-016-9332-2 CrossRefGoogle ScholarPubMed
Butcher, J.N., Dahlstrom, W.G., Graham, J.R., Tellegen, A., & Kaemmer, B. (1989). The Minnesota Multiphasic Personality Inventory-2 (MMPI-2): Manual for administration and scoring. Minneapolis, MN: University of Minnesota Press.Google Scholar
Cedres, N., Machado, A., Molina, Y., Diaz-Galvan, P., Hernandez-Cabrera, J.A., Barroso, J., … Ferreira, D. (2019). Subjective cognitive decline below and above the age of 60: A multivariate study on neuroimaging, cognitive, clinical, and demographic measures. Journal of Alzheimer’s Disease, 68, 295309. doi: 10.3233/JAD-180720 CrossRefGoogle Scholar
Chaytor, N., Temkin, N., Machamer, J., & Dikmen, S. (2007). The ecological validity of neuropsychological assessment and the role of depressive symptoms in moderate to severe traumatic brain injury. Journal of the International Neuropsychological Society, 13, 377385. doi: 10.1017/S1355617707070592 CrossRefGoogle ScholarPubMed
Coley, N., Ousset, P.J., Andrieu, S., Mathiex-Forunet, H., Vellas, B., & The GuidAge Study Group (2008). Memory complaints to the general practitioner: Data from the GuidAge study. Journal of Nutritional Health and Aging, 12, S66S72. doi: 10.1007/BF02982590 CrossRefGoogle ScholarPubMed
Crumley, J.J., Stetler, C.A., & Horhota, M. (2014). Examining the relationship between subjective and objective memory performance in older adults: A meta-analysis. Psychology and Aging, 29, 250263. doi: 10.1037/a0035908 CrossRefGoogle ScholarPubMed
Dardenne, S., Delrieu, J., Sourdet, S., Cantet, C., Andrieu, S., Mathiex-Fortunet, H., … Vellas, B. (2017). Memory complaints and cognitive decline: Data from the GUIDAGE Study1. Journal of Alzheimer’s Disease, 60, 15671578. doi: 10.3233/jad-170229 CrossRefGoogle ScholarPubMed
Derouesné, C., Dealberto, M., Boyer, P., Lubin, S., Sauron, B., Piette, F., … Alpérovitch, A. (1993). Empirical evaluation of the ‘Cognitive Difficulties Scale’ for assessment of memory complaints in general practice: A study of 1628 cognitively normal subjects aged 45–75 years. International Journal of Geriatric Psychiatry, 8, 599607. doi: 10.1002/gps.930080712 CrossRefGoogle Scholar
Derouesné, C., Thibault, S., Lagha-Pierlucci, S., Baudouin-Madec, V., Ancri, D., & Lacomblez, L. (1999). Decreased awareness of cognitive deficits in patients with mild dementia of the Alzheimer type. International Journal of Geriatric Psychiatry, 14, 10191030. doi: 10.1002/(sici)1099-1166(199912)14:12%3C1019::aid-gps61%3E3.0.co;2-f 3.0.CO;2-F>CrossRefGoogle ScholarPubMed
Diniz, B.S., Butters, M.A., Albert, S.M., Dew, M.A., Reynolds, C.F. III (2013). Late-life depression and risk of vascular dementia and Alzheimer’s disease: Systematic review and meta-analysis of community-based cohort studies. British Journal of Psychiatry, 202, 329335. doi: 10.1192/bjp.bp.112.118307 CrossRefGoogle ScholarPubMed
Dufouil, C., Fuhrer, R., & Alpérovitch, A. (2005). Subjective cognitive complaints and cognitive decline: Consequence or predictor? The epidemiology of vascular aging study. Journal of American Geriatrics Society, 53, 616621. doi: 10.1111/j.1532-5415.2005.53209.x CrossRefGoogle ScholarPubMed
Edmonds, E., Delano-Wood, L., Galasko, D., Salmon, D., & Bondi, M. (2014). Subjective cognitive complaints contribute to misdiagnosis of mild cognitive impairment. Journal of the International Neuropsychological Society, 20(8), 836847. doi: 10.1017/S135561771400068X CrossRefGoogle ScholarPubMed
Ezzati, A., Katz, M.J., Derby, C.A., Zimmerman, M.E., & Lipton, R.B. (2019). Depressive symptoms predict incident dementia in a community sample of older adults: Results from the Einstein aging study. Journal of Geriatric Psychiatry and Neurology, 32, 97103. doi: 10.1016/j.jalz.2018.06.2559 CrossRefGoogle Scholar
Galioto, R., Blum, A., & Tremont, G. (2015). Subjective cognitive complaints versus objective neuropsychological performance in older adults with epilepsy. Epilepsy & Behavior, 51, 4852. doi: 10.1016/j.yebeh.2015.06.035 CrossRefGoogle ScholarPubMed
Gass, C. (2018). Neuropsychological assessment. In Butcher, J.N. & Hooley, J.M. (Eds.), APA handbooks in psychology®. APA handbook of psychopathology: Psychopathology: Understanding, assessing, and treating adult mental disorders (pp. 201220). American Psychological Association. doi: 10.1037/0000064-009 Google Scholar
Gass, C.S., & Apple, C. (1997). Cognitive complaints in closed-head injury: Relationship to memory test performance and emotional disturbance. Journal of Clinical and Experimental Neuropsychology, 19, 290299. doi: 10.1080/01688639708403858 CrossRefGoogle ScholarPubMed
Haley, A., Eagan, D., Gonzales, M., Biney, F., & Cooper, R. (2011). Functional magnetic resonance imaging of working memory reveals frontal hypoactivation in middle-aged adults with cognitive complaints. Journal of the International Neuropsychological Society, 17, 915924. doi: 10.1017/S1355617711000956 CrossRefGoogle ScholarPubMed
Haley, A.P., Hoth, K.F., Gunstad, J., Paul, R.H., Jefferson, A.J., Tate, D.F., … Cohen, R.A. (2009). Subjective cognitive complaints relate to white matter hyperdensities and future cognitive decline in patients with cardiovascular disease. Journal of Geriatric Psychiatry, 17, 976985. doi: 10.1097/jgp.0b013e3181b208ef CrossRefGoogle Scholar
Hill, P.L., Aschwanden, D., Payne, B.R., & Allemand, M. (2020). Daily cognitive complaints and engagement in older adulthood: Personality traits are more predictive than cognitive performance. Psychology and Aging, 10, 1037. doi: 10.1037/pag0000452 Google Scholar
Holm, S. (1979). A simple sequentially rejective multiple test procedure. Scandinavian Journal of Statistics, 6, 6570.Google Scholar
Jessen, F., Amariglio, R.E., Buckley, R.F., van der Flier, W.M., Han, Y., Milinuevo, J.L., … Wagner, M. (2020). The characterization of subjective cognitive decline. The Lancet Neurology, 19, 271278. doi: 10.1016/S1474-4422(19)30368-0 CrossRefGoogle Scholar
Kim, J.W., Byun, M.S., Yi, D., Lee, J.H., Ko, K., Jung, G., & Lee, D.Y. (2019). Vascular risk modulates the relationship between cerebral amyloid deposition and subjective memory complaints. Neuropsychiatric Disease Treatment, 15, 637645. doi: 10.2147/ndt.s192231 CrossRefGoogle ScholarPubMed
LaDuke, C., Barr, W., Brodale, D.L., & Rabin, L.A. (2018). Toward generally accepted forensic assessment practices among clinical neuropsychologists: a survey of professional practice and common test use. The Clinical Neuropsychologist, 32, 145164. doi: 10.1080/13854046.2017.1346711 CrossRefGoogle ScholarPubMed
Lin, Y., Shan, P., Jiang, W., Sheng, C., & Ma, L. (2019). Subjective cognitive decline: Preclinical manifestation of Alzheimer’s disease. Neurological Sciences, 40, 4149. doi: 10.1007/s10072-018-3620-y CrossRefGoogle ScholarPubMed
Mark, R.E. & Sitskoorn, M.M. (2013). Are subjective cognitive complaints relevant in preclinical Alzheimer’s disease? A review and guidelines for healthcare professionals. Reviews in Clinical Gerontology, 23, 6174. doi: 10.1017/s0959259812000172 CrossRefGoogle Scholar
Mazzeo, S., Padiglioni, S., Bagnoli, S., Carraro, M., Piaceri, I., Bracco, L., … Bessi, V. (2020). Assessing the effectiveness of subjective cognitive decline plus criteria in predicting the progression to Alzheimer’s disease: An 11-year follow-up study. European Journal of Neurology. doi: 10.1111/ene.14167 CrossRefGoogle Scholar
McNair, D.M. & Kahn, R.J. (1983). Self-assessment of cognitive deficits. In Crook, T., Ferris, S., & Bartus, R. (Eds.), Assessment in geriatric psychopharmacology (pp. 119136). New Canaan, CT: Mark Powley.Google Scholar
Mitchell, A.J., Beaumont, H., Ferguson, D., Yadegarfar, M., and Stubbs, B. (2014). Risk of dementia and mild cognitive impairment in older people with subjective memory complaints: Meta-analysis. Acta Psychiatrica Scandinavica, 130, 439451. doi: 10.1111/acps.12336 CrossRefGoogle ScholarPubMed
Muñoz, N., Gomà-i-Freixanet, M., Valero, S., Rodríguez-Gómez, O., Sanabria, A., Pérez- Cordón, A., … FACEHBI Study (2020). Personality factors and subjective cognitive decline: The FACEHBI Cohort. Behavioral Neurology. doi: 10.1155/2020/5232184 CrossRefGoogle Scholar
Nunnally, J.C. (1978). Psychometric theory. New York: McGraw-Hill.Google Scholar
Okonkwo, O.C., Spitznagel, M.B., & Tremont, G. (2010). Associations among measures of awareness of cognitive deficits in dementia. Alzheimers Dementia, 6, 312318. doi: 10.1016/j.jalz.2009.06.005 CrossRefGoogle ScholarPubMed
Porter, R.J., Robinson, L.J., Mahhi, G.S., & Gallagher, P. (2015). The neurocognitive profile of mood disorders – A review of the evidence and methodological issues. Bipolar Disorders: An International Journal of Psychiatry and Neurosciences, 17, 2140. doi: 10.1111/bdi.12342 CrossRefGoogle ScholarPubMed
Rabin, L.A., Smart, C.M., & Amariglio, R.E. (2017). Subjective cognitive decline in preclinical Alzheimer’s disease. Annual Review of Clinical Psychology, 13, 369396. doi: 10.1146/annurev-clinpsy-032816-045136 CrossRefGoogle ScholarPubMed
Rabin, L.A., Smart, C.M., Crane, P., Amariglio, R.E., Berman, L.M., Boada, M., … the Subjective Cognitive Decline Initiative (SCD-I) Working Group (2015). Subjective cognitive decline in older adults: An overview of self-report measures used across 19 international research studies. Journal of Alzheimer’s Disease, 48, S63-S86. doi: 10.1016/j.jalz.2015.07.435 CrossRefGoogle Scholar
Reisberg, B. & Gauthier, S. (2008). Current evidence for subjective cognitive impairment (SCI) as the pre-mild cognitive impairment (MCI) stage of subsequently manifest Alzheimer’s disease. International Psychogeriatrics, 20, 116. doi: 10.1017/S1041610207006412 CrossRefGoogle ScholarPubMed
Russell, E.W. (1987). A reference scale method for constructing neuropsychological test batteries. Journal of Clinical and Experimental Neuropsychology, 9, 376392. doi: 10.1080/01688638708405058 CrossRefGoogle ScholarPubMed
Russell, E.W. & Starkey, R.I. (2001). Halstead-Russell neuropsychological evaluation system – Revised [Manual and computer program]. Western Psychological Services.Google Scholar
Silva, D., Guerreiro, M., Faria, C., Maroco, J., Schmand, B.A., & de Mendonca, A. (2014). Significance of memory complaints in the clinical setting. Journal of Geriatric Psychiatry and Neurology, 27, 259265. doi: 10.1177/0891988714532018 CrossRefGoogle ScholarPubMed
Slot, R.E., Sikkes, A.A., Berkhof, J., Brodaty, H., Buckley, R., Cavedo, E., … van der Flier, W.M. (2018). Subjective cognitive decline and rates of incident Alzheimer’s disease and non-Alzheimer’s disease dementia. Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, 15, 465476. doi: 10.1016/j.jatz.2018.10.003 CrossRefGoogle ScholarPubMed
Spitznagel, M.B. & Tremont, G. (2005). Cognitive reserve and anosognosia in questionable and mild dementia. Archives of Clinical Neuropsychology, 20, 505515. doi: 10.1016/j.acn.2004.11.003 CrossRefGoogle ScholarPubMed
Spreij, L.A., Sluiter, D., Gosselt, I.K., Visser-Meily, J.M., & Nijboer, T.C. (2019): CoCo – Participation: The development and clinical use of a novelinventory measuring cognitive complaints in daily life. Neuropsychological Rehabilitation, 123. doi: 10.1080/09602011.2019.1691017 CrossRefGoogle Scholar
Stillman, A.M., Madigan, N., Torres, K., Swan, N., & Alexander, M.P. (2020). Subjective cognitive complaints in concussion. Journal of Neurotrauma, 37, 305311. doi: 10.1089/neu.2018.5925 CrossRefGoogle ScholarPubMed
Thomas, K.R., Bangen, K.J., Weigand, A.J., Edmonds, E.C., Wong, C.G., Cooper, S., … Bondi, M.W. (2020). Objective subtle cognitive difficulties predict future amyloid accumulation and neurodegeneration. Neurology, 94, e397e406. doi: 10.1212/WNL.0000000000008838 CrossRefGoogle ScholarPubMed
van Rijsbergen, M., Mark, R.E., Kop, W.J., de Kort, P.L., Sitskoorn, M.M. (2019). Psychological factors and subjective cognitive complaints after stroke: Beyond depression and anxiety. Neuropsychological Rehabilitation, 29, 16711684. doi: 10.1080/09602011.2018.1441720 CrossRefGoogle ScholarPubMed
Yates, J.A., Clare, L., Woods, R.T., & MRC CFAS (2017) Subjective memory complaints, mood and MCI: A follow-up study. Aging & Mental Health, 21, 313321. doi: 10.1080/13607863.2015.1081150 CrossRefGoogle ScholarPubMed
Wechsler, D. (2008). Wechsler adult intelligence scale (4th ed.). Pearson. doi: 10.1037/t15175-000 CrossRefGoogle Scholar
Wechsler, D. (2009). Test of Premorbid Functioning (TOPF). Bloomington, MN: NCS Pearson, Inc. Google Scholar