Demographic, Neuropsychological, and Functional Predictors of Rate of Longitudinal Cognitive Decline in Hispanic Older Adults

Objective: The identification of older adults who are at increased risk of future cognitive decline is often difficult, particularly in individuals of an ethnic minority. This study evaluated which baseline demographic, neuropsychological, and functional variables were most strongly associated with future longitudinal decline in global cognitive function. Design/Setting: Participants were part of a community-based prospective longitudinal study of 1,789 older Hispanics (Sacramento Area Latino Study on Aging). Participants: A subsample of 639 individuals was evaluated, comprising cognitively normal, mildly impaired, and dementia cases, and were followed longitudinally for up to 7 years. Sixty-three percent were tested in Spanish. Measurements: Latent growth curve modeling of longitudinal data was used to assess the effects of age, gender, education, language of test administration (Spanish or English), acculturation, baseline measures of neuropsychological function (i.e., verbal memory and confrontation naming), and baseline everyday functioning (as measured by the Informant Questionnaire on Cognitive Decline in the Elderly) on rate of change in global cognitive impairment (measured by the 3MS). Results: Less education, being tested in English, and poorer scores on the neuropsychological tests were all cross-sectionally associated with lower baseline 3MS scores. However, longitudinal decline in global cognition over time was primarily associated with older age and poorer everyday function at baseline. Conclusions: Informant-based ratings of functional impairment, which are easy to collect in a clinical setting, have significant use in identifying Hispanic older adults at increased risk for future cognitive decline. (Am J Geriatr Psychiatry 2011; 19:440-450)