Does the Cognitive Change Index Predict Progression of Clinical Dementia Status? Longitudinal Analysis in a Demographically Diverse Aging Cohort

The Cognitive Change Index (CCI; Rattanabannakit et al., 2016) is a widely used measure of self-perceived cognitive functioning. There are several versions, the most common being a 20-item version, which queries memory, executive functioning, and language concerns (CCI-20), and a 12-item version (CCI-12), which includes only memory concerns. Little is known about how the CCI may predict future clinical decline or which version may be most sensitive to dementia risk. We investigated the capacity of the CCI-20, CCI-12, and an expanded version of the CCI (CCI-40), to predict progression of clinical dementia status in a demographically diverse sample.Einstein Aging Study participants (community-dwelling cohort; n = 324; M age = 70.4; M education = 15; 67% female; 46.3% White) completed the CCI-40 (self-report) and Clinical Dementia Rating Scale (CDR) at baseline and over annual follow-up (M wave = 1.48). Inclusion criteria were > age 70, English speaking, and nondemented. We investigated the CCI-12, the CCI-20, and the CCI-40 (memory, language, executive functioning, attention, visuospatial, calculation, and orientation domains). We used generalized LME to examine how CCI at baseline impacts rate change of CDR status, with CCI, time and their interaction term as independent variables, adjusting for covariates.All CCI total scores were significantly associated with the rate change in log odds on CDR (CCI-40, β = 0.013, p = 0.001; CCI-20, β = 0.020, p = 0.002; CCI-12, β = 0.013, p = 0.002).Regardless of version, the CCI performance at baseline predicts future progression in clinical dementia status. Using the CCI to assess self-perceived cognition may enhance risk detection in clinical and research settings. Future research will replicate these findings across a range of predementia diagnoses.