Introduction: Clinicians and researchers frequently ask informants about changes in a person's cognition, but whether informant assessments correspond to objectively measured change is unclear.
Methods: A subset (n = 2710) of US Health and Retirement Study participants and their informants completed the Harmonized Cognitive Assessment Protocol (HCAP). Using generalized estimating equations, we compared informant-reported change in memory and daily functioning to prospectively collected delayed word recall and instrumental activities of daily living (iADL) in the 10 years preceding HCAP.
Results: Informant reports of worsened memory were associated with declining word recall, and informant-reported iADL loss was associated with declining iADLs. Informant-reported memory impairment was more strongly associated with declining word recall when informants saw the respondent weekly or more compared to one to three times monthly or less (p < 0.0001 for interaction).
Discussion: Informant assessments of memory and iADLs are generally consistent with prospective measurements, but this relationship depends significantly on frequency of informant contact.
Highlights: Informant ratings of a person's memory and daily functioning are generally reliable.Quality of reporting depends on frequency of informant contact.Knowing an informant's characteristics is important for interpreting responses.
Keywords: harmonized cognitive assessment protocol; health and retirement study; informant; instrumental activities of daily living; memory.
© 2025 The Author(s). Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, LLC on behalf of Alzheimer's Association.