Objective: Self- and informant-ratings of functional abilities are used to diagnose mild cognitive impairment (MCI) and are commonly measured in clinical trials. Ratings are assumed to be accurate, yet they are subject to biases. Biases in self-ratings have been found in individuals with dementia who are older and more depressed and in caregivers with higher distress, burden, and education. This study aimed to extend prior findings using an objective approach to identify determinants of bias in ratings. Method: Participants were 118 individuals with MCI and their informants. Three discrepancy variables were generated including the discrepancies between (1) self- and informant-rated functional status, (2) informant-rated functional status and objective cognition (in those with MCI), and (3) self-rated functional status and objective cognition. These variables served as dependent variables in forward linear regression models, with demographics, stress, burden, depression, and self-efficacy as predictors. Results: Informants with higher stress rated individuals with MCI as having worse functional abilities relative to objective cognition. Individuals with MCI with worse self-efficacy rated their functional abilities as being worse compared to objective cognition. Informant-ratings were worse than self-ratings for informants with higher stress and individuals with MCI with higher self-efficacy. Conclusion: This study highlights biases in subjective ratings of functional abilities in MCI. The risk for relative underreporting of functional abilities by individuals with higher stress levels aligns with previous research. Bias in individuals with MCI with higher self-efficacy may be due to anosognosia. Findings have implications for the use of subjective ratings for diagnostic purposes and as outcome measures.

中文翻译：

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功能能力和客观认知的自我评分和知情者评分之间的差异：轻度认知障碍偏差的预测因素

目的：功能能力的自我评估和知情者评估用于诊断轻度认知障碍（MCI），并且通常在临床试验中进行测量。评级被认为是准确的，但它们可能存在偏差。年龄较大、抑郁程度更高的痴呆症患者以及痛苦、负担和教育程度较高的护理人员的自我评价存在偏差。本研究旨在使用客观方法来扩展先前的发现，以确定评级偏差的决定因素。方法：参与者为 118 名 MCI 患者及其知情者。产生了三个差异变量，包括 (1) 自评功能状态和知情者评分功能状态之间的差异，(2) 知情者评分功能状态和客观认知（MCI 患者），以及 (3) 自评功能状态和目标之间的差异认识。这些变量作为正向线性回归模型中的因变量，以人口统计、压力、负担、抑郁和自我效能作为预测因子。结果：压力较高的受访者认为轻度认知障碍患者的功能能力相对于客观认知较差。自我效能较差的 MCI 个体认为，与客观认知相比，他们的功能能力更差。对于压力较高的线人和自我效能感较高的 MCI 个体，线人的评分比自我评分更差。结论：本研究强调了 MCI 功能能力主观评分的偏差。压力水平较高的个体相对低估功能能力的风险与之前的研究一致。具有较高自我效能感的 MCI 个体的偏差可能是由于认知缺失造成的。研究结果对于将主观评分用于诊断目的和作为结果测量具有影响。