Assessment of Instrumental Activities of Daily Living in Dementia: Diagnostic Value of the Amsterdam Instrumental Activities of Daily Living Questionnaire (original) (raw)
Related papers
Validation and diagnostic accuracy of the Alzheimer's questionnaire
Age and Ageing, 2012
Background: accurately identifying individuals with cognitive impairment is difficult. Given the time constraints that many clinicians face, assessment of cognitive status is often not undertaken. The intent of this study is to determine the diagnostic accuracy of the Alzheimer's questionnaire (AQ) in identifying individuals with mild cognitive impairment (MCI) and AD. Methods: utilising a case-control design, 300 [100 AD, 100 MCI, 100 cognitively normal (CN)] older adults between the ages of 53 and 93 from a neurology practice and a brain donation programme had the AQ administered to an informant. Diagnostic accuracy was assessed through receiver-operating characteristic analysis, which yielded sensitivity, specificity and area under the curve (AUC). Results: the AQ demonstrated high sensitivity and specificity for detecting )]; [91.00 (83.60-65.80)] and AD [99.00 (94.60-100.00)]; [96.00 (90.10-98.90)]. AUC values also indicated high diagnostic accuracy for both MCI [0.95 (0.91-0.97)] and AD [0.99 (0.96-1.00)]. Internal consistency of the AQ was also high (Cronbach's alpha = 0.89).
The Alzheimer's disease assessment scale (ADAS): An instrument for early diagnosis of dementia?
International Journal of Geriatric Psychiatry, 1988
With the aim of detecting mild dementias, 94 elderly subjects who had been participating in a long‐term study since 1976 were studied by means of a new diagnostic instrument, the Alzheimer's Disease Assessment Scale (ADAS) (Rosen et al., 1984). Data available from intelligence tests performed during the course of the long‐term study were also analysed.On the basis of an independent clinical assessment, four subjects were rated as clearly demented, seven as possibly demented, and 83 as normal. A comparison of these three groups showed that the subjects classified as demented obtained significantly poorer scores on the ADAS than did the group of normal subjects. The cognitive section of the ADAS distinguished even better between the normal and the clearly demented subjects. On the other hand, there was no indication that the ADAS was specifically sensitive to degenerative types of dementia since the subject with the highest ADAS score was suffering from vascular dementia. There we...
Comparative Analysis of the Alzheimer Questionnaire (AQ) With the CDR Sum of Boxes, MoCA, and MMSE
Alzheimer Disease & Associated Disorders, 2012
The Alzheimer Questionnaire (AQ) has been established as a valid and accurate informant-based screening questionnaire for Alzheimer disease and amnestic mild cognitive impairment. Although the AQ's validity and diagnostic accuracy has been established, its performance in comparison with other instruments has not. Thirty-nine amnestic mild cognitive impairment cases and 34 Alzheimer disease cases were matched on the basis of age, education, and sex to 73 cognitively normal individuals. The sample had a mean age of 82.54 ± 7.77 years and a mean education level of 14.61 ± 2.61 years. The diagnostic accuracy of the CDR Sum of Boxes, Mini Mental State Exam (MMSE), and Montreal Cognitive Assessment (MoCA) were compared with the AQ. The AQ correlated strongly with the CDR Sum of Boxes (r = 0.79) and demonstrated similar diagnostic accuracy with the MoCA and MMSE. These results suggest that the AQ is comparable with other established informant-based and patient-based measures.
Age and ageing, 2018
many people living with dementia remain underdiagnosed and unrecognised. Screening strategies are important for early detection. to examine whether the Lawton's Instrumental Activities of Daily Living (IADL) scale, compared with other cognitive screening tools-the Mini-Mental State Examination (MMSE), and the Ascertain Dementia 8-item Informant Questionnaire (AD8)-can identify older (≥ 65 years) adults with dementia. population-based cross-sectional observational study. all 19 counties in Taiwan. community-dwelling older adults (n = 10,340; mean age 74.87 ± 6.03). all participants underwent a structured in-person interview. Dementia was identified using National Institute on Aging-Alzheimer's Association core clinical criteria for all-cause dementia. Receiver operator characteristic curves were used to determine the discriminant abilities of the IADL scale, MMSE and AD8 to differentiate participants with and without dementia. we identified 917 (8.9%) participants with dement...
Dementia and Geriatric Cognitive Disorders, 2012
Early diagnosis of Alzheimer's disease ؒ Executive function ؒ Instrumental activities of daily living ؒ Instrumental functional impairment assessment ؒ Mild cognitive impairment ؒ Cognitive decline Abstract Bac kground: The need to detect early changes in instrumental activities of daily life led us to modify the Disability Assessment for Dementia Scale (DAD) by focusing on executive components of 6 instrumental items (DAD-6). Aim: To evaluate the relevance of the DAD-6 for detecting early impairment in a nondemented population. Methods: The DAD-6 was administered to informants of 84 patients: 31 with mild dementia (MD), 53 with mild cognitive impairment (MCI) and 55 healthy controls. Results: DAD-6 scores gradually decreased with increasing severity of the cognitive status [18 in healthy controls vs. 15.1 ± 3.2 in MCI versus 9.6 ± 3.5 in MD, p < 0.0001). Receiver-operating characteristic curve analyses yielded an optimal cut score of 14 to distinguish MCI from MD with a sensitivity of 0.83 (95% confidence interval 0.74-0.92) and a specificity of 0.84 (0.71-0.94), and a cut score of 15 to distinguish single-domain MCI from multi-domain MCI with a sensitivity of 0.96 (0.90-0.99) and a specificity of 0.54 (0.33-0.75). Conclusion: The DAD-6 reliably detects early loss of autonomy due to cognitive impairment.
Dementia and Geriatric Cognitive Disorders Extra, 2019
Aim: The aim of this study was to determine Activities of Daily Living/Instrumental Activities of Daily Living (ADL/IADL) evaluations that will enable better understanding of the severity of Alzheimer’s disease (AD). Methods: AD patients were evaluated by Functional Independence Measure (FIM), Hyogo Activities of Daily Living Scale (HADLS), and Assessment of Motor and Process Skills (AMPS) to identify the assessments that will enable highly precise discrimination of AD Clinical Dementia Rating (CDR) 2 (moderate) and CDR3 (severe) using receiver operating characteristic (ROC) curve and discriminant analyses. Results: The participants were 75 AD patients (CDR2 = 50, mean age = 80.3 ± 5.9 years; CDR3 = 25, mean age = 78.3 ± 9.0 years). The evaluation methods consisted of FIM, HADLS, and AMPS. The results were divided into FIM-M, FIM-C, HADLS-ADL, HADLS-IADL, AMPS-motor skills, and AMPS-process skills. The values for the area under the curve (AUC) were compared by ROC curve and discrimi...
A Brief Dementia Test with Subjective and Objective Measures
Dementia and Geriatric Cognitive Disorders Extra, 2015
Background: The development of an effective brief dementia test will help in the early identification of dementia. Aim: This study investigates the diagnostic utility of a brief cognitive test for dementia which combines a short subjective informant-rated questionnaire (AD8) with an objective cognitive measure (Mini-Mental State Examination, MMSE) or its subcomponents. Methods: Subjects with mild dementia (Clinical Dementia Rating Scale score ≤ 1) were matched with community-dwelling, cognitively intact controls. MMSE and Clinical Dementia Rating Scale were administered to all subjects, while AD8 was completed by a reliable informant. Receiver operating characteristics analysis determined the diagnostic accuracies of AD8, MMSE, and AD8 combined with MMSE (AD8+MMSE). Stepwise logistic regression identified the subcomponents of MMSE which, combined with AD8, best discriminated dementia patients from controls. Results: The AD8 (area under the curve [AUC] = 0.92, 95% confidence interval [CI] 0.89-0.95) was superior to the MMSE (AUC = 0.87, 95% CI 0.83-0.92) in discriminating mild dementia patients from controls, and AD8+MMSE (AUC = 0.95, 0.92-0.98) increased its superior discrimination over MMSE alone. AD8 combined with three-item recall and intersecting pentagon copy (AUC = 0.95, 95% CI 0.92-0.97) performed as well as AD8 combined with full MMSE. Conclusion: AD8 combined with the MMSE subcomponents threeitem recall and intersecting pentagon copy has excellent diagnostic utility and is a promising brief cognitive test for early dementia.
Combined instruments for the screening of dementia in older people with low Education
Arquivos de Neuro-Psiquiatria, 2009
Objective: To determine which combination of cognitive tests and informant reports can improve the diagnostic accuracy of dementia screening in low educated older people. Method: Patients with mild to moderate dementia (n=34) according to ICD-10 and DSM-III-R criteria and 59 older controls were assessed with the Mini-Mental State Examination (MMSE) and the Fuld Object Memory Evaluation (FOME). Informants were assessed using the Informant Questionnaire on Cognitive Decline in the Elderly and the Bayer-Activities of Daily Living Scale. Results: The 4 instruments combined with the mixed rule correctly classified 100% and the logistic regression (weighted sum) classified 95.7% of subjects. The weighted sum had a significantly larger ROC area compared to MMSE (p=0.008) and FOME (p=0.023). The specificity of the tested combinations was superior to the MMSE alone (p=0.002). Conclusions: Cognitive tests combined with informant reports can improve the screening of mild to moderate dementia in low educated older people.