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An Informant Questionnaire for Detecting Alzheimer's Disease: Are Some Items Better Than Others?

Published online by Cambridge University Press:  01 June 2011

Sietske A.M. Sikkes*
Affiliation:
Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
Dirk L. Knol
Affiliation:
Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
Mark T. van den Berg
Affiliation:
Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
Elly S.M. de Lange-de Klerk
Affiliation:
Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands
Philip Scheltens
Affiliation:
Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands
Martin Klein
Affiliation:
Department of Medical Psychology, VU University Medical Center, Amsterdam, the Netherlands
Yolande A.L. Pijnenburg
Affiliation:
Alzheimer Center, VU University Medical Center, Amsterdam, the Netherlands Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands
Bernard M.J. Uitdehaag
Affiliation:
Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands Department of Neurology, VU University Medical Center, Amsterdam, the Netherlands
*
Correspondence and reprint requests to: S.A.M. Sikkes, Alzheimer Center, PK -1 Z 035, PO Box 7037, 1007 MB Amsterdam, the Netherlands. E-mail: s.sikkes@vumc.nl

Abstract

A decline in everyday cognitive functioning is important for diagnosing dementia. Informant questionnaires, such as the informant questionnaire on cognitive decline in the elderly (IQCODE), are used to measure this. Previously, conflicting results on the IQCODEs ability to discriminate between Alzheimer's disease (AD), mild cognitive impairment (MCI), and cognitively healthy elderly were found. We aim to investigate whether specific groups of items are more useful than others in discriminating between these patient groups. Informants of 180 AD, 59 MCI, and 89 patients with subjective memory complaints (SMC) completed the IQCODE. To investigate the grouping of questionnaire items, we used a two-dimensional graded response model (GRM).The association between IQCODE, age, gender, education, and diagnosis was modeled using structural equation modeling. The GRM with two groups of items fitted better than the unidimensional model. However, the high correlation between the dimensions (r=.90) suggested unidimensionality. The structural model showed that the IQCODE was able to differentiate between all patient groups. The IQCODE can be considered as unidimensional and as a useful addition to diagnostic screening in a memory clinic setting, as it was able to distinguish between AD, MCI, and SMC and was not influenced by gender or education. (JINS, 2011, 17, 674–681)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2011

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References

REFERENCES

Ahn, I.S., Kim, J.H., Kim, S., Chung, J.W., Kim, H., Kang, H.S., Kim, D.K. (2009). Impairment of instrumental activities of daily living in patients with mild cognitive impairment. Psychiatry Investigation, 6, 180184.CrossRefGoogle ScholarPubMed
Allaire, J.C., Gamaldo, A., Ayotte, B.J., Sims, R., Whitfield, K. (2009). Mild cognitive impairment and objective instrumental everyday functioning: The Everyday cognition battery memory test. Journal of the American Geriatrics Society, 57, 120125.CrossRefGoogle ScholarPubMed
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders (4th ed). Washington, DC: American Psychiatric Publishing Press.Google Scholar
Babyak, M.A., Green, S.B. (2010). Confirmatory factor analysis: An introduction for psychosomatic medicine researchers. Psychosomatic Medicine, 72, 587597.CrossRefGoogle ScholarPubMed
Benton, A.L., Hamsher, K. (1989). Multilingual aphasia examination. Iowa City: AJA Associates.Google Scholar
Bjorner, J., Smith, K., Stone, C., Sun, X. (2007). IRTFIT: A macro for item fit and local dependence tests under IRT models. Lincoln, RI: Quality Metric, Inc.Google Scholar
Burton, C.L., Strauss, E., Bunce, D., Hunter, M.A., Hultsch, D.F. (2009). Functional Abilities in Older Adults with Mild Cognitive Impairment. Gerontology, 55, 570581.CrossRefGoogle ScholarPubMed
Butt, Z. (2008). Sensitivity of the informant questionnaire on cognitive decline: An application of item response theory. Aging Neuropsychology and Cognition, 15, 642655.CrossRefGoogle ScholarPubMed
de Abreu, I., Nunes, P.V., Diniz, B.S., Forlenza, O.V. (2008). Combining functional scales and cognitive tests in screening for mild cognitive impairment at a university-based memory clinic in Brazil. Revista Brasileira de Psiquiatria, 30, 346349.CrossRefGoogle Scholar
de Jonghe, J.F.M. (1997). Differentiating between demented and psychiatric patients with the Dutch version of the IQCODE. International Journal of Geriatric Psychiatry, 12, 462465.3.0.CO;2-Q>CrossRefGoogle ScholarPubMed
de Jonghe, J.F., Schmand, B., Ooms, M.E., Ribbe, M.W. (1997). Verkorte informantvragenlijst over cognitieve achteruitgang bij ouderen (IQCODE-N) [Abbreviated form of the Informant Questionnaire on cognitive decline in the elderly]. Tijdschrift voor Gerontologie en Geriatrie, 28, 224229.Google ScholarPubMed
Del Ser, T., Morales, J.M., Barquero, M.S., Canton, R., Bermejo, F. (1997). Application of a Spanish version of the “informant questionnaire on cognitive decline in the elderly” in the clinical assessment of dementia. Alzheimer Disease & Associated Disorders, 11, 38.CrossRefGoogle ScholarPubMed
Desai, A.K., Grossberg, G.T., Sheth, D.N. (2004). Activities of daily living in patients with dementia: Clinical relevance, methods of assessment and effects of treatment. CNS Drugs, 18, 853875.CrossRefGoogle ScholarPubMed
Ehrensperger, M.M., Berres, M., Taylor, K.I. (2009). Screening properties of the German IQCODE with a two-year time frame in MCI and early Alzheimer's disease. International Psychogeriatrics, 14, 110.Google Scholar
Farias, S.T., Mungas, D., Reed, B., Haan, M.N., Jagust, W.J. (2004). Everyday functioning in relation to cognitive functioning and neuroimaging in community-dwelling Hispanic and non-Hispanic older adults. Journal of the International Neuropsychological Society, 10, 342354.CrossRefGoogle ScholarPubMed
Fuh, J.L., Teng, E.L., Lin, K.N., Larson, E.B., Wang, S.J., Liu, C.Y., Liu, H.C. (1995). The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) as a screening tool for dementia for a predominantly illiterate Chinese population. Neurology, 45, 9296.CrossRefGoogle ScholarPubMed
Gauthier, S., Gelinas, I., Gauthier, L. (1997). Functional disability in Alzheimer's disease. International Psychogeriatrics, 9(Suppl 1), 163165.CrossRefGoogle ScholarPubMed
Grundman, M., Petersen, R.C., Ferris, S.H., Thomas, R.G., Aisen, P.S., Bennett, D.A., Thal, L.J. (2004). Mild cognitive impairment can be distinguished from Alzheimer disease and normal aging for clinical trials. Archives of Neurology, 61, 5966.CrossRefGoogle ScholarPubMed
Harwood, D.M.J., Hope, T., Jacoby, R. (1997). Cognitive impairment in medical inpatients. 1. Screening for dementia - Is history better than mental state? Age and Ageing, 26, 3135.CrossRefGoogle ScholarPubMed
Isella, V., Villa, L., Russo, A., Regazzoni, R., Ferrarese, C., Appollonio, I.M. (2006). Discriminative and predictive power of an informant report in mild cognitive impairment. Journal of Neurology, Neurosurgery, and Psychiatry, 77, 166171.CrossRefGoogle ScholarPubMed
Jorm, A.F. (1994). A short-form of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) - Development and cross-validation. Psychological Medicine, 24, 145153.CrossRefGoogle ScholarPubMed
Jorm, A.F. (2004). The informant questionnaire on cognitive decline in the elderly (IQCODE): A review. International Psychogeriatrics, 16, 275293.CrossRefGoogle ScholarPubMed
Jorm, A.F., Broe, G.A., Creasey, H., Sulway, M.R., Dent, O., Fairley, M.J., Tennant, C. (1996). Further data on the validity of the informant questionnaire on cognitive decline in the elderly (IQCODE). International Journal of Geriatric Psychiatry, 11, 131139.3.0.CO;2-5>CrossRefGoogle Scholar
Jorm, A.F., Jacomb, P.A. (1989). The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) - Socio-demographic correlates, reliability, validity and some norms. Psychological Medicine, 19, 10151022.CrossRefGoogle ScholarPubMed
Jorm, A.F., Korten, A.E. (1988). Assessment of cognitive decline in the elderly by informant interview. British Journal of Psychiatry, 152, 209213.CrossRefGoogle ScholarPubMed
Jorm, A.F., Scott, R., Cullen, J.S., Mackinnon, A.J. (1991). Performance of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) as a screening-test for dementia. Psychological Medicine, 21, 785790.CrossRefGoogle ScholarPubMed
Kim, K.R., Lee, K.S., Cheong, H.K., Eom, J.S., Oh, B.H., Hong, C.H. (2009). Characteristic profiles of instrumental activities of daily living in different subtypes of mild cognitive impairment. Dementia and Geriatric Cognitive Disorders, 27, 278285.CrossRefGoogle ScholarPubMed
Lawton, M.P., Brody, E.M. (1969). Assessment of older people - Self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179186.CrossRefGoogle ScholarPubMed
Lindeboom, J., Matto, D. (1994). Cijferreeksen en Knox blokken als concentratietest voor ouderen [Digit series and Knox cubes as concentration tests for elderly subjects]. Tijdschrift voor Gerontologie en Geriatrie, 25, 6368.Google Scholar
Lindeboom, J., Schmand, B., Tulner, L., Walstra, G., Jonker, C. (2002). Visual association test to detect early dementia of the Alzheimer type. Journal of Neurology, Neurosurgery, and Psychiatry, 73, 126133.CrossRefGoogle ScholarPubMed
Loewenstein, D., Acevodo, A. (2010). The relationship between instrumental activities of daily living and neurpsychological performance. In T. Marcotte & I. Grant (Eds.), Neuropsychology of everyday functioning (pp. 93112) New York: The Guilford Press.Google Scholar
Luteijn, F.P., van der Ploeg, F.A.E. (1982). GIT Groninger Intelligentie Test [Groninger Intelligence Test]. Lisse: Swets & Zeitlinger.Google Scholar
Mc Khann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., Stadlan, E.M. (1984). Clinical-diagnosis of Alzheimers-disease - Report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimers Disease. Neurology, 34, 939944.CrossRefGoogle Scholar
Morales, J.M., Bermejo, F., Romero, M., Del Ser, T. (1997). Screening of dementia in community-dwelling elderly through informant report. International Journal of Geriatric Psychiatry, 12, 808816.3.0.CO;2-5>CrossRefGoogle ScholarPubMed
Morales, J.M., Gonzalez-Montalvo, J.I., Bermejo, F., Del Ser, T. (1995). The screening of mild dementia with a shortened Spanish version of the “Informant Questionnaire on Cognitive Decline in the Elderly”. Alzheimer Disease and Associated Disorders, 9, 105111.CrossRefGoogle ScholarPubMed
Muthén, L.K., Muthén, B.O. (1998–2007). Mplus user's guide (5th ed.). Los Angeles, CA: Muthén & Muthén.Google Scholar
Narasimhalu, K., Lee, J., Auchus, A.P., Chen, C.P. (2008). Improving detection of dementia in Asian patients with low education: Combining the Mini-Mental State Examination and the Informant Questionnaire on cognitive decline in the elderly. Dementia and Geriatric Cognitive Disorders, 25, 1722.CrossRefGoogle ScholarPubMed
Nygard, L. (2003). Instrumental activities of daily living: A stepping-stone towards Alzheimer's disease diagnosis in subjects with mild cognitive impairment? Acta Neurologica Scandinavica Supplementum, 179, 4246.CrossRefGoogle ScholarPubMed
Oakley, F., Sunderland, T. (1997). Assessment of motor and process skills as a measure of IADL functioning in pharmacologic studies of people with Alzheimer's disease: A pilot study. International Psychogeriatrics, 9, 197206.CrossRefGoogle ScholarPubMed
Orlando, M., Thissen, D. (2003). Further investigation of the performance of S-X-2: An item fit index for use with dichotomous item response theory models. Applied Psychological Measurement, 27, 289298.CrossRefGoogle Scholar
Peres, K., Chrysostome, V., Fabrigoule, C., Orgogozo, J.M., Dartigues, J.F., Barberger-Gateau, P. (2006). Restriction in complex activities of daily living in MCI: Impact on outcome. Neurology, 67, 461466.CrossRefGoogle ScholarPubMed
Petersen, R.C., Morris, J.C. (2005). Mild cognitive impairment as a clinical entity and treatment target. Archives of Neurology, 62, 11601163.CrossRefGoogle ScholarPubMed
Petersen, R.C., Negash, S. (2008). Mild cognitive impairment: An overview. CNS Spectrums, 13, 4553.CrossRefGoogle ScholarPubMed
Petersen, R.C., Smith, G.E., Waring, S.C., Ivnik, R.J., Tangalos, E.G., Kokmen, E. (1999). Mild cognitive impairment - Clinical characterization and outcome. Archives of Neurology, 56, 303308.CrossRefGoogle ScholarPubMed
Reitan, R.M. (1958). Validity of the Trail Making Test as an indicator of organic brain damage. Perceptual & Motor Skills, 8, 271276.CrossRefGoogle Scholar
Rey, A. (1964). L'examen clinique en psychologie [clinical exam in psychology]. Paris: Presse de Universitaire de France.Google Scholar
Saan, R.J., Deelman, B.G. (1986). De 15-woorden Test A en B (een voorlopige handleiding) [15 word test A and B (a preliminary manual)]. Groningen: Afd. Neuropsychologie, AZG.Google Scholar
Samejima, F. (1969). Estimation of latent ability using a response pattern of graded scores. Psychometrika, 34, 139.CrossRefGoogle Scholar
Schmand, B., Groenink, S.C., van den Dungen, M. (2008). Letter fluency: Psychometrische eigenschappen en Nederlandse normen [Letter Fluency: Psychometric properties and Dutch normative data]. Tijdschrift voor Gerontologie en Geriatrie, 39, 6476.CrossRefGoogle Scholar
Sikkes, S.A.M., van den Berg, M.T., Knol, D.L., de Lange-de Klerk, E.S.M., Scheltens, P., Uitdehaag, B.M.J., Pijnenburg, Y. A. L. (2010). How useful is the IQCODE for discriminating between AD, MCI and subjective memory complaints? Dementia and Geriatric Cognitive Disorders, 30, 411416.CrossRefGoogle ScholarPubMed
Stone, C. (2004). IRTFIT-RESAMPLE: A computer program for assessing goodness of fit of items response theory models based on posterior expectations. Applied Psychological Measurement, 28, 143144.CrossRefGoogle Scholar
Stone, C., Zhang, B. (2003). Assessing goodness of fit of item response theory models: A comparison of traditional and alternative procedures. Journal of Educational Measurement, 40, 331352.CrossRefGoogle Scholar
Takane, Y., De Leeuw, J. (1987). On the relationship between item response theory and factor-analysis of discretized variables. Psychometrika, 52, 393408.CrossRefGoogle Scholar
Tang, W.K., Wong, E., Chan, S.S.M., Chiu, H.F.K., Wong, K.S., Kwok, T.C.Y., Ungvari, G.S. (2004). The scoring scheme of the informant questionnaire on cognitive decline in the elderly needs revision: Results of Rasch analysis. Dementia and Geriatric Cognitive Disorders, 18, 250256.CrossRefGoogle ScholarPubMed
Tomarken, A.J., Waller, N.G. (2005). Structural equation modeling: Strengths, limitations, and misconceptions. Annual Review of Clinical Psychology, 1, 3165.CrossRefGoogle ScholarPubMed
Verhage, F. (1964). Intelligentie en leeftijd: Onderzoek bij Nederlanders van twaalf tot zevenenzeventig jaar [intelligence and age in a Dutch sample]. Assen: van Gorcum.Google Scholar
Warrington, E.K., James, M. (1991). The Visual Object and Space Perception Battery. Bury St. Edmunds, UK: Thames Valley Test Company.Google Scholar
Wirth, R.J., Edwards, M.C. (2007). Item factor analysis: Current approaches and future directions. Psychological Methods, 12, 5879.CrossRefGoogle ScholarPubMed