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Screening properties of the German IQCODE with a two-year time frame in MCI and early Alzheimer's disease

Published online by Cambridge University Press:  14 September 2009

Michael M. Ehrensperger*
Affiliation:
Memory Clinic, Department of Geriatrics, University Hospital Basel, Switzerland
Manfred Berres
Affiliation:
Department of Mathematics and Technics, University of Applied Sciences Koblenz, Germany
Kirsten I. Taylor
Affiliation:
Memory Clinic, Department of Geriatrics, University Hospital Basel, Switzerland
Andreas U. Monsch
Affiliation:
Memory Clinic, Department of Geriatrics, University Hospital Basel, Switzerland
*
Correspondence should be addressed to: Michael M. Ehrensperger, University Hospital Basel, Memory Clinic – Neuropsychology Center, Schanzenstrasse 55, 4031 Basel, Switzerland. Phone: +41 61 265 3731; Fax +41 61 265 3788. Email: ehrenspergerm@uhbs.ch.

Abstract

Background: The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) is a widely used screening tool for dementia. We aimed to determine the ability of the German version of the 16-item IQCODE with a two-year time frame to discriminate healthy mature control participants (NC) from mild cognitive impairment (MCI) and probable early Alzheimer's disease (AD) patients (all with Mini-mental State Examination (MMSE) scores ≥ 24/30) and to optimize diagnostic discriminability by shortening the IQCODE.

Methods: 453 NC (49.7% women, age = 69.5 years ± 8.2, education = 12.2 ± 2.9), 172 MCI patients (41.9% women, age = 71.5 years ± 8.8, education = 12.3 ± 3.1) and 208 AD patients (59.1% women, age = 76.0 years ± 6.4, education = 11.4 ± 2.9) participated. Stepwise binary logistic regression analyses (LR) were used to shorten the test. Receiver operating characteristic curves (ROC) determined sensitivities, specificities, and correct classification rates (CCRs) for (a) NC vs. all patients; (b) NC vs. MCI; and (c) NC vs. AD patients.

Results: The mean IQCODE was 3.00 for NC, 3.35 for MCI, and 3.73 for AD. CCRs were 85.5% (NC-patient group), 79.9% (NC-MCI), and 90.7% (NC-AD), respectively. The diagnostic discriminability of the shortened 7-item IQCODE (i.e. items 1, 2, 3, 5, 7, 10, 14) was comparable with the longer version (i.e. 7-item CCRs: NC-patient group: 85.3%; NC-MCI: 80.1%, NC-AD: 90.5%).

Conclusions: The German 16-item IQCODE with two-year time frame showed excellent screening properties for MCI and early AD patients. An abbreviated 7-item version demonstrated equally high diagnostic discriminability, thus allowing for more economical screening.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2009

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References

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington, DC: American Psychiatric Association.Google Scholar
Anastasi, A. (1981). Coaching, test sophistication, and developed abilities. American Psychologist, 36, 10861093.CrossRefGoogle Scholar
Barba, R., Martinez-Espinosa, S., Rodriguez-Garcia, E., Pondal, M., Vivancos, J. and Del-Ser, T. (2000). Post-stroke dementia: clinical features and risk factors. Stroke, 31, 14941501.CrossRefGoogle Scholar
Berres, M., Bläsi, S., Zehnder, A. E. and Monsch, A. U. (2008). Evaluation of diagnostic scores with adjustment for covariates. Statistics in Medicine, 27, 17771790.CrossRefGoogle ScholarPubMed
Calero-Garcia, M. D., Navarro-Gonzales, E. and Munoz-Manzano, L. (2007). Influence of level of activity on cognitive performance and cognitive plasticity in elderly persons. Psychology and Aging, 22, 796810.Google Scholar
Clopper, C. and Pearson, S. (1934). The use of confidence or fiducial limits illustrated in the case of the binomial. Biometrika, 26, 404413.CrossRefGoogle Scholar
Coughlin, S.S. (1990). Recall bias in epidemiologic studies. Journal of Clinical Epidemiology, 43, 8791.CrossRefGoogle ScholarPubMed
de Jonghe, J. F., Schmand, B., Ooms, M. E. and Ribbe, M. W. (1997). 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. and Bermejo, F. (1997). Application of the Spanish version of the “Informant Questionnaire on Cognitive Decline in the Elderly” in the clinical assessment of dementia. Alzheimer Disease and Associated Disorders, 11, 38.CrossRefGoogle ScholarPubMed
Efron, B. (1979). Bootstrap methods: another look at the jackknife. Annals of Statistics, 7, 126.CrossRefGoogle Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-Mental State”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.CrossRefGoogle ScholarPubMed
Frisoni, G. B. et al. (2009). Markers of Alzheimer's disease in a population attending a memory clinic. Alzheimer's and Dementia, 5, 307317.CrossRefGoogle Scholar
Fuh, J. L. et al. (1995). The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) as screening tool for dementia for a predominantly illiterate Chinese population. Neurology, 45, 9296.CrossRefGoogle ScholarPubMed
Galvin, J. E. et al. (2005). The AD8: a brief informant interview to detect dementia. Neurology, 65, 559564.CrossRefGoogle ScholarPubMed
Hanley, J. A. and McNeil, B. J. (1983). A method of comparing the areas under receiver operating characteristic curves derived from the same cases. Radiology, 148, 839843.CrossRefGoogle ScholarPubMed
Isella, V., Villa, M. L., Frattola, L. and Appollonio, I. (2002). Screening cognitive decline in dementia: preliminary data on the Italian version of the IQCODE. Neurological Sciences, 23, S79S80.CrossRefGoogle ScholarPubMed
Isella, V., Villa, M. L., Russo, A., Regazzoni, R., Ferrarese, C. and Appollonio, I. (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. (2004). The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): a review. International Psychogeriatrics, 16, 275293.CrossRefGoogle ScholarPubMed
Jorm, A. F., Scott, R. and Jacomb, P. A. (1989). Assessment of cognitive decline in dementia by informant questionnaire. International Journal of Geriatric Psychiatry, 4, 3539.CrossRefGoogle Scholar
Jorm, A. F. et al. (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
Kühner, C. (1997). Frage bogen zur Depressionsdiagnostik nach DSM-IV (FDD-DSM-IV). Göttingen: Hogrefe.Google Scholar
Law, S. and Wolfson, C. (1995). Validation of a French version of an informant-based questionnaire as a screening test for Alzheimer's disease. British Journal of Psychiatry, 167, 541544.CrossRefGoogle ScholarPubMed
Lim, H. J., Lim, J. P. P., Anthony, P., Yeo, D. H. H. and Sahadevan, S. (2003). Prevalence of cognitive impairment amongst Singapore's elderly Chinese: a community-based study using the ECAQ and the IQCODE. International Journal of Geriatric Psychiatry, 18, 142148.Google ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA work group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939944.CrossRefGoogle ScholarPubMed
Monsch, A. U. et al. (1995). Improving the diagnostic accuracy of the Mini-mental State Examination. Acta Neurolologica Scandinavica, 92, 145150.CrossRefGoogle ScholarPubMed
Monsch, A. U. et al. (2000). The Basel Study on the elderly's search for preclinical cognitive markers of Alzheimers's disease. Neurobiology of Aging, 21, 31.CrossRefGoogle Scholar
Morris, J. C., Mohs, R. C., Rogers, H., Fillenbaum, G. and Heyman, A. (1988). Consortium to Establish a Registry for Alzheimer's Disease (CERAD) clinical and neuropsychological assessment of Alzheimer's disease. Psychopharmacology Bulletin, 24, 641652.Google ScholarPubMed
Morris, J. C. et al. (1989). The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer's disease. Neurology, 39, 11591165.Google Scholar
Parker, C. and Philp, I. (2004). Screening for cognitive impairment among older people in black and minority ethnic groups. Age and Ageing, 33, 447452.CrossRefGoogle ScholarPubMed
Patel, P., Goldberg, D. and Moss, S. (1993). Psychiatric morbidity in older people with moderate and severe learning disability. II. The prevalence study. British Journal of Psychiatry, 163, 481491.CrossRefGoogle ScholarPubMed
Perroco, T. R. et al. (2009). Performance of Brazilian long and short IQCODE on the screening of dementia in elderly people with low education. International Psychogeriatrics, 21, 531538.CrossRefGoogle ScholarPubMed
Pisani, M. A., Inouye, S. K., McNicoll, L. and Redlich, C. A. (2003). Screening for pre-existing cognitive impairment in older intensive care unit patients: use of proxy assessment. Journal of the American Geriatrics Society, 51, 689693.CrossRefGoogle Scholar
Powell, D. H. (1994). Profiles in Cognitive Aging. London: Harvard University Press.Google Scholar
Rosness, T. A., Ulstein, I. and Engedal, K. (2009). Stress affects carers before patient's first visit to a memory clinic. International Journal of Geriatric Psychiatry. Epublished ahead of print, doi: 10.1002/gps.2238.CrossRefGoogle Scholar
Senanarong, V. et al. (2001). The IQCODE: an alternative screening test for dementia for low educated Thai elderly. Journal of the Medical Association of Thailand, 84, 648655.Google ScholarPubMed
Shultz, J. M., Aman, M. G. and Rojahn, J. (1998). Psychometric evaluation of a measure of cognitive decline in elderly people with mental retardation. Research in Developmental Disabilities, 19, 6371.CrossRefGoogle ScholarPubMed
Welsh, K. A. et al. (1994). The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part V. A normative study of the neuropsychological battery. Neurology, 44, 609614.CrossRefGoogle Scholar
Winblad, B. et al. (2004). Mild cognitive impairment: beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. Journal of Internal Medicine, 256, 240246.CrossRefGoogle Scholar