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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
*Corresponding
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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