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Informant-based screening tools for dementia: an overview of systematic reviews

Published online by Cambridge University Press:  25 May 2021

Martin Taylor-Rowan ,
Sara Nafisi ,
Rhiannon Owen ,
Robyn Duffy ,
Amit Patel ,
Jennifer K. Burton  and
Terence J. Quinn
Martin Taylor-Rowan*
Affiliation:
Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK
Sara Nafisi
Affiliation:
Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK
Rhiannon Owen
Affiliation:
Swansea University Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, UK
Robyn Duffy
Affiliation:
Older People's Psychology Service, NHS Greater Glasgow and Clyde, Glasgow G12 0XH, UK.
Amit Patel
Affiliation:
Swansea University Medical School, Swansea University, Singleton Park, Swansea SA2 8PP, UK
Jennifer K. Burton
Affiliation:
Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK
Terence J. Quinn
Affiliation:
Institute of Cardiovascular and Medical Sciences, University of Glasgow, 126 University Place, Glasgow G12 8TA, UK
*
Author for correspondence: Martin Taylor-Rowan, E-mail: Martin.taylor-rowan@glasgow.ac.uk
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Abstract

Background

Informant-based questionnaires may have utility for cognitive impairment or dementia screening. Reviews describing the accuracy of respective questionnaires are available, but their focus on individual questionnaires precludes comparisons across tools. We conducted an overview of systematic reviews to assess the comparative accuracy of informant questionnaires and identify areas where evidence is lacking.

Methods

We searched six databases to identify systematic reviews describing diagnostic test accuracy of informant questionnaires for cognitive impairment or dementia. We pooled sensitivity and specificity data for each questionnaire and used network approaches to compare accuracy estimates across the differing tests. We used grading of recommendations, assessment, development and evaluation (GRADE) to evaluate the overall certainty of evidence. Finally, we created an evidence ‘heat-map’, describing the availability of accurate data for individual tests in different populations and settings.

Results

We identified 25 reviews, consisting of 93 studies and 13 informant questionnaires. Pooled analysis (37 studies; 11 052 participants) ranked the eight-item interview to ascertain dementia (AD8) highest for sensitivity [90%; 95% credible intervals (CrI) = 82–95; ‘best-test’ probability = 36]; while the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) was most specific (81%; 95% CrI = 66–90; ‘best-test’ probability = 29%). GRADE-based evaluation of evidence suggested certainty was ‘low’ overall. Our heat-map indicated that only AD8 and IQCODE have been extensively evaluated and most studies have been in the secondary care settings.

Conclusions

AD8 and IQCODE appear to be valid questionnaires for cognitive impairment or dementia assessment. Other available informant-based cognitive screening questionnaires lack evidence to justify their use at present. Evidence on the accuracy of available tools in primary care settings and with specific populations is required.

Keywords

Cognitive impairmentdementiainformantoverviewscreeningsystematic review
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 2 , January 2023 , pp. 580 - 589
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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