Accuracy of the Brazilian Version of the Informant Questionnaire on Cognitive Decline in the Elderly at Screening for Dementia in Community-Dwelling Elderly Participants

Abstract

Objectives:

To determine the accuracy of the Brazilian version of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE-BR) for screening for dementia and to analyze the association of sociodemographic variables of the elderly participants and informant, as well as the mental health of the informant, in the scores of the questionnaire.

Methods:

A cross-sectional study was carried out with 417 elderly participants and their informants from the sample of the Frailty in the Brazilian Elderly Study, Rio de Janeiro, Brazil. The older individuals were assessed by clinical, functional, and neurocognitive evaluation, and the diagnosis of dementia was established according to Diagnostic and Statistical Manual of Mental Disorder (Fourth Edition) criteria. The informants were evaluated by Mini-Mental State Examination (MMSE), Center of Epidemiologic Studies—Depression Scale, and Burden Interview Scale. The Cambridge Cognitive Examination Test—Revised (CAMCOG-R) was used for convergent validity analysis. The association between IQCODE-BR and the study variables was determined by multivariate logistic regression analysis.

Results:

The best cutoff point was 3.26; the sensitivity, specificity, and area under the receiver–operating characteristic curve were 89%, 72%, and 0.88 (95% confidence interval: 0.837-0.917), respectively. The CAMCOG-R and the MMSE showed a moderate and negative association with IQCODE-BR.

Conclusion:

The IQCODE-BR is an instrument with good accuracy for the detection of dementia syndrome in Brazilian older person.

Keywords

cognitive screening cognitive impairment Alzheimer disease dementia elderly IQCODE

Get full access to this article

View all access options for this article.

References

World Health Organization. Neurologial Disorders: Public Health Challenges. Geneva: World Health Organization; 2006:42–55.

Bradford

Kunik

Schulz

Williams

Singh

. Missed and delayed diagnosis of dementia in primary care: prevalence and contributing factors. Alzheimer Dis Assoc Disord. 2009;23(4):306–314.

Bustamante

Bottino

Lopes

. Combined instruments on the evaluation of dementia in the elderly: preliminary results. Arq Neuropsiquiatr. 2003;61(3A):601–606.

McKhann

Drachman

Folstein

Katzman

Price

Stadlan

. 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. 1984;34(7):939–944.

Jorm

Jacomb

. The informant questionnaire on cognitive decline in the elderly (IQCODE): socio-demographic correlates, reliability, validity and some norms. Psychol Med. 1989;19(4):1015–1022.

Jansen

van Hout

Nijpels

. Self-reports on the IQCODE in older adults: a psychometric evaluation. J Geriatr Psychiatry Neurol. 2008;21(2):83–92.

Sanchez

Lourenço

. Informant questionnaire on cognitive decline in the elderly (IQCODE): cross-cultural adaptation for use in Brazil. Cad Saude Publica. 2009;25(7):1455–1465.

Herdman

Fox-Rushby

Badia

. A model of equivalence in the cultural adaptation of HRQoL instruments: the universalist approach. Qual Life Res. 1998;7(4):323–335.

Sanchez

Lourenço

. Screening for dementia: Brazilian version of the informant questionnaire on cognitive decline on the elderly and its psychometric properties. Geriatr Gerontol Int. 2013;13(3):687–693.

10.

Ribeiro

PCC

Lopes

Lourenco

. Prevalence of dementia in elderly clients of a private health care plan: a study of the FIBRA-RJ, Brazil. Dement Geriatr Cogn Disord. 2013;35(1-2):77–86.

11.

Folstein

, McHugh PR. “Mini-mental state”. a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189–198.

12.

Pfeffer

Kurosaki

Harrah

Jr Chance

Filos

. Measurement of functional activities in older adults in the community. J Gerontol. 1982;37(3):323–329.

13.

Lourenço

Veras

. Mini-mental state examination: psychometric characteristics in elderly outpatients. Rev Saúde Pública. 2006;40(4):712–719.

14.

Sanchez

MAS

Correa

PCR

Lourenço

. Cross-cultural Adaptation of the “functional activities questionnaire—FAQ” for use in Brazil. Dement Neuropsychol. 2011;5(4):322–327.

15.

Katz

. Assessing self-maintenance: activities of daily living, mobility, and instrumental activities of daily living. J Am Geriatr Soc. 1983;31(12):721–727.

16.

Lawton

Brody

. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist. 1969;9(3):179–86.

17.

Reuben

Laliberte

Hiris

Mor

. A hierarchical exercise scale to measure function at the advanced activities of daily living (AADL) level. J Am Geriatr Soc. 1990;38(8):855–861.

18.

Spitizer

Williams

Gibbon

First

. Structured Clinical Interview for DSM-III-R—Patient Edition (SCID-P, Version 1.0). Washington, DC: American Psychiatric Press; 1990:1–124.

19.

Roth

Huppert

Mountjou

Tym

. CAMDEX-R: The Cambridge Examination for Mental Disorders of the Elderly. Cambridge: Cambridge University Press; 1998.

20.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders—DSM-IV-TR. Forth ed. Washington: American Psychiatric Pub Inc; 2000.

21.

Roman

Tatemichi

Erkinjuntti

. Vascular dementia: diagnostic criteria for research studies. report of the NINDS-AIREN international workshop. Neurology. 1993;43(2):250–260.

22.

The Lund Manchester Groups. Clinical and neuropathological criteria for frontotemporal dementia. J Neurol Neurosurg Psychiatry. 1994;57(4):416–418.

23.

Radloff

. The CES-D scale: a self report depression scale for research in the general population. Appl Psych Meas. 1977;1(3):385–401.

24.

Zarit

Reever

Bach-Peterson

. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist. 1980;20(6):649–655.

25.

Paradela

EMP

Lopes

Lourenço

. Portuguese adaptation of the Cambridge Cognitive Examination-Revised in a public geriatric outpatient clinic [in Portuguese]. Cad Saúde Pública. 2009;25(12):2562–2570.

26.

Del-Ser

Morales

Barquero

Canton

Bermejo

. Application of a Spanish version of the “informant questionnaire on cognitive decline in the elderly” in the clinical assessment of dementia. Alzheimer Dis Assoc Disord. 1997;11(1):3–8.

27.

Mulligan

Mackinnon

Jorm

Giannakopoulos

Michel

. A comparison of alternative methods of screening for dementia in clinical settings. Arch Neurol. 1996;53(6):532–536.

28.

Jorm

. The informant questionnaire on cognitive decline in the elderly (IQCODE): a review. Int Psychogeriatr. 2004;16(3):275–293.

29.

Ozel-Kizil

Turan

Yilmaz

Cangoz

Uluc

. Discriminant validity and reliability of the Turkish version of informant questionnaire on cognitive decline in the elderly (IQCODE-T). Arch Clin Neuropsychol. 2010;25(2):139–145.

30.

Fuh

Teng

Lin

. The informant questionnaire on cognitive decline in the elderly (IQCODE) as a screening tool for dementia for a predominantly illiterate Chinese population. Neurology. 1995;45(1):92–96.

31.

Jorm

Broe

Creasey

. Further data on the validity of the informant questionnaire on cognitive decline in the elderly (IQCODE). Int J Geriatr Psych. 1996;11(2):131–139.

32.

Waltrowicz

Ames

McKenzie

Flicker

. Burden and stress on relatives (informal caretakers) of dementia sufferers in psychogeriatric nursing homes. Aust J Aging. 1996;15(3):115–118.

33.

Stratford

LoGiudice

Flicker

Cook

Waltrowicz

Ames

. A memory clinic at a geriatric hospital: a report on 577 patients assessed with the CAMDEX over 9 years. Aust N Z J Psych. 2003;37(3):319–326.

34.

Lim

Anthony

Yeo

Sahadevan

. Prevalence of cognitive impairment amongst Singapore's elderly Chinese: a community-based study using the ECAQ and the IQCODE. Int J Geriatr Psych. 2003;18(2):142–148.

35.

Dubois

Feldman

Jacova

. Revising the definition of Alzheimer's disease: a new lexicon. Lancet Neurol. 2010;9(11):1118–1127.