Diagnostic accuracy of Instrumental Activities of Daily Living for dementia in community-dwelling older adults
| Autor: | Wen Ni Wennie Huang, Ta-Fu Chen, Ming-Jang Chiu, Hui-Fen Mao, Yea-Ing Lotus Shyu, Pei Ning Wang, Yu Sun, Li Yu Tang, Huey Jane Lee, Ker Neng Lin, Athena Yi-Jung Tsai, Ling Hui Chang |
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| Rok vydání: | 2018 |
| Předmět: |
Male
Gerontology Aging Activities of daily living Population Taiwan Diagnostic accuracy Likelihood ratios in diagnostic testing Disability Evaluation 03 medical and health sciences Cognition 0302 clinical medicine Predictive Value of Tests Surveys and Questionnaires Activities of Daily Living mental disorders Humans Medicine Dementia 030212 general & internal medicine education Geriatric Assessment Cutoff score Aged Aged 80 and over education.field_of_study Receiver operating characteristic business.industry Age Factors Reproducibility of Results General Medicine Mental Status and Dementia Tests medicine.disease Cross-Sectional Studies Female Observational study Independent Living Geriatrics and Gerontology business human activities 030217 neurology & neurosurgery |
| Zdroj: | Age and Ageing. 47:551-557 |
| ISSN: | 1468-2834 0002-0729 |
| DOI: | 10.1093/ageing/afy021 |
| Popis: | Background many people living with dementia remain underdiagnosed and unrecognised. Screening strategies are important for early detection. Objective to examine whether the Lawton's Instrumental Activities of Daily Living (IADL) scale, compared with other cognitive screening tools-the Mini-Mental State Examination (MMSE), and the Ascertain Dementia 8-item Informant Questionnaire (AD8)-can identify older (≥ 65 years) adults with dementia. Design population-based cross-sectional observational study. Setting all 19 counties in Taiwan. Participants community-dwelling older adults (n = 10,340; mean age 74.87 ± 6.03). Methods all participants underwent a structured in-person interview. Dementia was identified using National Institute on Aging-Alzheimer's Association core clinical criteria for all-cause dementia. Receiver operator characteristic curves were used to determine the discriminant abilities of the IADL scale, MMSE and AD8 to differentiate participants with and without dementia. Results we identified 917 (8.9%) participants with dementia, and 9,423 (91.1%) participants without. The discriminant abilities of the MMSE, AD8 and IADL scale (cutoff score: 6/7; area under curve = 0.925; sensitivity = 89%; specificity = 81%; positive likelihood ratio = 4.75; accuracy = 0.82) were comparable. Combining IADL with AD8 scores significantly improved overall accuracy: specificity = 93%; positive likelihood ratio = 11.74; accuracy = 0.92. Conclusions our findings support using IADL scale to screen older community-dwelling residents for dementia: it has discriminant power comparable to that of the AD8 and MMSE. Combining the IADL and the AD8 improves specificity. |
| Databáze: | OpenAIRE |
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