Diagnostic accuracy of Instrumental Activities of Daily Living for dementia in community-dwelling older adults.
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...
| Publicado en: | Age & Ageing Vol. 47; no. 4; pp. 551 - 558 |
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| Autores principales: | , , , , , , , , , , , |
| Formato: | Artículo |
| Publicado: |
Oxford University Press / USA
Jul2018
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| Materias: | |
| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=130313381&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 130313381 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 00020729 AGA jtl: Age & Ageing issn: 00020729 maglogo: N pubinfo: dt: Jul2018 vid: 47 iid: 4 pid: 622 pub: Oxford University Press / USA artinfo: ui: 130313381 10.1093/ageing/afy021 ppf: 551 ppct: 7 formats: tig: atl: Diagnostic accuracy of Instrumental Activities of Daily Living for dementia in community-dwelling older adults. aug: au: HUI-FEN MAO LING-HUI CHANG ATHENA YI-JUNG TSAI WEN-NI WENNIE HUANG LI-YU TANG HUEY-JANE LEE YU SUN TA-FU CHEN KER-NENG LIN PEI-NING WANG YEA-ING LOTUS SHYU MING-JANG CHIU affil: School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan Department of Occupational Therapy, Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan Department of Occupational Therapy, Kaohsiung Medical University, Kaohsiung, Taiwan Department of Physical Therapy, I-Shou University, Kaohsiung, Taiwan Taiwan Alzheimer's Disease Association, Taipei, Taiwan Department of Neurology, En Chu Kong Hospital, New Taipei City, Taiwan Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan Department of Psychology, Soochow University, Taipei, Taiwan Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan School of Nursing, College of Medicine, Chang Gung University, Taoyuan City, Taiwan Graduate Institute of Brain and Mind Sciences, Graduate Institute of Psychology, National Taiwan University, Taipei, Taiwan Graduate Institute of Biomedical Engineering and Bioinformatics, National Taiwan University, Taipei, Taiwan su: Interviewing Medical screening Activities of daily living Cross-sectional method Old age Diagnosis of dementia Discriminant analysis Research methodology Scientific observation Questionnaires Independent living Receiver operating characteristic curves sug: subj: Interviewing Medical screening Activities of daily living Cross-sectional method Old age All Other Miscellaneous Ambulatory Health Care Services Diagnosis of dementia Discriminant analysis Research methodology Scientific observation Questionnaires Independent living Receiver operating characteristic curves keyword: Alzheimer's disease dementia diagnostic accuracy instrumental activity of daily living older people screen Alzheimer's disease dementia diagnostic accuracy instrumental activity of daily living older people screen ab: 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. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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