An Informant Questionnaire for Detecting Alzheimer's Disease: Are Some Items Better Than Others?

2011 ◽  
Vol 17 (4) ◽  
pp. 674-681 ◽  
Author(s):  
Sietske A.M. Sikkes ◽  
Dirk L. Knol ◽  
Mark T. van den Berg ◽  
Elly S.M. de Lange-de Klerk ◽  
Philip Scheltens ◽  
...  

AbstractA 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)

2016 ◽  
Vol 28 (7) ◽  
pp. 1125-1132 ◽  
Author(s):  
Masateru Matsushita ◽  
Ming-Chyi Pai ◽  
Cai-Ying Jhou ◽  
Asuka Koyama ◽  
Manabu Ikeda

ABSTRACTBackground:Caregiver burden (CB) of Alzheimer's disease (AD) in Taiwan is becoming an urgent social issue as well as that in Japan. The comparison of CB may explain how caregiver feels burden in each country.Methods:The participants were 343 outpatients with AD and their caregivers of Japan (n= 230) and Taiwan (n= 113). We assessed the CB using the Japanese and Chinese version of Zarit Caregiver Burden Interview (ZBI). The initial analysis was an exploratory factor analysis for each group to confirm the factor structure of ZBI. Then, the multiple-group structural equation modeling (MG-SEM) was used to assess the measurement invariance of ZBI such as configural, metric, and scalar invariances. Lastly, we compared the latent factor means of the ZBI between Japan and Taiwan.Results:In both groups, the confirmatory factor analysis extracted 3 factors which were labeled “Impact on caregiver's life”, “Embarrassed/anger”, and “Dependency”. The MG-SEM indicated an acceptable model fit, and established the partial scalar measurement invariance (comparative fit index (CFI) = 0.901, root mean square error of approximation (RMSEA) = 0.066). When we compared the latent factor means, the score of “Impact on caregiver's life” in Taiwanese caregivers was significantly higher than that in Japanese (p= 0.001). However, “Dependency” in Taiwanese caregivers was lower than that in Japanese (p< 0.001).Conclusions:Partial measurement invariance allowed comparing the latent factor mean across two countries. The results of comparisons suggested that there may be differences in the way of feeling CB between Japan and Taiwan.


2011 ◽  
Vol 26 (S2) ◽  
pp. 498-498
Author(s):  
M.T. Santos ◽  
G.C. Couto ◽  
J.C. Achieri ◽  
C.A. Júnior

Dementia are increasingly prevalent in population. The most common causes of dementia is Alzheimer's disease (AD). Screening tests have been used for the premature diagnosis of Alzheimer Disease (AD), specifically in the executive functions and language, which are compromised at an initial stage. However, the necessity standardized means and validated for our middle, to show oneself a pressing subject.ObjectiveTo analyze the impact of the length of sentences in the abstraction of proverbs in the Screening Test for Alzheimer's disease with Proverbs (TRDAP), healthy elderly and with Alzheimer's disease at early stage.MethodSurvey document in the database, analyzing the responses of the elderly (abstract or concrete interpretation of proverbs), relating the length of sentences (sayings) of stage B of TRDAP with the diagnosis of Alzheimer's disease and the interference of age and schooling.ResultsHealthy older people showed greater capacity for abstraction than those with AD. There was Significant differences, in the sayings 1 (p = 0.033) and 2 (p = 0.001), corresponding to lower sentences, which did not occur with the proverb 3. As for age no verified significant difference among the healthy and only saying 3 in AD patients, however schooling differenced the healthy.ConclusionElderly with Alzheimer's disease at an initial stage have lower performance in the comprehension of ambiguous sentences, interpretation and abstraction of proverbs, corroborating with the data of the literature. The size of these sentences appears to be inversely proportional to the correctness of interpretation in elderly patients with and without AD.


2018 ◽  
Vol 15 (12) ◽  
pp. 1142-1150 ◽  
Author(s):  
Maria Gonzalez-Nosti ◽  
Fernando Cuetos ◽  
Carmen Martinez

Background: The expressive difficulties in patients with Alzheimer’s dementia have been extensively studied, mainly in oral language. However, the deterioration of their writing processes has received much less attention. Objective: The present study aims to examine the decline of the performance of patients with Alzheimer’s disease in both oral and written picture-naming tasks. Method: Sixty-four participants (half with Alzheimer’s disease and half healthy elderly) were compared in the oral and written versions of a picture-naming task. Follow-up lasted two and a half years and patients were evaluated every six months. Results: Cross-sectional data indicate that the controls performed better than the patients, and both groups showed a different pattern of errors. In terms of longitudinal data, the results show a similar pattern of deterioration in both tasks. In terms of errors, lexical-semantics were the most numerous at the beginning and their number remained constant throughout all evaluations. In the case of non-responses, there was a significant increase in the last session, both in oral and written naming. Conclusion: These results replicate those found in previous studies and highlight the utility of the naming task to detect minimal changes in the evolution of patients with Alzheimer’s disease.


2020 ◽  
Author(s):  
Francesco Iodice ◽  
Valeria Cassano ◽  
Paolo Maria Rossini

Abstract This article reviews the main articles that have been published so far about the direct and indirect effects of the COVID-19 pandemic on a particularly fragile population represented by the healthy elderly people as well as those with Mild Cognitive Impairment and Alzheimer's disease. Such populations have been among the most affected in the early stages of the pandemic due to the direct effects of the virus and numerous indirect effects now emerge and will have to be carefully assessed over time. The pandemic associated to COVID-19 has shifted most of the health resources to the emergency area and has consequently left the three main medical areas that dealing with the elderly population (oncology, time-dependent diseases and degenerative disease) temporarily “uncovered”. In the phase following the emergency, it will be crucial to guarantee to each area the economic and organizational resources to quickly return to the level of support of the pre-pandemic state. The emergency phase represented an important moment of discussion on the possibilities of telemedicine which will inevitably become increasingly important but all the limits of its use in the elderly population have to be considered. In the post-lockdown recovery phase, alongside the classic medical evaluation, the psychological evaluation must become even more important for doctors caring about people with cognitive decline.


2019 ◽  
Vol 34 (4) ◽  
pp. 254-260
Author(s):  
JaeHoon Jung ◽  
Chang Hyun Lee ◽  
Kitack Shin ◽  
Daeyoung Roh ◽  
Sang-Kyu Lee ◽  
...  

Objectives: This study aimed to identify the specific relationship between subdomains of religious variables and cognitive functions in outpatients with Alzheimer’s disease (AD). Methods: We recruited 325 patients with AD from a psychiatry outpatient clinic. The Korean version of the Consortium to Establish a Registry for Alzheimer’s Disease and the Duke University Religion Index were used to assess cognitive functions and religiosity. We performed structural equation modeling and partial correlation analysis after controlling for demographic data. Results: The model in which religiosity beneficially affects cognitive functions showed acceptable model fit (root-mean-square error of approximation = 0.076, Tucker-Lewis index = 0.921, comparative fit index = 0.947). In the partial correlation analysis, organizational religious activity demonstrated positive relationships with memory ( r = 0.144, P = .010), language ( r = 0.149, P = .007), and constructional ability ( r = 0.191 P = .001). Nonorganizational religious activity and intrinsic religiosity were positively associated with memory ( r = 0.115, P = .040; r = 0.140, P = .012) and constructional ability ( r = 0.207, P = .000; r = 0.136, P = .015). Conclusions: The findings suggest that religiosity positively affects cognitive functions and that each religious variable is related differently to the subdomains of cognitive functions in patients with AD.


Author(s):  
Ka-Man Leung ◽  
Folake Orekoya ◽  
Adrian J. Bailey ◽  
Hor-Yan Lai ◽  
Ka-Yi Chan ◽  
...  

This study aimed to examine the impact of individual (level of vigorous physical activity (VPA) and frequency of using sports and recreation facilities), interpersonal (perceived social cohesion (PSC)), and neighborhood environmental (availability of sports and recreation facilities) factors on youths’ health in transition in Hong Kong. A sample of 508 individuals aged 17–23 years from all Hong Kong council districts randomly completed validated questionnaires by telephone survey. Of 508,302 individuals with complete data pertaining to address geocoding were selected for further analyses. Overall, more than half of them (56.3%) used sports and recreation facilities once per month or less. Structural equation modeling was used to examine the relationship among the studies’ constructs. The results indicated that the proposed model sufficiently fitted the data (χ2 (24) = 32.23, p < 0.12; CFI = 0.977; SRMR = 0.051; RMSEA = 0.034 (90% CI = 0.000 to 0.061). However, two items of PSC were sequentially removed due to their low standardized factor loadings (<0.3). A structural model was reinserted into data analyses, and the modified model fitted the data well as indicated by fit indices (χ2 (11) = 15.29, p < 0.17; CFI = 0.987; SRMR = 0.054; RMSEA = 0.036 (90% CI = 0.000 to 0.075). Only VPA (β = 0.27, p = 0.0005) and PSC (β = 0.12, p = 0.048) were significantly related to perceived health at an individual level. To promote youth health, the Hong Kong government may work with the business sector, community groups, or education institutions to develop community programs to keep youths active (especially VPA) and to build more cohesive, trustful relationships among youths in the neighborhood.


2022 ◽  
Vol 13 ◽  
Author(s):  
Qiang Wang ◽  
Ben Chen ◽  
Xiaomei Zhong ◽  
Huarong Zhou ◽  
Min Zhang ◽  
...  

Background: Odor identification dysfunction is an early predictor of the development of Alzheimer's disease (AD), but neuropsychiatric symptoms (NPS), which are common in AD and mild cognitive impairment (MCI), are also associated with odor identification dysfunction. Whether NPS affect the specificity of using odor identification dysfunction to predict cognitive decline in AD and MCI remains unclear.Methods: Patients (233 with MCI and 45 with AD) and 45 healthy controls (HCs) underwent assessments of odor identification (Sniffin' Sticks), NPS (Neuropsychiatric Inventory-12), and cognitive function (global cognition, memory, language, executive function, visual-spatial skill, and attention). Structural equation modeling (SEM) with bootstrapping estimation was conducted to explore the relationships between odor identification, NPS, and cognition.Results: Patients with NPS showed significantly worse performance in odor identification and cognition than patients without NPS and HCs. The SEM showed odor identification to be positively associated with cognition, and cognition had special indirect effects on odor identification through affective and psychosis symptoms (two factors extracted from Neuropsychiatric Inventory-12). Additionally, affective and psychosis symptoms partially mediated the effect of cognition on odor identification.Conclusion: Neuropsychiatric symptoms are associated with odor identification dysfunction in patients with AD and MCI. Studies exploring the relationship between odor identification dysfunction and cognitive decline in patients with AD and MCI should include an assessment of affective and psychosis symptoms, and adjust their confounding effects.


2018 ◽  
Vol 31 (1) ◽  
pp. 123-132
Author(s):  
Xuxia Wang ◽  
Xiaomeng Xu ◽  
Hongjuan Han ◽  
Runlian He ◽  
Liye Zhou ◽  
...  

ABSTRACTBackground:Our study aims to detect different types of response shifts (RS) and true changes of quality of life (QOL) measurement in patients with Alzheimer's disease (AD) using structural equation modeling (SEM) in domain level.Methods:Patients with AD aged over 60 years old were collected from the Department of Neurology and Geriatrics in Taiyuan Central Hospital, China. The 12-item Short Form (SF-12) Health Survey was measured in 238 patients with AD prior to hospitalization and one month following discharge. RS was detected by SEM approach. The statistical process consisted of four steps and fitted four models. We interpreted changes of parameters in models to detect RS and to assess true change.Results:The results showed reprioritization of social functioning (SF) (χ2 = 4.13, p < 0.05), reconceptualization of role limitations due to emotional problems (RE) (χ2 = 17.03, p < 0.001), uniform recalibration of bodily pain (BP) (χ2 = 12.24, p < 0.001), and non-uniform recalibration of mental health (MH) (χ2 = 4.41, p < 0.05), respectively. The true changes of common factors were deteriorated in general physical health (PHYS) (−0.10, χ2 = 8.30, p < 0.005) and improved in general mental health (MENT) (+0.29, χ2 = 20.95, p < 0.001). The effect-sizes of RS were only small.Conclusion:This study showed that patients with AD occurred three types of RS and true changes one month following discharge. RS had effects on the QOL of patients. Better understanding of potential changes in QOL in patients with AD is crucial.


2000 ◽  
Vol 30 (3) ◽  
pp. 619-627 ◽  
Author(s):  
B. SCHMAND ◽  
G. WALSTRA ◽  
J. LINDEBOOM ◽  
S. TEUNISSE ◽  
C. JONKER

Background. Dementia screening instruments, such as the Cambridge Cognitive Examination (CAMCOG), measure a variety of cognitive functions. However, memory impairment generally is the first sign of Alzheimer's disease (AD). It seems logical, therefore, to use only memory-related items for the early detection of AD. We divided the CAMCOG into a memory section and a non-memory section, and tested the hypothesis that the memory section predicts AD better than the non-memory section. We also provide normative data for both sections.Methods. Normal subjects (N = 169) and patients with incident AD (i.e. satisfying AD criteria between 1 and 3 years from baseline; N = 25) were participants in the Amsterdam Study of the Elderly (AMSTEL), a population-based longitudinal study on cognitive decline and dementia. Patients with prevalent AD (i.e. satisfying AD criteria at baseline; N = 155) were either recruited in a memory clinic or came from AMSTEL. Normal subjects were cognitively intact at baseline and remained so for at least 3 years. The CAMCOG was administered to all subjects. AD was diagnosed by DSM-III-R criteria.Results. Logistic regression analysis showed that the memory section was related to prevalent AD, whereas in multivariate analysis the non-memory section was not (after correction for the memory score and demographic characteristics). A similar analysis showed that the memory section predicted incident AD, as did a higher score on the non-memory section. The MMSE did not predict incident AD better than age alone.Conclusion. For the early detection of AD it is best to use the memory and non-memory sections separately instead of the total CAMCOG score.


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