Symptoms of Early Dementia-11 Questionnaire (SED-11Q): A Brief Informant-Operated Screening for Dementia

Abstract

The aim of this study was to develop a brief informant-based questionnaire, namely the Symptoms of Early Dementia-11 Questionnaire (SED-11Q), for the screening of early dementia. 459 elderly individuals participated, including 39 with mild cognitive impairment in the Clinical Dementia Rating scale (CDR) 0.5, 233 with mild dementia in CDR 1, 106 with moderate dementia in CDR 2, and 81 normal controls in CDR 0. Informants were required to fill out a 13-item questionnaire. Two items were excluded after analyzing sensitivities and specificities. The final version of the SED-11Q assesses memory, daily functioning, social communication, and personality changes. Receiver operator characteristic curves assessed the utility to discriminate between CDR 0 (no dementia) and CDR 1 (mild dementia). The statistically optimal cutoff value of 2/3, which indicated a sensitivity of 0.84 and a specificity of 0.90, can be applied in the clinical setting. In the community setting, a cutoff value of 3/4, which indicated a sensitivity of 0.76 and a specificity of 0.96, is recommended to avoid false positives. The SED-11Q reliably differentiated nondemented from demented individuals when completed by an informant, and thus is practical as a rapid screening tool in general practice, as well as in the community setting, to decide whether to seek further diagnostic confirmation.

Keywords: Activities of daily living; Alzheimer's disease; Cognitive deficits; Dementia; Dementia screening; Early detection; Mild cognitive impairment; Non-Alzheimer's disease.

Fig. 1

Format of the SED-11Q. The questionnaire represents an informant-based screening and should not be used as a patient-completed screening questionnaire. The total SED-11Q score is the sum of the items marked ‘Yes’.

Fig. 2

The ratio of positive answers in the subitems (quotients) according to the CDR groups.

Fig. 3

Distribution according to the severity of dementia. The distribution is shown in the quotients. Modes of scores were 0 in CDR 0, 1 in CDR 0.5, 5 in CDR 1, and 9/10 in CDR 2.

Fig. 4

The ROC curve of the SED-11Q in the differentiation between CDR 0 and CDR 1. The area under the curve is 0.932 (p < 0.001, 95% CI: 0.903-0.961). The statistically optimal cutoff value of 2/3 indicated a sensitivity of 0.841 and a specificity of 0.901.