Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Dec 22:7:25988.
doi: 10.3402/gha.v7.25988. eCollection 2014.

Development and community-based validation of the IDEA study Instrumental Activities of Daily Living (IDEA-IADL) questionnaire

Cecilia Collingwood  1 , Stella-Maria Paddick  2 , Aloyce Kisoli  3 , Catherine L Dotchin  4 , William K Gray  5 , Godfrey Mbowe  6 , Sarah Mkenda  6 , Sarah Urasa  7 , Declare Mushi  6 , Paul Chaote  3 , Richard W Walker  8
Affiliations

Development and community-based validation of the IDEA study Instrumental Activities of Daily Living (IDEA-IADL) questionnaire

Cecilia Collingwood et al. Glob Health Action. .

Abstract

Background: The dementia diagnosis gap in sub-Saharan Africa (SSA) is large, partly due to difficulties in assessing function, an essential step in diagnosis.

Objectives: As part of the Identification and Intervention for Dementia in Elderly Africans (IDEA) study, to develop, pilot, and validate an Instrumental Activities of Daily Living (IADL) questionnaire for use in a rural Tanzanian population to assist in the identification of people with dementia alongside cognitive screening.

Design: The questionnaire was developed at a workshop for rural primary healthcare workers, based on culturally appropriate roles and usual activities of elderly people in this community. It was piloted in 52 individuals under follow-up from a dementia prevalence study. Validation subsequently took place during a community dementia-screening programme. Construct validation against gold standard clinical dementia diagnosis using DSM-IV criteria was carried out on a stratified sample of the cohort and validity assessed using area under the receiver operating characteristic (AUROC) curve analysis.

Results: An 11-item questionnaire (IDEA-IADL) was developed after pilot testing. During formal validation on 130 community-dwelling elderly people who presented for screening, the AUROC curve was 0.896 for DSM-IV dementia when used in isolation and 0.937 when used in conjunction with the IDEA cognitive screen, previously validated in Tanzania. The internal consistency was 0.959. Performance on the IDEA-IADL was not biased with regard to age, gender or education level.

Conclusions: The IDEA-IADL questionnaire appears to be a useful aid to dementia screening in this setting. Further validation in other healthcare settings in SSA is required.

Keywords: Africa; Tanzania; dementia; instrumental activities of daily living; screening; validation.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Flow diagram of the IDEA-IADL development and validation process.
See this image and copyright information in PMC

References

    1. Prince M, Guerchet M, Prina M. London, UK: Alzheimer Disease International; 2013. Policy brief for heads of government: the global impact of dementia 2013–2050.
    1. Dotchin CL, Akinyemi RO, Gray WK, Walker RW. Geriatric medicine: services and training in Africa. Age Ageing. 2013;42:124–8. - PubMed
    1. Bower JH, Zenebe G. Neurologic services in the nations of Africa. Neurology. 2005;64:412–15. - PubMed
    1. Saxena S, Thornicroft G, Knapp M, Whiteford H. Resources for mental health: scarcity, inequity, and inefficiency. Lancet. 2007;370:878–89. - PubMed
    1. World Health Organization. Geneva, Switzerland: World Health Organization; 2010. mhGAP Intervention Guide for mental, neurological and substance use disorders in non-specialized health settings. - PubMed

Publication types