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. 2017 Mar 31:8:26-35.
doi: 10.1016/j.dadm.2017.03.002. eCollection 2017.

Detecting functional decline from normal aging to dementia: Development and validation of a short version of the Amsterdam IADL Questionnaire

Roos J Jutten  1 , Carel F W Peeters  2 , Sophie M J Leijdesdorff  3 , Pieter Jelle Visser  1   4 , Andrea B Maier  5   6 , Caroline B Terwee  2 , Philip Scheltens  1 , Sietske A M Sikkes  1   2
Affiliations

Detecting functional decline from normal aging to dementia: Development and validation of a short version of the Amsterdam IADL Questionnaire

Roos J Jutten et al. Alzheimers Dement (Amst). .

Abstract

Introduction: Detecting functional decline from normal aging to dementia is relevant for diagnostic and prognostic purposes. Therefore, the Amsterdam IADL Questionnaire (A-IADL-Q) was developed: a 70-item proxy-based tool with good psychometric properties. We aimed to design a short version while preserving its psychometric quality.

Methods: Study partners of subjects (n = 1355), ranging from cognitively normal to dementia subjects, completed the original A-IADL-Q. We selected the short version items using a stepwise procedure combining missing data, Item Response Theory, and input from respondents and experts. We investigated internal consistency of the short version and concordance with the original version. To assess its construct validity, we additionally investigated concordance between the short version and the Mini-Mental State Examination (MMSE) and Disability Assessment for Dementia (DAD). Finally, we investigated differences in instrumental activities of daily living (IADL) scores between diagnostic groups across the dementia spectrum.

Results: We selected 30 items covering the entire spectrum of IADL functioning. Internal consistency (0.98) and concordance with the original version (0.97) were very high. Concordance with the MMSE (0.72) and DAD (0.87) scores was high. IADL impairment scores increased across the spectrum from normal cognition to dementia.

Discussion: The A-IADL-Q short version (A-IADL-Q-SV) consists of 30 items and has maintained the psychometric quality of the original A-IADL-Q. As such, the A-IADL-Q-SV is a concise measure of functional decline.

Keywords: Alzheimer's disease; Dementia; Functional decline; Instrumental activities of daily living; Item Response Theory; Mild cognitive impairment; Subjective cognitive decline.

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Figures

Fig. 1
Fig. 1
Example item of the A-IADL-Q, including response options and scoring. Abbreviation: A-IADL-Q, Amsterdam IADL Questionnaire.
Fig. 2
Fig. 2
Flowchart of the item selection procedure that led to the short version of the Amsterdam IADL Questionnaire (A-IADL-Q). Abbreviations: IADL, Instrumental Activities of Daily Living; IRT, Item Response Theory.
Fig. 3
Fig. 3
Item information curves of the 30 Amsterdam IADL items that resulted in the short version. The bold black line represents the total test information curve. The latent trait ranges from −4 (good IADL functioning) to +4 (poor IADL functioning). Abbreviation: IADL, instrumental activities of daily living.
Fig. 4
Fig. 4
Short version latent trait scores for each diagnostic group. Latent trait scores reflect IADL functioning, with higher scores indicating poorer IADL functioning. Post hoc analyses gave the following significant pairwise differences: (1) NC versus all other groups; (2) SCD versus AD dementia, non-AD dementia, and Other group; and (3) MCI versus AD dementia. Abbreviations: AD, Alzheimer's disease; IADL, instrumental activities of daily living; MCI, mild cognitive impairment; NC, normal cognition; SCD, subjective cognitive decline.
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