Assessment of the Instrumental Activities of Daily Living in Mild Cognitive Impairment and Dementia Due to Alzheimer's Disease: Diagnostic Accuracy of the Serbian Version of the Amsterdam Iadl Questionnaire

Abstract

To establish a diagnosis of dementia, it is necessary, in addition to cognitive impairment, to prove the existence of a disorder of instrumental activities of daily living (IADL). The Amsterdam IADL Questionnaire is a reliable instrument translated into different languages. This study aims to assess the diagnostic accuracy of the Serbian version of the Amsterdam IADL Questionnaire. The study included 75 patients with mild cognitive impairment (MCI) and dementia due to Alzheimer's disease. The questionnaire was scored using the weighted average (WA) and item response theory (IRT) scoring method. Diagnostic accuracy was examined using receiver–operating characteristic (ROC) curves. The area under the curves (AUC) was calculated with 95% confidence intervals (CI). The correlation between IRT and WA scores was strong and significant (r=-0.980, p<0.001). The AUC for the IRT scores of A-IADL-Q was 0.832 (95% CI: 0.729 to 0.909), while the AUC for the WA scores of A-IADL-Q was 0.848 (95% CI: 0.746 to 0.920). Both were significantly different from the AUC of 0.5 (p<0.001). There was no significant difference between the AUCs of IRT and WA scoring (z=1.157; p=0.247). Cutoffs and the highest combination of sensitivity and specificity for the IRT (sensitivity 0.767; specificity 0. 844) and WA (sensitivity 0.744; specificity 0. 844) scores of A-IADL-Q were calculated. We have shown that A-IADL-Q has moderate diagnostic accuracy in differentiating dementia and MCI. This instrument can be used in combination with cognitive measures to diagnose dementia in its early stages.

The INFLUENCE OF THE APOEε4 ALLELE ON PRO-INFLAMMATORY CYTOKINE LEVELS IN THE CEREBROSPINAL FLUID OF PATIENTS WITH ALZHEIMER’S DISEASE

“…The study involved 36 patients diagnosed with probable dementia due to AD at the Neurology Clinic, University Clinical Center Niš, based on the NIA-AA guidelines [6]. Patients underwent neurological examination and cognitive function assessments, including Mini-Mental State Examination (MMSE), Addenbrooke's Cognitive Examination Revised (ACE-R), Clinical Dementia Rating (CDR), and Instrumental activities of daily living (IADL) using the recently validated Serbian version of the Amsterdam IADL questionnaire (A-IADL-Q) [10,11]. Brain MRI was performed according to dementia protocol.…”

Matrix Remodeling Enzymes as Potential Fluid Biomarkers of Neurodegeneration in Alzheimer’s Disease

“…The A/T/N classification system further refines the diagnostic process [ 5 ]. The clinical presentation of AD is categorized into three phases: the asymptomatic phase; followed by the stage of mild cognitive impairment (MCI); and lastly, dementia, characterized by a decline in activities of daily living (ADL) due to cognitive impairment [ 6 , 7 , 8 ].…”