Development of a novel convenient Alzheimer's disease assessment scale, the ABC Dementia Scale, using item response theory

Umeda‐Kameyama, Yumi; Mori, Takahiro; Wada‐Isoe, Kenji; Kikuchi, Takashi; Kojima, Shinsuke; Kagimura, Tatsuo; Ueki, Akinori; Watabe, Toshiyuki; Kudoh, Chiaki; Akishita, Masahiro; Nakamura, Yu

doi:10.1111/ggi.13552

Cited by 17 publications

(20 citation statements)

References 16 publications

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“…The MHLW cognitive function scores also had an excellent inter-rater reliability, MHLW as indicated by a kappa coefficient of 0.62, Cronbach’s α of 0.87, and intraclass correlation coefficient 0.78. The MMSE [ 18 ] and ABC Dementia Scale [ 19 ] are existing measures of cognitive function that have been reported to have good inter-rater reliabilities, as shown by a kappa coefficient of 0.98 and weighted kappa coefficient of 0.75, respectively [ 7 ]. However, the MMSE consists of 11 items, including drawing pictures [ 7 ], and the ABC Dementia Scale of 13 items [ 19 ], which makes these measures cumbersome to use in extremely busy clinical settings in Japan, such as acute care hospitals or for mass screenings [ 5 ].…”

Section: Discussionmentioning

confidence: 99%

“…The MMSE [ 18 ] and ABC Dementia Scale [ 19 ] are existing measures of cognitive function that have been reported to have good inter-rater reliabilities, as shown by a kappa coefficient of 0.98 and weighted kappa coefficient of 0.75, respectively [ 7 ]. However, the MMSE consists of 11 items, including drawing pictures [ 7 ], and the ABC Dementia Scale of 13 items [ 19 ], which makes these measures cumbersome to use in extremely busy clinical settings in Japan, such as acute care hospitals or for mass screenings [ 5 ]. In contrast, cognitive function scores are simpler and easier-to-use, while also having sufficient reliability for use in mass screening or busy clinical settings, despite their slightly lower inter-rater reliability than the MMSE and ABC Dementia Scale.…”

Section: Discussionmentioning

confidence: 99%

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High inter-rater reliability of Japanese bedriddenness ranks and cognitive function scores: a hospital-based prospective observational study

et al. 2021

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Background The statistical validities of the official Japanese classifications of activities of daily living (ADLs), including bedriddenness ranks (BR) and cognitive function scores (CFS), have yet to be assessed. To this aim, we evaluated the ability of BR and CFS to assess ADLs using inter-rater reliability and criterion-related validity. Methods New inpatients aged ≥75 years were enrolled in this hospital-based prospective observational study. BR and CFS were assessed once by an attending nurse, and then by a social worker/medical clerk. We evaluated inter-rater reliability between different professions by calculating the concordance rate, kappa coefficient, Cronbach’s α, and intraclass correlation coefficient. We also estimated the relationship of the Barthel Index and Katz Index with the BR and CFS using Spearman’s correlation coefficients. Results For the 271 patients enrolled, BR at the first assessment revealed 66 normal, 10 of J1, 15 of J2, 18 of A1, 31 of A2, 37 of B1, 35 of B2, 22 of C1, and 32 of C2. The concordance rate between the two BR assessments was 68.6%, with a kappa coefficient of 0.61, Cronbach’s α of 0.91, and an intraclass correlation coefficient of 0.83, thus showing good inter-rater reliability. BR was negatively correlated with the Barthel Index (r = − 0.848, p < 0.001) and Katz Index (r = − 0.820, p < 0.001), showing justifiable criterion-related validity. Meanwhile, CFS at the first assessment revealed 92 normal, 47 of 1, 19 of 2a, 30 of 2b, 60 of 3a, 8 of 3b, 8 of 4, and 0 of M. The concordance rate between the two CFS assessments was 70.1%, with a kappa coefficient of 0.62, Cronbach’s α of 0.87, and an intraclass correlation coefficient 0.78, thus also showing good inter-rater reliability. CFS was negatively correlated with the Barthel Index (r = − 0.667, p < 0.001) and Katz Index (r = − 0.661, p < 0.001), showing justifiable criterion-related validity. Conclusions BR and CFS could be reliable and easy-to-use grading scales of ADLs in acute clinical practice or large-scale screening, with high inter-rater reliabilities among different professions and significant correlations with well-established, though complicated to use, instruments to assess ADLs. Trial registration UMIN000041051 (2020/7/10).

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

High inter-rater reliability of Japanese bedriddenness ranks and cognitive function scores: a hospital-based prospective observational study

et al. 2021

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“…Our previous research on the concurrent validity of ABC-DS with standard assessment scales [26] found that the correlation was 0.67, -0.64, 0.70, and -0.83 between ABC-DS scores for ADL, BPSD, CF, and TDD and 1) the corresponding scales in the Disability Assessment for Dementia (DAD), 2) the Neuropsychiatric Inventory (NPI), 3) the MMSE, and 4) Clinical Dementia Rating sum of boxes (CDR-SOB), respectively. Also, the intraclass correlation coefficient of the TDD score was 0.96, which was determined by evaluating scores measured at baseline, and those taken one week later [27].…”

Section: Abc-dsmentioning

confidence: 99%

“…We have previously validated a brief assessment scale-the "ABC Dementia Scale" (ABC-DS)-which can concurrently evaluate ADL, BPSD, and CF in ten minutes on average [26][27][28]. We developed a novel algorithm for this scale called the three-dimensional distance (TDD), for estimating the overall severity of each state while taking into account the fact that ADL, BPSD, and CF levels should explain a patient's disease condition.…”

Section: Introductionmentioning

confidence: 99%

ABC Dementia Scale Classifies Alzheimer’s Disease Patients into Subgroups Characterized by Activities of Daily Living, Behavioral and Psychological Symptoms of Dementia, and Cognitive Function

Wada‐Isoe

Kikuchi

Umeda‐Kameyama

et al. 2020

JAD

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The course of Alzheimer's disease (AD) varies between individuals, and the relationship between cognitive and functional decline and the deterioration of behavioral and psychological symptoms of dementia (BPSD) is still poorly understood. Until recently, it was challenging to monitor subsequent changes in these symptoms because there was no single composite scale available that could simultaneously evaluate activities of daily living (ADL), BPSD, and cognitive function (CF) states. The present authors developed a new, brief assessment scale, the "ABC Dementia Scale" (ABC-DS), which is based on item response theory and facilitates concurrent measurement of ADL, BPSD, and CF states. We previously presented the reliability, construct validity, concurrent validity, and responsiveness of the ABC-DS. We obtained the evidence through three clinical trials featuring 1,400 subjects in total. In the present study, we performed a secondary analysis of the data obtained in the previous study. We conducted hierarchical cluster analyses that allowed us to classify 197 AD patients in terms of similarities regarding ADL, BPSD, and CF domain scores, as measured by the ABC-DS. Consequently, the scale identified subgroups of patients with global clinical dementia ratings of 1, 2, and 3. Considering our results in conjunction with the clinical experiences of the AD expert among the present authors regarding longitudinal changes in ADL, BPSD, and CF, we were able to propose potential progression pathways of AD in the form of a hypothetical roadmap.

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“…With the rapid aging of the population in Japan, the numbers of patients with dementia will increase in the coming years. It is estimated that the number of elderly patients with dementia will rise from 4.62 million in 2012 to 7.3 million in 2025, at which time approximately 1 in 5 individuals aged 65 years or older will be affected by this disease [1].…”

Section: Introductionmentioning

confidence: 99%

Concurrent Validity of the ABC Dementia Scale with Other Standard Scales: A New Comprehensive Instrument for Assessing Dementia in Japan

Shimoda

Murata²,

Nakatani³

et al. 2020

Dement Geriatr Cogn Disord

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Background/Aims: The ABC Dementia Scale (ABC-DS), a new tool for evaluating dementia, was developed in Japan. The ABC-DS is a comprehensive instrument that can simultaneously evaluate activities of daily living (ADLs), behavioral and psychological symptoms of dementia (BPSD), and cognitive function. The ABC-DS can be administered easily and quickly and can clarify the severity of dementia and its changes over time. While the ABC-DS has been reported to be useful in Alzheimer disease (AD)-type dementia, it has not yet been studied in other types of dementia. The purpose of this study was to reevaluate the standard validity of ABC-DS separately for various dementia types and severities. Methods: We evaluated the ABC-DS in outpatients at 1 hospital in Nagasaki Prefecture and patients who use the facility. Domain A, corresponding to ADLs, correlated with Disability Assessment for Dementia (DAD); domain B, corresponding to BPSD, correlated with the Neuropsychiatric Inventory (NPI); domain C, corresponding to cognitive functions, correlated with Mini-Mental State Examination (MMSE); and the total score of the ABC-DS correlated with the Clinical Dementia Rating (CDR). Results: 102 patients, comprising 38 males and 64 females with an average age of 80.7 ± 8.6 years, were enrolled. AD-type dementia was present in 38 cases, vascular dementia (VaD) in 23, mixed dementia in 23, dementia with Lewy bodies in 6, argyrophilic grain dementia in 9, and mild cognitive impairment in 3. A strong correlation was found between ABC-DS domain scores and their respective reference neuropsychological instruments (domain A and the DAD, domain B and the NPI, domain C and the MMSE, and total score and CDR). The correlation of each ABC-DS domain score with the corresponding standard scale depended on the type and severity of dementia, and we observed moderate or high correlations in AD and VaD patients with moderate and severe dementia. Discussion: Although the ABC-DS targets AD, it can be used in VaD based on the results of this study. In other types of dementia, the results differed depending on the domain; in some conditions, the ABC-DS may not show sufficient concurrent validity with other standard scales. Also, the ABC-DS is more beneficial for moderate-to-severe dementia, as reported in previous studies. It is highly useful in clinical practice in Japan since there more than half of all patients have moderate-to-severe dementia.

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Development of a novel convenient Alzheimer's disease assessment scale, the ABC Dementia Scale, using item response theory

Cited by 17 publications

References 16 publications

High inter-rater reliability of Japanese bedriddenness ranks and cognitive function scores: a hospital-based prospective observational study

High inter-rater reliability of Japanese bedriddenness ranks and cognitive function scores: a hospital-based prospective observational study

ABC Dementia Scale Classifies Alzheimer’s Disease Patients into Subgroups Characterized by Activities of Daily Living, Behavioral and Psychological Symptoms of Dementia, and Cognitive Function

Concurrent Validity of the ABC Dementia Scale with Other Standard Scales: A New Comprehensive Instrument for Assessing Dementia in Japan

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