Informant‐based tools for assessment and monitoring of cognition, behavior, and function in neurocognitive disorders: Systematic review and report from a CCCDTD5 Working Group

Abstract

Objective As part of the fifth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia, we assessed the literature on informant‐based tools for assessment and monitoring of cognition, behavior, and function in neurocognitive disorders (NCDs) to provide evidence‐based recommendations for clinicians and researchers. Methods A systematic review was conducted following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses standards guidelines. Publications that validated the informant‐based tools or described their key properties were reviewed. Quality of the studies was assessed using the modified Quality Assessment tool for Diagnostic Accuracy Studies. Results Out of 386 publications identified through systematic search, 34 that described 19 informant‐based tools were included in the final review. Most of these tools are backed by good‐quality studies and are appropriate to use in clinical care or research. The tools vary in their psychometric properties, domains covered, comprehensiveness, completion time, and ability to detect longitudinal change. Based on these properties, we identify different tools that may be appropriate for primary care, specialized memory clinic, or research settings. We also identify barriers to use of these tools in routine clinical practice. Conclusion There are several good‐quality tools available to collect informant‐report for assessment and monitoring of cognition, behavior, or function in patients with NCDs. Clinicians and researchers may choose a particular tool based on their specific needs such as domains of interest, desired psychometric properties, and feasibility. Further work is needed to make the tools more user‐friendly and to adopt them into routine clinical care.

Decision making under uncertainty in the diagnosis and management of Alzheimer's Disease in primary care: A study protocol applying concepts from neuroeconomics

“…Since 1989, the Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD) has been generating clinical guidelines for dementia care, with the 5 th iteration published in 2020 ( 2 ). Eight topics were addressed including: (1) utility of the National Institute on Aging research framework for clinical Alzheimer's disease (AD) diagnosis ( 14 ); (2) updating diagnostic criteria for vascular cognitive impairment, and its management ( 15 ); (3) dementia case finding and detection ( 16 , 17 ); (4) neuroimaging and fluid biomarkers in diagnosis ( 18 ); (5) use of non-cognitive markers of dementia for better dementia detection ( 19 ); (6) risk reduction/prevention ( 20 ); (7) psychosocial and non-pharmacological interventions ( 21 ); and (8) deprescription of medications used to treat dementia ( 22 ). Many of these themes and recommendations can be implemented primary care.…”

Diagnostic accuracy of Ascertain Dementia 8-item Questionnaire by participant and informant–A systematic review and meta-analysis

“…A cut-off score of two or greater suggests that a patient may have CI and should undergo further evaluation and diagnosis [ 7 ]. AD8 has been recommended by a subgroup of the fifth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia as a potential informant-based tool to assess the cognition and function of patients suspected of neurocognitive disorders in clinical settings [ 9 ]. The AD8 has also been validated for use as a self-completed CI screening tool [ 10 ].…”