The Interview for Deterioration in Daily Living Activities in Dementia: Agreement Between Primary and Secondary Caregivers

Abstract

Inability to perform activities of daily life is inherent to dementia and an essential component of its severity. Examination of this disability is crucial for diagnosis, management of the patient and family, and evaluation of treatment effects. To examine everyday disability in community-dwelling patients with mild dementia, we developed the Interview for Deterioration in Daily living Activities in Dementia (IDDD) at the memory clinic of the Academic Medical Center at Amsterdam. The IDDD is a caregiver-based measure, which consists of 20 concretely worded items, reflecting the initiative to perform and actual performance of self-care and more complex activities. The original version of the IDDD (1988) was an interview measure, but since 1990 a paper-and-pencil version has been used, which has good construct validity and test-retest reliability, as well as good responsiveness to deterioration over 6 months. In the present study, we examined interobserver agreement among 25 caregiver pairs, which consisted of primary and secondary caregivers. Although the reliability of caregiver reports is often questioned, we found substantial to almost perfect agreement at subscale level and acceptable agreement for most of the items. We conclude that the paper-and-pencil version of the IDDD is a suitable instrument for the description and discrimination of disability among patients with mild dementia still living at home. The IDDD may also be a useful method to incorporate in clinical trials and longitudinal studies.

Identification of Responders to Rivastigmine: A Prospective Cohort Study

“…Patients were evaluated clinically by the same neurologist (AWL) at baseline, at 3 months and 6 months after receiving rivastigmine. Clinical tests included: MMSE; Interview for Deterioration in Daily Living (IDDD), an 11-item paper-and-pencil questionnaire, which is completed by the caregiver, covering self-care activities such as dressing and eating, and complex instrumental activities such as shopping and taking care of financial affairs, total scores range from 0 (no assistance required for any activity) to 44 (always assistance required for all activities) [29] ; NPI, a widely used measure of dementia-associated neuropsychiatric disturbances [30] ; Unified Parkinson Disease Rating Scale-motor part (UPDRS-III) [31] ; and the Clinician Assessment of Fluctuation (CAF), a series of screening questions regarding fluctuating confusion and impaired consciousness, producing a severity score from 0 to 12 (0 representing no fluctuating confu-sion, 12 representing severe fluctuating confusion) [32] . Medication doses and side effects were noted separately.…”

Development of a core outcome set for disease modification trials in mild to moderate dementia: a systematic review, patient and public consultation and consensus recommendations

“…The 33 items are assessed on a seven-point scale. 319 It was initially designed for use in a 15-minute carer interview, but there is now a self-complete version for the carer.…”

Profinteg: A Tool for Real-Life Assessment of Activities of Daily Living in Patients with Cognitive Impairment

“…A large number of assessment scales have been developed to assess IADL (Burns, Lawlor, & Craig, 2004;Keith, Granger, Hamilton, & Sherwin, 1987;Lindeboom, Vermeulen, Math, & De Haan, 2003;Moore, Palmer, Patterson, & Jeste, 2007;Sikkes, de Lange-de Klerk, Pijnenburg, Scheltens, & Uitdehaag, 2009;Teunisse & Derix, 1997;Voigt-Radloff, Leonhart, Schützwohl, Jurianz, Reuster, Gerner et al, 2012). The typical purposes of these scales are to screen a population in terms of general levels of functional independence and to assess the severity of symptoms for a small number of activities (Athlin, Norberg, Axelsson, Moller, & Nordstrom, 1989;Beck, 1988;Galasko, Bennett, Sano, Ernesto, Thomas, Grundman et al, 1997;Kuriansky & Gurland, 1976;Lawton & Brody, 1969;Loewenstein, Amigo, Duara, Guterman, Hurwitz, Wilkie et al, 1989;LucasBlaustein, Filipp, Dungan, & Tune, 1988;Oakley, Sunderland, Hill, Phillips, Makahon, & Ebner, 1991;Teunisse & Derix, 1997).…”

“…The typical purposes of these scales are to screen a population in terms of general levels of functional independence and to assess the severity of symptoms for a small number of activities (Athlin, Norberg, Axelsson, Moller, & Nordstrom, 1989;Beck, 1988;Galasko, Bennett, Sano, Ernesto, Thomas, Grundman et al, 1997;Kuriansky & Gurland, 1976;Lawton & Brody, 1969;Loewenstein, Amigo, Duara, Guterman, Hurwitz, Wilkie et al, 1989;LucasBlaustein, Filipp, Dungan, & Tune, 1988;Oakley, Sunderland, Hill, Phillips, Makahon, & Ebner, 1991;Teunisse & Derix, 1997). This restriction does not offer the clinician the opportunity to establish a complete profile of the patient's difficulties, while s/he is still attempting to carry out many daily activities.…”

“…This restriction does not offer the clinician the opportunity to establish a complete profile of the patient's difficulties, while s/he is still attempting to carry out many daily activities. Secondly, a number of scales rate each activity as a function of global autonomy scores, but they do not consider the sub-activities of an entire activity (Bucks, Ashworth, Wilcock, & Siegdried, 1996;Galasko et al, 1997;Hindmarch, Lehfeld, De Jongh, & Erzigkeit, 1998;Lawton & Brody, 1969;Linn & Linn, 1982;Mahurin, DeBettignies, & Pirozzolo, 1991;Teunisse & Derix, 1997). Only a few consider sub-activities (Gélinas, Gauthier, McIntyre, & Gauthier, 1999;Loewenstein et al, 1989;Patterson, Mack, Neundorfer, Martin, Smyth, & Whitehouse, 1992;Skurla, Rogers, & Sunderland, 1988;Tappen, 1994).…”