Use of Dementia Assessment Sheet for Community‐based Integrated Care System 8‐items (DASC‐8) for the screening of frailty and components of comprehensive geriatric assessment

Abstract

Aim We examined whether the Dementia Assessment Sheet for Community‐based Integrated Care System 8‐items (DASC‐8) is useful for screening frailty and as a comprehensive geriatric assessment (CGA). Methods Outpatients (N = 431; 269 women; Mage = 78.9 ± 6.8 years) with cardiometabolic disease from a frailty clinic participated. Frailty status was assessed using modified Cardiovascular Health Study criteria, the Clinical Frailty Scale and the Kihon Checklist. Cognition, higher‐level activities of daily living, sarcopenia, physical activities, depression, nutrition, medication adherence, social network and quality of life were assessed as CGA components. We examined the association of DASC‐8 category with frailty or CGA components using multiple logistic regression analyses, adjusted for age and sex. Results Most participants (n = 310, 71.9%) were in Category I, 90 (20.9%) were in Category II and 31 (7.1%) were in Category III. There were no significant differences in sex, body mass index, or past medical history, except regarding age or cerebral infarction. Logistic regression analyses showed that, for all definitions of frailty, the odds ratios of frailty significantly increased as category progressed. Cognitive function, higher‐level activities of daily living, handgrip strength, gait speed, physical activities, medication adherence, social network and quality of life decreased as the category increased. Although depressive tendency increased in Category II, there was no significant difference in muscle mass or prevalence of sarcopenia among the categories. Malnutrition was observed in Category III. Conclusions DASC‐8 category was associated with frailty and several CGA components in older patients with cardiometabolic disease. Geriatr Gerontol Int 2020; 20: 1157–1163.

Nutrition Management in Older Adults with Diabetes: A Review on the Importance of Shifting Prevention Strategies from Metabolic Syndrome to Frailty

“…The Dementia Assessment Sheet for Community-based Integrated Care System-8 items (DASC-8) is an eight-item questionnaire based on IADL, BADL, and cognition [188], which has been used for the classification into the following three categories to determine glycemic targets in older Japanese adults with diabetes [5]: category I: intact cognitive function and no impairment of ADL, category II: mild cognitive impairment to mild dementia or impairment(s) of instrumental ADL, category III: moderate or severe dementia or impairment(s) of basic ADL or presence of multiple comorbidities or functional impairments. Because the prevalence rates of frailty and sarcopenia increase with more severe DASC-8 categories, those in DASC-8 categories II (11-16 points) and III (≥17 points) might be candidates for the prescription of a diet to prevent frailty [189].…”

“…and sarcopenia increase with more severe DASC-8 categories, those in DASC-8 categories II (11-16 points) and III (≥17 points) might be candidates for the prescription of a diet to prevent frailty [189].…”

Agreement on dementia severity levels between the 8‐item and 21‐item Dementia Assessment Sheet for Community‐based Integrated Care System

“…Seigo Mitsutake, 1 Tatsuro Ishizaki, 1 Ko Furuta, 2 Akira Hatakeyama, 3 Mika Sugiyama, 4 Shuichi Awata, 4 Kenji Toba 5 and Hideki Ito 5 1 Human Care Research Team, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan 2 Department of Psychiatry, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan 3 Dementia Support Center, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan 4 Research Team for Promoting Independence of the Elderly, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan 5 Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan Kihon Checklist: Thai version Dear Editor, After long-term care insurance was introduced in Japan in the year 2000, it became clear that a tool was needed to screen those at risk for dependence. 1 To that end, the Kihon Checklist (KCL) was introduced by the Japanese Ministry of Health, Labor and Welfare in 2006.…”

“…4 DASC-8 has also been applied to frailty screenings and comprehensive geriatric assessments in outpatient care. 5 Although DASC-8 was developed based on DASC-21, these tools employ different definitions of the presence and severity of impairments in daily living and cognitive function. 2,4 DASC-21 determines the risk of dementia and classifies patients into the following four categories as specified in the DASC-21 assessment manual: no dementia, low-level dementia, medium-level dementia, and serious-level dementia.…”

“…6 In contrast, DASC-8 classifies patients into the following three categories: Category I: no functional impairment of daily living and no cognitive impairment; Category II: mild cognitive impairment (MCI) or instrumental activities of daily living impairment and no basic activities of daily living (BADL) impairment; and Category III: moderate or severe dementia and BADL impairment. 4,5 Because DASC-8 is easier to use than DASC-21, ascertaining the agreement on dementia risk and severity between these tools may support clinical assessments of dementia among older inpatients on admission. We examined the agreement on dementia classifications between DASC-8 and DASC-21.…”