The influence of diversity on the measurement of functional impairment: An international validation of the Amsterdam IADL Questionnaire in eight countries

Dubbelman, Mark A.; Verrijp, Merike; Facal, David; Sánchez‐Benavides, Gonzalo; Brown, Laura J. E.; Flier, Wiesje M. van der; Jokinen, Hanna; Lee, Athene; Leroi, Iracema; Lojo‐Seoane, Cristina; Milošević, Vuk; Molinuevo, José Luís; Pereiro, Arturo X.; Ritchie, Craig W.; Salloway, Stephen; Stringer, Gemma; Zygouris, Stelios; Dubois, Bruno; Epelbaum, Stéphane; Scheltens, Philip; Sikkes, Sietske A.M.

doi:10.1002/dad2.12021

Cited by 22 publications

(37 citation statements)

References 54 publications

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“…The correlations between the A-IADL-Q-SV and the clinical measures of cognition and functioning were in the magnitude and direction as hypothesized and are, therefore, in line with previous studies [15,22]. However, we observed a moderate correlation between the A-IADL-Q-SV German and age, whilst the original A-IADL-Q and A-IADL-Q-SV observed small correlations [15,18,22]. Another study on the A-IADL-Q in Spain also observed a moderate correlation of the A-IADL-Q with age [45].…”

Section: Discussionsupporting

confidence: 91%

“…The items flagged for DIF using a priori thresholds matched the items flagged using the Monte Carlo thresholds, providing support for the a priori thresholds. The findings of the DIF analysis agree with a previous investigation on item bias in eight Western countries, which indicated that the A-IADL-Q-SV was robust to cultural differences, as well as to age, sex and education [18].…”

Section: Discussionsupporting

confidence: 88%

“…Non-uniform DIF occurs when an item is easier or more difficult for one group compared to the other at the same level of the latent trait [23]. Sufficient item endorsement, defined as at least two selected response categories per item, was required for DIF analysis [18]. The DIF analysis was based on ordinal logistic regressions: for every item a null model and three hierarchically nested models were created and compared.…”

Section: Discussionmentioning

confidence: 99%

“…The findings in our study might be explained by the significantly higher age of participants with MCI and MD (and hence with significantly more IADL limitations) than participants with NC. A study investigating age as a source of item bias on the A-IADL-Q-SV found that the T-scores were not influenced by age [18].…”

Section: Discussionmentioning

confidence: 99%

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Cross-cultural adaptation and validation of the Amsterdam Instrumental Activities of Daily Living questionnaire short version German for Switzerland

Bruderer-Hofstetter

Dubbelman

Meichtry

et al. 2020

Health Qual Life Outcomes

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Background Instrumental Activities of Daily Living (IADL) limitations are associated with reduced health-related quality of life for people with mild cognitive impairment (MCI). For these people, the assessment of IADL is crucial to the diagnostic process, as well as for the evaluation of new interventions addressing MCI. The Amsterdam IADL Questionnaire Short Version (A-IADL-Q-SV) is an established assessment tool with good psychometric properties that has been shown to be robust to cultural differences in Western countries. The aims of this study were to: (1) cross-culturally adapt and validate the A-IADL-Q-SV for the German-speaking population of Switzerland; (2) investigate its cultural comparability; and (3) evaluate further psychometric properties. Methods The A-IADL-Q-SV German was pretested on clinicians and participants in a memory clinic setting. The psychometric properties and cultural comparability of the questionnaire were investigated in memory clinic settings including participants with MCI or mild dementia, as well as participants with normal cognition recruited from the community. Item response theory (IRT) was applied to investigate measurement invariance by means of differential item functioning to assess item bias. Additionally, the test–retest reliability on scale level, the construct validity through hypothesis testing and the discriminant validity of the A-IADL-Q-SV German were evaluated. Results Ninety-six informants of participants with normal cognition, MCI or mild dementia completed the A-IADL-Q-SV German. The basic assumptions for IRT scoring were met. No meaningful differential item functioning for culture was detected between the Swiss and Dutch reference samples. High test–retest reliability on scale level (ICC 0.93; 95% CI 0.9–0.96) was found. More than 75% of the observed correlations between the A-IADL-Q-SV German and clinical measures of cognition and functional status were found to be in the direction and of the magnitude hypothesized. The A-IADL-Q-SV German was shown to be able to discriminate between participants with normal cognition and MCI, as well as MCI and mild dementia. Conclusions The A-IADL-Q-SV German is a psychometrically robust measurement tool for a Swiss population with normal cognition, MCI and mild dementia. Thus, it provides a valuable tool to assess IADL functioning in clinical practices and research settings in Switzerland. Trial registration This study was registered retrospectively in July 2019 on ClinicalTrials.gov (NCT04012398).

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Cross-cultural adaptation and validation of the Amsterdam Instrumental Activities of Daily Living questionnaire short version German for Switzerland

Bruderer-Hofstetter

Dubbelman

Meichtry

et al. 2020

Health Qual Life Outcomes

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“…The A-IADL-Q is aimed at assessing cognitively complex, relevant everyday activities [ 35 ]. It has been extensively validated [ 36 – 40 ]. Item scores range from 0 (no difficulty performing the activity) to 4 (unable to perform the activity), comparing current performance to the past.…”

Section: Methodsmentioning

confidence: 99%

Decline in cognitively complex everyday activities accelerates along the Alzheimer’s disease continuum

et al. 2020

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Background Impairment in daily functioning is a clinical hallmark of dementia. Difficulties with “instrumental activities of daily living” (IADL) seem to increase gradually over the course of Alzheimer’s disease (AD), before dementia onset. However, it is currently not well established how difficulties develop along the preclinical and prodromal stages of AD. We aimed to investigate the trajectories of decline in IADL performance, as reported by a study partner, along the early stages of AD. Methods In a longitudinal multicenter study, combining data from community-based and memory clinic cohorts, we included 1555 individuals (mean age 72.5 ± 7.8 years; 50% female) based on availability of amyloid biomarkers, longitudinal IADL data, and clinical information at baseline. Median follow-up duration was 2.1 years. All amyloid-positive participants (n = 982) were classified into the National Institute on Aging–Alzheimer’s Association (NIA-AA) clinical stages ranging from preclinical AD (1) to overt dementia (4+). Cognitively normal amyloid-negative individuals (n = 573) served as a comparison group. The total scores of three study-partner reported IADL questionnaires were standardized. Results The rate of decline in cognitively normal (stage 1) individuals with and without abnormal amyloid did not differ (p = .453). However, from stage 2 onwards, decline was significantly faster in individuals on the AD continuum (B [95%CI] = − 0.32 [− 0.55, − 0.09], p = .007). The rate of decline increased with each successive stage: one standard deviation (SD) unit per year in stage 3 (− 1.06 [− 1.27, − 0.85], p < .001) and nearly two SD units per year in stage 4+ (1.93 [− 2.19, − 1.67], p < .001). Overall, results were similar between community-based and memory clinic study cohorts. Conclusions Our results suggest that the rate of functional decline accelerates along the AD continuum, as shown by steeper rates of decline in each successive NIA-AA clinical stage. These results imply that incremental changes in function are a meaningful measure for early disease monitoring. Combined with the low-cost assessment, this advocates the use of these functional questionnaires for capturing the effects of early AD-related cognitive decline on daily life.

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Outcome measures for Alzheimer's disease: A global inter‐societal Delphi consensus

Ellison¹,

Cappa

Garrett

et al. 2023

Alzheimer's & Dementia

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Introduction We aim to provide guidance on outcomes and measures for use in patients with Alzheimer's clinical syndrome. Methods A consensus group of 20 voting members nominated by 10 professional societies, and a non‐voting chair, used a Delphi approach and modified GRADE criteria. Results Consensus was reached on priority outcomes (n = 66), measures (n = 49) and statements (n = 37) across nine domains. A number of outcomes and measurement instruments were ranked for: Cognitive abilities; Functional abilities/dependency; Behavioural and neuropsychiatric symptoms; Patient quality of life (QoL); Caregiver QoL; Healthcare and treatment‐related outcomes; Medical investigations; Disease‐related life events; and Global outcomes. Discussion This work provides indications on the domains and ideal pertinent measurement instruments that clinicians may wish to use to follow patients with cognitive impairment. More work is needed to develop instruments that are more feasible in the context of the constraints of clinical routine.

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The influence of diversity on the measurement of functional impairment: An international validation of the Amsterdam IADL Questionnaire in eight countries

Cited by 22 publications

References 54 publications

Cross-cultural adaptation and validation of the Amsterdam Instrumental Activities of Daily Living questionnaire short version German for Switzerland

Cross-cultural adaptation and validation of the Amsterdam Instrumental Activities of Daily Living questionnaire short version German for Switzerland

Decline in cognitively complex everyday activities accelerates along the Alzheimer’s disease continuum

Outcome measures for Alzheimer's disease: A global inter‐societal Delphi consensus

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