Importance of a functional measure in the evaluation of patients in a memory clinic: Validation of the Serbian version of the Amsterdam instrumental activities of daily living questionnaire.

INTRODUCTION AND AIM

The Amsterdam instrumental activities of daily living questionnaire (A-IADL-Q) was developed as a sensitive tool in detecting a functional decline in early dementia. The aim of our study was to analyze the validity and reliability of the Serbian translation of the short version of A-IADL-Q in a population of memory clinic patients.

MATERIAL AND METHODS

We have included 160 subjects with Alzhemier's disease (AD) dementia, mild cognitive impairment (MCI), or normal cognition (NC). All patients were examined by a neurologist, screened for cognitive impairment (MMSE) and depression, and referred to laboratory testing, neuroimaging examination, and neuropsychological assessment. Informants (close friends or relatives) completed Serbian language versions of the A-IADL-Q -Short version and the Lawton-Brody Instrumental Activities of Daily Living (LB-IADL) scale. Reliability analysis was performed by assessing internal consistency and reproducibility (test-retest reliability). Construct validity was assessed as the impact of gender, аgе, education, diagnosis, cognitive and functional measures on A-IADL-Q scores.

RESULTS

The internal consistency of the Serbian version of A-IADL-Q was acceptable (Cronbach's alpha 0.82), Test-retest reliability of the A-IADL-Q was excellent (ICC=0.92, 95% CI 0.84-0.98, p < 0.001). There was no statistically significant difference in A-IADL-Q scores between male and female subjects (t = 1.183; p = 0.241), while the difference was registered between subjects with different education levels (F=12.955; p < 0.001) and diagnosis (F=209.433; p < 0.001). There was a strong and statistically significant correlation between A-IADL-Q and MMSE scores (tau-b= 0.638; p < 0.001) and IADL-Q and LB-ADL scores (tau-b=0.714; p < 0.001). A significant multiple regression model was found (F(4, 155) = 103.692;p < 0.001), which explained 72.1% of the A-IADL-Q score variance with MMSE score and age as significant predictors.

CONCLUSION

The Serbian adaptation of the A-IADL-Q-short version is a reliable and valid measure of instrumental activities of daily living in patients with dementia and mild cognitive impairment. This easy-to-administer instrument is useful for the early diagnostics of dementia syndrome in a memory clinic population.