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Clinical staging in Swedish primary care using the Amsterdam Instrumental Activities of Daily Living Questionnaire
Ayesha Fawad1,2, Sophie M van der Landen3,4, Pontus Tideman1,2
1Clinical Memory Research Unit, Department of Clinical Sciences Malmö Lund University Lund Sweden.
Introduction:
We assessed the accuracy of the Amsterdam Instrumental Activities of Daily Living Questionnaire (A-IADL-Q) for clinical staging in Swedish primary care.
Methods:
Participants from the Swedish BioFINDER Primary Care study were included. Discriminative performance of the A-IADL-Q was evaluated using receiver operating curves. Multinomial and linear regression models assessed associations among A-IADL-Q scores, clinical stage, demographics, cognition, and comorbidities.
Results:
Among 623 patients, 148 (23.8%) had subjective cognitive decline (SCD), 274 (43.9%) mild cognitive impairment (MCI), and 201 (32.3%) dementia with a mean (standard deviation) age of 76.7 (7.3). The area under the curve (95% confidence interval) for discriminating between SCD versus MCI/dementia was 0.89 (0.86-0.91) and for SCD/MCI versus dementia 0.89 (0.87-0.92). Age (β = -0.25), Mini-Mental State Examination (β = 0.91) and Montreal Cognitive Assessment (β = 0.57), but no other demographics and comorbidities, were associated with the A-IADL-Q.
Discussion:
The A-IADL-Q may help primary care physicians determine clinical stage and shows promise for use to adequately refer patients to secondary or tertiary care.
