The IQCODE: Using Informant Reports to Assess Cognitive Change in the Clinic and in Older Individuals Living in the Community


Compared with 10 years ago how is this person at:
 
1

2

3

4

5

1. Remembering things about family and friends e.g. occupations, birthdays, addresses

Much improved

A bit improved

Not much change

A bit worse

Much worse

2. Remembering things that have happened recently

Much improved

A bit improved

Not much change

A bit worse

Much worse

3. Recalling conversations a few days later

Much improved

A bit improved

Not much change

A bit worse

Much worse

4. Remembering his/her address and telephone number

Much improved

A bit improved

Not much change

A bit worse

Much worse

5. Remembering what day and month it is

Much improved

A bit improved

Not much change

A bit worse

Much worse

6. Remembering where things are usually kept

Much improved

A bit improved

Not much change

A bit worse

Much worse

7. Remembering where to find things which have been put in a different place from usual

Much improved

A bit improved

Not much change

A bit worse

Much worse

8. Knowing how to work familiar machines around the house

Much improved

A bit improved

Not much change

A bit worse

Much worse

9. Learning to use a new gadget or machine around the house

Much improved

A bit improved

Not much change

A bit worse

Much worse

10. Learning new things in general

Much improved

A bit improved

Not much change

A bit worse

Much worse

11. Following a story in a book or on TV

Much improved

A bit improved

Not much change

A bit worse

Much worse

12. Making decisions on everyday matters

Much improved

A bit improved

Not much change

A bit worse

Much worse

13. Handling money for shopping

Much improved

A bit improved

Not much change

A bit worse

Much worse

14. Handling financial matters e.g. the pension, dealing with the bank

Much improved

A bit improved

Not much change

A bit worse

Much worse

15. Handling other everyday arithmetic problems e.g. knowing how much food to buy, knowing how long between visits from family or friends

Much improved

A bit improved

Not much change

A bit worse

Much worse

16. Using his/her intelligence to understand what’s going on and to reason things through

Much improved

A bit improved

Not much change

A bit worse

Much worse



Adapted versions of the IQCODE have also been produced to allow assessment in other languages (Arabic, Chinese, Dutch, Finnish, French, Canadian French, German, Italian, Japanese, Korean, Norwegian, Persian, Polish, Portuguese, Spanish, Thai and Turkish) or based on shorter [35] or more flexible [6] time frames than 10 years. Short forms of the IQCODE are also available in Spanish [7], Chinese [8], Portuguese [9] and in other languages (which to our knowledge have not been validated). In addition, in a recent review of the literature on dementia screening instruments suitable for self- or informant-assessment, particularly in a format that could be applicable for digital administration (e.g. computer-based or on the internet), the IQCODE was found to be one of three most promising instruments which warranted further validation for delivery on digital platforms [10].



13.3 Administration and Scoring


The IQCODE takes 10–25 min to complete depending on the form chosen (long/short) and whether it is administered in pen and paper form or electronically. It is generally perceived as easy to answer and can be mailed to informants or administered by telephone or by computer (although we are not aware of any validation data with non-pen-and-paper administration media).

Scoring the IQCODE requires adding up all ratings and dividing by the number of items, thus yielding a measure ranging from 1 to 5. An alternative scoring strategy used by some investigators involves using the sum of all responses as a summary measure. Norms have been developed by Jorm and Jacomb for 5-year age groups from 70 to 85+ years [11]. However, the use of an absolute cut-off, ranging from 3.3 to 3.6 in community samples to 3.4–4.0 in patient samples, is typically preferred and easier to communicate. A practical way of selecting a valid and effective cut-off is to identify studies (see Table 13.2) with characteristics most similar to the target population in the planned study and apply their cut-offs. Alternatively a weighted average computed from Table 13.2, of 3.3 for community samples and of 3.5 in patient samples, is also defensible (also note below, see Sect. 13.6, findings from systematic reviews which are consistent with the approach suggested above).


Table 13.2
Performance of the MMSE, and the long and short versions of the IQCODE as screening tests for dementia














































































































































































































































































































































































































































































































































































































Study

Sample

Diagnostic criteria

Cutoff

N

Mean age/age range

Sens.

Spec.

ROC curve

MMSE

Bustamante et al. (2003) [12]

Hospital out-patients and controls (Brazil)

1, 4

25/26

76

71

0.80

0.91


Callahan et al. (2002) [13]

Epidemiological study (USA)

1

23/24

344

74

0.95

0.87

0.96

Ferrucci et al. (1998) [14]

Geriatric clinic patients (Italy)

2

23/24

104

75

0.97

0.55


Flicker et al. (1997) [15]

Memory clinic patients (young, Australia)

1, 5

21/22

299

73

0.91

0.82


Flicker et al. (1997) [15]

Memory clinic patients (old, Australia)

1, 5

21/22

78

80

0.75

0.71


Forcano Garcia et al. (2002) [16]

Geriatric clinic patients (Spain)

1, 5

23/24

103

78

0.81

0.85

0.86

Gonçalves et al. (2011) [17]

Memory clinic patients (Australia)

2, 5

24/25

204

77

0.83

0.73

0.82

Isella et al. (2006) [18]

Cognitively normal volunteers and 45 MCI patients (Italy)

6

27/28

100

71

0.82

0.73


Jorm et al. (1996) [19]

Ex-servicemen (half former prisoners of war) (Australia)
 
23/24

144

73

0.45

0.99

0.81

Knafelc et al. (2003) [20]

Memory clinic patients (Australia)

1

23/24

323

75

0.84

0.73

0.86

Li et al. (2012) [21]

Neurology clinic patients with MCI (China)

6

26/27

928

70

0.89

0.76

0.85

Li et al. (2012) [21]

Neurology clinic patients with mild AD (China)

5, 8

24/25

554

70

0.81

0.84

0.91

MacKinnon et al. (1998) [22]

Memory clinic patients (Switzerland)

2, 5

23/24

106

80

0.76

0.90


Morales et al. (1997) [23]

Urban epidemiological study (Spain)

1

21/22

97

75

0.73

0.78


Morales et al. (1997) [23]

Rural epidemiological study (Spain)

1

21/22

160

74

0.83

0.74


Nasreddine et al. (2005) [24]

Memory clinic patients (Canada)

2

25/26

183

75

0.78

1.00


Perroco et al. (2008) [9]

Old Age Clinic Patients with low education (Brazil)

1, 4

25/26

91

71

0.94

0.78

0.94

Swearer et al. (2002) [25]

Primary care clinic outpatients and independent retirement community residents (USA)

2

23/24

46

80

0.13

1.00


IQCODE (Long Version)

Bustamante et al. (2003) [12]

Hospital out-patients and controls (Brazil)

1, 4

3.41+

76

71

0.83

0.97


De Jonghe et al. (1997) [26]

Psychiatric patients (49 with dementia) (Netherlands)

1

3.90+

82

78

0.88

0.79


Del-Ser et al. (1997) [27]

Neurology clinic outpatients (Spain)

1

3.62+

53

69

0.84

0.73

0.81

Flicker et al. (1997) [15]

Memory clinic patients (young, Australia)

1, 5

3.90+

299

73

0.74

0.71


Flicker et al. (1997) [15]

Memory clinic patients (old, Australia)

1, 5

3.90+

78

80

0.79

0.78


Fuh et al. (1995) [8]

Non-demented community resident and dementia patients (Taiwan)

1

3.40+

399

69

0.89

0.88

0.91

Hancock and Larner (2009) [28]

Memory clinic patients

2, 5

3.60+

144

67

0.86

0.39

0.71

Isella et al. (2006) [18]

Cognitively normal volunteers and 45 MCI neuropsychology out-patients (Italy)

6

3.45

100

71

0.84

0.75


Jorm et al. (1991) [29]

Patients seen by a geriatrician (Australia)

3, 4

3.60+

69

80

0.80

0.82

0.87

Jorm et al. (1994) [2]

Epidemiological study (Australia)

1

3.60+

684

70

0.69

0.80

0.77

Jorm et al. (1996) [19]

Ex-servicemen (half former prisoners of war) (Australia)

3

3.30+

144

73

0.79

0.65

0.77

Law and Wolfson (1995) [30]

Epidemiological study (Canada)

1

3.30+

237

81

0.76

0.96


Lim et al. (2003) [31]

Cognitively normal volunteers and 53 dementia patients (Singapore)

2

3.40+

153


0.94

0.94


Morales et al. (1997) [23]

Urban epidemiological study (Spain)

1

3.27+

97

75

0.82

0.90

0.89

Morales et al. (1997) [23]

Rural epidemiological study (Spain)

1

3.31+

160

74

0.83

0.83

0.83

Mulligan et al. (1996) [32]

Geriatric patients (Switzerland)

1

3.60+

76

82

0.76

0.70

0.86

Perroco et al. (2008) [9]

Old Age Clinic Patients with low education (Brazil)

1, 4

3.53+

91

71

0.85

1.00

0.94

Siri et al. (2006) [33]

Geriatric clinic patients (Thailand)

2, 5

3.42+

100

73

0.90

0.95

0.98

Stratford et al. (2003) [34]

Memory clinic patients (Australia)

4

4.00+

577

73



0.82

Tang et al. (2003) [35]

Stroke patients (China)

2

3.40+

189

68

0.88

0.75

0.88

Tokuhara et al. (2006) [36]

Japanese American primary care patients

5

3.40+

230


1.0

0.87


IQCODE (Short version)

Ayalon (2011) [5]

Epidemiological study (USA)

1, 2

3.30+

462

80

0.77

0.93

0.89

Ayalon (2011) [5]

Epidemiological study (USA)

7

3.30+

441

79

0.55

0.93

0.89

Del-Ser et al. (1997) [27]

Neurology clinic outpatients (Spain)

1

3.88

53

69

0.79

0.73

0.77

Forcano Garcia et al. (2002) [16]

Geriatric clinic patients (Spain)

1, 5

3.62+

103

78

0.82

0.81

0.91

Gonçalves et al. (2011) [17]

Memory clinic patients (Australia)

2, 5

4.20+

204

77

0.72

0.67

0.77

Harwood et al. (1997) [37]

Medical inpatients (England)

1

3.44

177

65+

1.00

0.86


Jorm et al. (1994) [2]

Epidemiological study (Australia)

1

3.38

684

70+

0.79

0.82

0.85

Jorm et al. (1996) [19]

Ex-servicemen (half former prisoners of war) (Australia)

3

3.38+

144

73

0.75

0.68

0.77

Knafelc et al. (2003) [20]

Memory clinic patients (Australia)

1

3.60+

323

44–93

0.94

0.47

0.82

Li et al. (2012) [21]

Neurology clinic patients with MCI (China)

6

3.19+

928

70

0.98

0.71

0.87

Li et al. (2012) [21]

Neurology clinic patients with mild AD (China)

5, 8

3.31+

554

70

0.89

0.78

0.90

MacKinnon et al. (1998) [22]

Memory clinic patients (Switzerland)

2, 5

3.60+

106

80

0.90

0.65


Narasimhalu et al. (2008) [38]

Dementia clinic patients and stroke patients (Singapore)

2

3.38+

576

66

0.78

0.86

0.89

Perroco et al. (2008) [9]

Old Age Clinic Patients with low education (Brazil)

1, 4

3.53+

91

71

0.85

1.00

0.96

Phung et al. (2015) [39]

(Lebanon)

2

3.35+

236

65+

0.92

0.94
 

IQCODE-MMSE (3MS) (Combined)

Bustamante et al. (2003) [12]

Hospital out-patients and controls (Brazil)

1, 4

25/26 or 3.41+

76

71

0.83

0.98


Flicker et al. (1997) [15]

Memory clinic patients (young, Australia)

1, 5

21/22 or 4+

299

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Jun 27, 2017 | Posted by in NEUROLOGY | Comments Off on The IQCODE: Using Informant Reports to Assess Cognitive Change in the Clinic and in Older Individuals Living in the Community

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