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 [3–5] 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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