Do Instrumental Activities of Daily Living Predict Dementia at 1- and 2-Year Follow-Up? Findings from the Development of Screening Guidelines and Diagnostic Criteria for Predementia Alzheimer's Disease Study

Sietske A. M. Sikkes*, Pieter Jelle Visser, Dirk L Knol, Elly S. M. de Lange-de Klerk, Magda Tsolaki, Giovani B. Frisoni, Flavio Nobili, Luiza Spiru, Anne Sophie Rigaud, Lutz Froelich, Marcel Olde Rikkert, Hilkka Soininen, Jacques Touchon, Gordon Wilcock, Merce Boada, Harald Hampel, Roger Bullock, Bruno Vellas, Yolande A L Pijnenburg, Philip ScheltensFrans R. Verhey, Bernard M. J. Uitdehaag

*Corresponding author for this work

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OBJECTIVES: To investigate whether problems in instrumental activities of daily living (IADL) can add to conventionally used clinical measurements in helping to predict a diagnosis of dementia at 1- and 2-year follow-up. DESIGN: Multicenter prospective cohort study. SETTING: Memory clinics in Europe. PARTICIPANTS: Individuals aged 55 and older without dementia. MEASUREMENTS: IADLs were measured using pooled activities from five informant-based questionnaires. Structural equation modeling (SEM) was used to investigate the relation between IADLs and dementia. Age, sex, education, depression, and cognitive measures (Mini-Mental State Examination and verbal memory) were included in the model. RESULTS: Five hundred thirty-one participants had baseline and 1-year follow-up assessments; 69 (13.0%) of these had developed dementia at 1-year follow-up. At 2-year follow- up, 481 participants were seen, of whom 100 (20.8%) had developed dementia. Participants with IADL disabilities at baseline had a higher conversion rate (24.4%) than participants without IADL disabilities (16.7%) (chisquare = 4.28, degrees of freedom = 1, P =.04). SEM showed that IADL disability could help predict dementia in addition to the measured variables at 1-year follow-up (odds ratio (OR) = 2.20, 95% confidence interval (CI) = 1.51-3.13) and 2-year follow-up (OR = 2.11, 95% CI = 1.33-3.33). CONCLUSION: IADL disability is a useful addition to the diagnostic process in a memory clinic setting, indicating who is at higher risk of developing dementia at 1- and 2-year follow-up. J Am Geriatr Soc 59: 2273-2281, 2011.
Original languageEnglish
Pages (from-to)2273-2281
JournalJournal of the American Geriatrics Society
Issue number12
Publication statusPublished - Dec 2011


  • everyday functioning
  • activities of daily living
  • Alzheimer's disease
  • mild cognitive impairment
  • memory
  • structural equation modeling

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