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Lookup NU author(s): Dr Stella-Maria Paddick,
Dr Catherine Dotchin,
Professor Richard Walker
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
Background: The dementia diagnosis gap in sub-Saharan Africa (SSA) is large, partly due to difficulties in assessing function, an essential step in diagnosis.Objectives: As part of the Identification and Intervention for Dementia in Elderly Africans (IDEA) study, to develop, pilot, and validate an Instrumental Activities of Daily Living (IADL) questionnaire for use in a rural Tanzanian population to assist in the identification of people with dementia alongside cognitive screening.Design: The questionnaire was developed at a workshop for rural primary healthcare workers, based on culturally appropriate roles and usual activities of elderly people in this community. It was piloted in 52 individuals under follow-up from a dementia prevalence study. Validation subsequently took place during a community dementia-screening programme. Construct validation against gold standard clinical dementia diagnosis using DSM-IV criteria was carried out on a stratified sample of the cohort and validity assessed using area under the receiver operating characteristic (AUROC) curve analysis.Results: An 11-item questionnaire (IDEA-IADL) was developed after pilot testing. During formal validation on 130 community-dwelling elderly people who presented for screening, the AUROC curve was 0.896 for DSM-IV dementia when used in isolation and 0.937 when used in conjunction with the IDEA cognitive screen, previously validated in Tanzania. The internal consistency was 0.959. Performance on the IDEA-IADL was not biased with regard to age, gender or education level.Conclusions: The IDEA-IADL questionnaire appears to be a useful aid to dementia screening in this setting. Further validation in other healthcare settings in SSA is required.
Author(s): Collingwood C, Paddick SM, Kisoli A, Dotchin CL, Gray WK, Mbowe G, Mkenda S, Urasa S, Mushi D, Chaote P, Walker RW
Publication type: Article
Publication status: Published
Journal: Global Health Action
Online publication date: 29/12/2014
Acceptance date: 01/12/2014
Date deposited: 11/09/2015
ISSN (print): 1654-9880
Publisher: CO-ACTION PUBLISHING
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