The Development and Validation of Korean Dementia Screening Questionnaire (KDSQ)

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1 The Development and Validation of Korean Dementia Screening Questionnaire (KDSQ) Dong Won Yang, M.D., Belong Cho, M.D.*, Jean Yung Chey, Ph.D., Sang Yun Kim, M.D., Beum Saeng Kim, M.D. Department of Neurology, College of Medicine, Catholic University of Korea Department of Family Medicine*& neurology, Seoul National University College of Medicine, Department of Psychology, Seoul National University Background : Dementia Screening Questionnaire is sensitive to detect early dementia patients and is not influenced by age and educational level. We conducted a case-control study to assess the validity and reliability of the Korean Dementia Screening Questionnaire (KDSQ) for the diagnosis of early dementia. Methods : We developed KDSQ in a semi-structured manner with the questionnaire of 15 items about cognitive dysfunctions and 5 items of ischemic and depression scales respectively to evaluate the possibility of vascular dementia and degree of depression. It was administrated to informants of 72 dementia patients (39 Alzheimer s disease, 33 vascular dementia) with Clinical Dementia Rating (CDR) scales of 0.5, or 1.0 and to those of 66 hospital control subjects. Test-retest data for the KDSQ were obtained from informants within a time interval of days. Results : The KDSQ was not influenced by education level, age, or sex. KDSQ score correlated with the K-MMSE (r=-0.75) and Short form Samsung Dementia Questionnaire (r=0.80). The area under the receiver operating characteristic curve for the KDSQ was 88.9% (S.E.=0.028). KDSQ depression score was correlated with Geriatric Depression Scale (r=0.34). With respect to a diagnosis of dementia, the KDSQ (cut-off point 6) had a sensitivity of 79% and a specificity of 80%. The KDSQ was found to have a high test-retest reliability (r=0.81) Conclusions : The KDSQ has high validity and reliability for the diagnosis of early dementias. It may be a useful tool to screen early stage of dementias. J Korean Neurol Assoc 20(2):000~000, 2002 Key Words : Dementia, Screening, Questionnaire, Alzheimer s disease, Vascular dementia Sang Yun Kim, M.D. Copyright 2002 by the Korean Neurological Association 1

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4 Figure 1. The receiver operating characteristic curve of the KDSQ. Table 1. Demographic data of the subjects Dementia patients (N=72) Control subjects (N=66) Age(yr) 68.63± ±5.99 Sex(male, female) M:38, F: 34 M:36, F: 30 Education(yr) 9.74± ±4.50 Informant Spouse Children+daughter-in-law Others 7 4 K-MMSE* 22.58± ±1.41 K-MMSE: Korean Mini-mental State Examination, yr: year Data are presented as mean±standard deviation *P<0.001 Table 2. Correlation among KDSQ, K-MMSE, SSDQ, KDSQ-D Scales r p-value KDSQ vs. K-MMSE <0.001 KDSQ vs. S-SDQ 0.80 <0.001 KDSQ-D vs. S-GDS 0.34 <0.010 KDSQ-D vs. KDSQ 0.50 <0.001 HIS vs. KDSQ-H 0.39 <0.001 KDSQ vs. KDSQ-retest 0.81 <0.010 K-MMSE: Korean Mini-mental State Examination KDSQ-D: KDSQ Depression score S-GDS: Short form Geriatric Depression Scale HIS: Hachinski Ischemic Score KDSQ-H: KDSQ Ischemic score S-SDQ: Short form Samsung Dementia Questionnaire 4 J Korean Neurol Assoc / Volume 20 / March, 2002

5 Table 3. Sensitivities and specificities for the KDSQ at selected cutting points Cutting point Sensitivity Specificity J Korean Neurol Assoc / Volume 20 / March,

6 1992;45(6): Kawas C, Segal J, Stewart WF, Corrada M, Thal LJ. A 11. Kang YW, Na DL, Hahn SH. A validity study on the Korean mini-mental state examination (K-MMSE) in dementia patients. J Korean Neurol Assoc ; 1 5 ( 2 ) : Choi SH. Introduction of dementia screening questionnaire, activities of daily living (ADL), and Neuropsychiatric Inventory (NPI). J Korean Neurol Assoc ; s u p l. 2 : Uhlmann RF, Larson EB. Effect of education on the minimental state examination as a screening test for dementia. J Am Geriatr Soc 1991;39(9): Tombaugh TN, McIntyre NJ. The mini-mental state exam - ination: a comprehensive review. J Am Geriatr Soc 1992;40(9): Roman GC, Royall DR. Executive control function: a rational basis for the diagnosis of vascular dementia. Alzheimer Dis Assoc Disord 1999;13 Suppl 3:S Jorm AF, Korten AE. Assessment of cognitive decline in the elderly by informant interview. Br J Psychiatry 1988;152: Morales JM, Gonzalez-Montalvo JI, Bermejo F, Del-Ser T. The screening of mild dementia with a shortened Spanish version of the Informant Questionnaire on Cognitive Decline in the Elderly. Alzheimer Dis Assoc Disord 1995;9(2): Fuh JL, Teng EL, Lin KN, Larson EB, Wang SJ, Liu CY, et al. The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) as a screening tool for dementia for a predominantly illiterate Chinese population. N e u r o l o g y 1995 ; 45 ( 1 ): Ritchie K, Fuhrer R. A comparative study of the performance of screening tests for senile dementia using receiver operating characteristics analysis. J Clin Epidemiol validation study of the Dementia Questionnaire. A r c h Neurol 1994;51(9): Silverman JM, Breitner JC, Mohs RC, Davis KL. Reliability of the family history method in genetic studies of Alzheimer s disease and related dementias. Am J Psychiatry 1986;143(10): Dixon RA, Hultsch DF, Hertzog C. The Metamemory in Adulthood (MIA) questionnaire. Psychopharmacol Bull 1988;24(4): Broadbent DE, Cooper PF, FitzGerald P, Parkes KR. The Cognitive Failures Questionnaire (CFQ) and its correlates. Br J Clin Psychol 1982;21(Pt 1): Gilewski MJ, Zelinski EM, Schaie KW. The Memory Functioning Questionnaire for assessment of memory complaints in adulthood and old age. Psychol Aging 1990 ; 5 ( 4 ): Bolla LR, Filley CM, Palmer RM. Dementia DDx. Office diagnosis of the four major types of dementia. Geriatrics 2000;55(1):34-37, 41-42, Ueda K, Kawano H, Hasuo Y, Fujishima M. Prevalence and etiology of dementia in a Japanese community. Stroke 1992;23(6): Woo JI, Lee JH, Yoo KY, Hong JP, Kim CY, Kim YI, et al. Prevalence of dementia in the elderly residents of a rural community in Korea. J Korean Neuropsychiatr Assoc ; 3 6 ( 1 ) : Moroney JT, Bagiella E, Desmond DW, Hachinski VC, Molsa PK, Gustafson L, et al. Meta-analysis of the Hachinski Ischemic Score in pathologically verified dementias. Neurology 1997;49(4): Brody DS, Hahn SR, Spitzer RL, Kroenke K, Linzer M, degruy FV, 3rd, et al. Identifying patients with depression in the primary care setting: a more efficient method. Arch Intern Med 1998;158(22): McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer s Disease. Neurology ; 3 4 ( 7 ) : J Korean Neurol Assoc / Volume 20 / March, 2002

7 21. Ameican Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; Christensen KJ, Multhaup KS, Nordstrom S, Voss K. A cognitive battery for dementia: development and measurement characteristics. Psychological Assessment ; 3 : Choi SH ND, Oh KM, Park BJ. A short form of the Samsung Dementia Questionnaire (S-SDQ): development and cross-validation. J Korean Neurol Assoc ; 1 7 ( 2 ) : Kee BS. A preliminary study for the standardization of geriatric depression scale short form Korean version. J Korean Neuropsychiatr Assoc 1996;35(2): Coyle J, Kershaw P. Galantamine, a cholinesterase inhibitor that allosterically modulates nicotinic receptors: effects on the course of Alzheimer s disease. B i o l Psychiatry 2001;49(3): Giacobini E. Cholinesterase inhibitors stabilize Alzheimer s disease. Ann N Y Acad Sci 2000;920: Giacobini E. Is anti-cholinesterase therapy of Alzheimer s disease delaying progression? Aging (Milano) ; 1 3 ( 3 ) : Choi SH, Na DL, Kang YW, Lee WY, Park BJ. The validity and reliability of the Samsung Dementia Questionnaire (SDQ). J Korean Neurol Assoc 1998;16(3): Juva K, Makela M, Erkinjuntti T, Sulkava R, Ylikoski R, Valvanne J, et al. Functional assessment scales in detecting dementia. Age Ageing 1997;26(5): Hachinski VC, Iliff LD, Zilhka E, Du Boulay GH, McAllister VL, Marshall J, et al. Cerebral blood flow in dementia. Arch Neurol 1975;32(9): J Korean Neurol Assoc / Volume 20 / March,

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