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 20.82 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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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±7.58 66.42±5.99 Sex(male, female) M:38, F: 34 M:36, F: 30 Education(yr) 9.74±5.28 11.65±4.50 Informant Spouse 30 40 Children+daughter-in-law 35 22 Others 7 4 K-MMSE* 22.58±3.37 28.35±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 -0.65 <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
Table 3. Sensitivities and specificities for the KDSQ at selected cutting points Cutting point Sensitivity Specificity 3 0.99 0.41 4 0.93 0.52 5 0.84 0.63 6 0.79 0.80 7 0.71 0.86 8 0.60 0.90 9 0.53 1.00 J Korean Neurol Assoc / Volume 20 / March, 2002 5
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21. Ameican Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994. 22. Christensen KJ, Multhaup KS, Nordstrom S, Voss K. A cognitive battery for dementia: development and measurement characteristics. Psychological Assessment 1 9 9 1 ; 3 : 1 6 8-1 7 4. 23. 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 9 9 9 ; 1 7 ( 2 ) : 2 5 3-2 5 8. 24. Kee BS. A preliminary study for the standardization of geriatric depression scale short form Korean version. J Korean Neuropsychiatr Assoc 1996;35(2):298-307. 25. 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):289-299. 26. Giacobini E. Cholinesterase inhibitors stabilize Alzheimer s disease. Ann N Y Acad Sci 2000;920:321-327. 27. Giacobini E. Is anti-cholinesterase therapy of Alzheimer s disease delaying progression? Aging (Milano) 2 0 0 1 ; 1 3 ( 3 ) : 2 4 7-2 5 4. 28. 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):307-314. 29. 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):393-400. 30. 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):632-637. J Korean Neurol Assoc / Volume 20 / March, 2002 7
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