title: 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.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  Multicenter prospective cohort study.
  
  
  METHODS
  Memory clinics in Europe.
  
  
  METHODS
  Individuals aged 55 and older without dementia.
  
  
  METHODS
  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%) (chi-square = 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Epidemiology and Biostatistics, VU University Medical Center, Amsterdam, the Netherlands. s.sikkes@vumc.nl
authors.forename: Sietske A M
authors.initials: SA
authors.lastname: Sikkes
authors.forename: Pieter Jelle
authors.initials: PJ
authors.lastname: Visser
authors.forename: Dirk L
authors.initials: DL
authors.lastname: Knol
authors.forename: Elly S M
authors.initials: ES
authors.lastname: de Lange-de Klerk
authors.forename: Magda
authors.initials: M
authors.lastname: Tsolaki
authors.forename: Giovani B
authors.initials: GB
authors.lastname: Frisoni
authors.forename: Flavio
authors.initials: F
authors.lastname: Nobili
authors.forename: Luiza
authors.initials: L
authors.lastname: Spiru
authors.forename: Anne Sophie
authors.initials: AS
authors.lastname: Rigaud
authors.forename: Lutz
authors.initials: L
authors.lastname: Frölich
authors.forename: Marcel Olde
authors.initials: MO
authors.lastname: Rikkert
authors.forename: Hilkka
authors.initials: H
authors.lastname: Soininen
authors.forename: Jacques
authors.initials: J
authors.lastname: Touchon
authors.forename: Gordon
authors.initials: G
authors.lastname: Wilcock
authors.forename: Mercè
authors.initials: M
authors.lastname: Boada
authors.forename: Harald
authors.initials: H
authors.lastname: Hampel
authors.forename: Roger
authors.initials: R
authors.lastname: Bullock
authors.forename: Bruno
authors.initials: B
authors.lastname: Vellas
authors.forename: Yolande A L
authors.initials: YA
authors.lastname: Pijnenburg
authors.forename: Philip
authors.initials: P
authors.lastname: Scheltens
authors.forename: Frans R
authors.initials: FR
authors.lastname: Verhey
authors.forename: Bernard M J
authors.initials: BM
authors.lastname: Uitdehaag
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D003704:Dementia / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D013997:Time Factors