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The IQCODE: Using Informant Reports to Assess Cognitive Change in the Clinic and in Older Individuals Living in the Community

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Cognitive Screening Instruments

Abstract

The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) uses the report of an informant to assess an individual’s change in cognition in the last 10 years. Unlike cognitive screening tests administered at one point in time, it is unaffected by pre-morbid cognitive ability or by level of education. When used as a screening test for dementia, the IQCODE performs as well as the Mini-Mental State Examination (MMSE), which is the most widely used cognitive screening instrument. Other evidence of validity comes from correlations with change in cognitive test scores and associations with neuropathological and neuroimaging changes. The main limitation of the IQCODE is that it can be affected by the informant’s emotional state. The IQCODE is suitable for use as a screening test in clinical settings, for retrospective cognitive assessment where direct data are not available, and for assessment in large-scale epidemiological studies. Versions are available in many languages.

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References

  1. Jorm AF, Korten AE. Assessment of cognitive decline in the elderly by informant interview. Br J Psychiatry. 1988;152:209–13.

    Article  PubMed  CAS  Google Scholar 

  2. Jorm AF. A short form of the informant questionnaire on cognitive decline in the elderly (IQCODE): development and cross-validation. Psychol Med. 1994;24:145–53.

    Article  PubMed  CAS  Google Scholar 

  3. Barba R, Martinez-Espinosa S, Rodriguez-Garcia E, Pondal M, Vivancos J, Del Ser T. Poststroke dementia: clinical features and risk factors. Stroke. 2000;31:1494–501.

    Article  PubMed  CAS  Google Scholar 

  4. Pisani MA, Inouye SK, McNicoll L, Redlich CA. Screening for preexisting cognitive impairment in older intensive care unit patients: use of proxy assessment. J Am Geriatr Soc. 2003;51:689–93.

    Article  PubMed  Google Scholar 

  5. Ayalon L. The IQCODE versus a single-item informant measure to discriminate between cognitively intact individuals and individuals with dementia or cognitive impairment. J Geriatr Psychiatry Neurol. 2011;24:168–73.

    Article  PubMed  Google Scholar 

  6. Patel P, Goldberg D, Moss S. Psychiatric morbidity in older people with moderate and severe learning disability. II: the prevalence study. Br J Psychiatry. 1993;163:481–91.

    Article  PubMed  CAS  Google Scholar 

  7. 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;9:105–11.

    Article  PubMed  CAS  Google Scholar 

  8. Fuh JL, Teng EL, Lin KN, et al. The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) as a screening tool for dementia for a predominantly illiterate Chinese population. Neurology. 1995;45:92–6.

    Article  PubMed  CAS  Google Scholar 

  9. Perroco T, Damin AE, Frota NA, et al. Short IQCODE as a screening tool for MCI and dementia. Dement Neuropsychol. 2008;2:300–4.

    Google Scholar 

  10. Cherbuin N, Anstey KJ, Lipnicki DM. Screening for dementia: a review of self- and informant-assessment instruments. Int Psychogeriatr. 2008;20:431–58.

    PubMed  Google Scholar 

  11. Jorm AF, Jacomb PA. The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): socio-demographic correlates, reliability, validity and some norms. Psychol Med. 1989;19:1015–22.

    Article  PubMed  CAS  Google Scholar 

  12. Morales JM, Bermejo F, Romero M, Del-Ser T. Screening of dementia in community-dwelling elderly through informant report. Int J Geriatr Psychiatry. 1997;12:808–16.

    Article  PubMed  CAS  Google Scholar 

  13. Callahan CM, Unverzagt FW, Hui SL, Perkins AJ, Hendrie HC. Six-item screener to identify cognitive impairment among potential subjects for clinical research. Med Care. 2002;40:771–81.

    Article  PubMed  Google Scholar 

  14. Swearer JM, Drachman DA, Li L, Kane KJ, Dessureau B, Tabloski P. Screening for dementia in “real world” settings: the Cognitive Assessment Screening Test: CAST. Clin Neuropsychol. 2002;16:128–35.

    Article  PubMed  Google Scholar 

  15. Ferrucci L, Del Lungo I, Guralnik JM, et al. Is the telephone interview for cognitive status a valid alternative in persons who cannot be evaluated by the Mini Mental State Examination? Aging (Milano). 1998;10:332–8.

    CAS  Google Scholar 

  16. Flicker L, Logiudice D, Carlin JB, Ames D. The predictive value of dementia screening instruments in clinical populations. Int J Geriatr Psychiatry. 1997;12:203–9.

    Article  PubMed  CAS  Google Scholar 

  17. Heun R, Papassotiropoulos A, Jennssen F. The validity of psychometric instruments for detection of dementia in the elderly general population. Int J Geriatr Psychiatry. 1998;13:368–80.

    Article  PubMed  CAS  Google Scholar 

  18. Jorm AF, Broe GA, Creasey H, et al. Further data on the validity of the informant questionnaire on cognitive decline in the elderly (IQCODE). Int J Geriatr Psychiatry. 1996;11:131–9.

    Article  Google Scholar 

  19. Jorm AF, Christensen H, Henderson AS, Jacomb PA, Korten AE, Mackinnon A. Informant ratings of cognitive decline of elderly people: relationship to longitudinal change on cognitive tests. Age Ageing. 1996;25:125–9.

    Article  PubMed  CAS  Google Scholar 

  20. Knafelc R, Lo Giudice D, Harrigan S, et al. The combination of cognitive testing and an informant questionnaire in screening for dementia. Age Ageing. 2003;32:541–7.

    Article  PubMed  Google Scholar 

  21. Nasreddine ZS, Phillips NA, Bedirian V, et al. The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. J Am Geriatr Soc. 2005;53:695–9.

    Article  PubMed  Google Scholar 

  22. Isella V, Villa L, Russo A, Regazzoni R, Ferrarese C, Appollonio IM. Discriminative and predictive power of an informant report in mild cognitive impairment. J Neurol Neurosurg Psychiatry. 2006;77:166–71.

    Article  PubMed  CAS  Google Scholar 

  23. Bustamante SE, Bottino CM, Lopes MA, et al. Combined instruments on the evaluation of dementia in the elderly: preliminary results [in Portuguese]. Arq Neuropsiquiatr. 2003;61:601–6.

    Article  PubMed  Google Scholar 

  24. Jorm AF, Scott R, Cullen JS, MacKinnon AJ. Performance of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) as a screening test for dementia. Psychol Med. 1991;21:785–90.

    Article  PubMed  CAS  Google Scholar 

  25. Law S, Wolfson C. Validation of a French version of an informant-based questionnaire as a screening test for Alzheimer’s disease. Br J Psychiatry. 1995;167:541–4.

    Article  PubMed  CAS  Google Scholar 

  26. Hancock P, Larner AJ. Diagnostic utility of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) and its combination with the Addenbrooke’s Cognitive Examination-Revised (ACE-R) in a memory clinic-based population. Int Psychogeriatr. 2009;21:526–30.

    Article  PubMed  CAS  Google Scholar 

  27. Mulligan R, Mackinnon A, Jorm AF, Giannakopoulos P, Michel JP. A comparison of alternative methods of screening for dementia in clinical settings. Arch Neurol. 1996;53:532–6.

    Article  PubMed  CAS  Google Scholar 

  28. Del-Ser T, Morales JM, Barquero MS, Canton R, Bermejo F. Application of a Spanish version of the “Informant Questionnaire on Cognitive Decline in the Elderly” in the clinical assessment of dementia. Alzheimer Dis Assoc Disord. 1997;11:3–8.

    Article  PubMed  CAS  Google Scholar 

  29. de Jonghe JF, Schmand B, Ooms ME, Ribbe MW. Abbreviated form of the Informant Questionnaire on cognitive decline in the elderly [in Dutch]. Tijdschr Gerontol Geriatr. 1997;28:224–9.

    PubMed  Google Scholar 

  30. Lim HJ, Lim JP, Anthony P, Yeo DH, Sahadevan S. Prevalence of cognitive impairment amongst Singapore’s elderly Chinese: a community-based study using the ECAQ and the IQCODE. Int J Geriatr Psychiatry. 2003;18:142–8.

    Article  PubMed  Google Scholar 

  31. Stratford JA, LoGiudice D, Flicker L, Cook R, Waltrowicz W, Ames D. A memory clinic at a geriatric hospital: a report on 577 patients assessed with the CAMDEX over 9 years. Aust N Z J Psychiatry. 2003;37:319–26.

    Article  PubMed  Google Scholar 

  32. Tang WK, Chan SS, Chiu HF, et al. Can IQCODE detect poststroke dementia? Int J Geriatr Psychiatry. 2003;18:706–10.

    Article  PubMed  Google Scholar 

  33. Harwood DM, Hope T, Jacoby R. Cognitive impairment in medical inpatients. I: screening for dementia – is history better than mental state? Age Ageing. 1997;26:31–5.

    Article  PubMed  CAS  Google Scholar 

  34. Narasimhalu K, Lee J, Auchus AP, Chen CP. Improving detection of dementia in Asian patients with low education: combining the mini-mental state examination and the informant questionnaire on cognitive decline in the elderly. Dement Geriatr Cogn Disord. 2008;25:17–22.

    Article  PubMed  Google Scholar 

  35. Khachaturian AS, Gallo JJ, Breitner JC. Performance characteristics of a two-stage dementia screen in a population sample. J Clin Epidemiol. 2000;53:531–40.

    Article  PubMed  CAS  Google Scholar 

  36. de Jonghe JF. Differentiating between demented and psychiatric patients with the Dutch version of the IQCODE. Int J Geriatr Psychiatry. 1997;12:462–5.

    Article  PubMed  Google Scholar 

  37. Jorm AF, Scott R, Jacomb PA. Assessment of cognitive decline in dementia by informant questionnaire. Int J Geriatr Psychiatry. 1989;4:35–9.

    Article  Google Scholar 

  38. Jansen AP, van Hout HP, Nijpels G, et al. Self-reports on the IQCODE in older adults: a psychometric evaluation. J Geriatr Psychiatry Neurol. 2008;21:83–92.

    Article  PubMed  Google Scholar 

  39. Butt Z. Sensitivity of the informant questionnaire on cognitive decline: an application of item response theory. Neuropsychol Dev Cogn B Aging Neuropsychol Cogn. 2008;15:642–55.

    Article  PubMed  Google Scholar 

  40. Jorm AF. The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): a review. Int Psychogeriatr. 2004;16:275–93.

    Article  PubMed  Google Scholar 

  41. Gavett R, Dunn JE, Stoddard A, Harty B, Weintraub S. The Cognitive Change in Women study (CCW): informant ratings of cognitive change but not self-ratings are associated with neuro-psychological performance over 3 years. Alzheimer Dis Assoc Disord. 2011;25:305–11.

    Article  PubMed  Google Scholar 

  42. Thomas LD, Gonzales MF, Chamberlain A, Beyreuther K, Masters CL, Flicker L. Comparison of clinical state, retrospective informant interview and the neuropathologic diagnosis of Alzheimer’s disease. Int J Geriatr Psychiatry. 1994;9:233–6.

    Article  Google Scholar 

  43. Rockwood K, Howard K, Thomas VS, et al. Retrospective diagnosis of dementia using an informant interview based on the Brief Cognitive Rating Scale. Int Psychogeriatr. 1998;10:53–60.

    Article  PubMed  CAS  Google Scholar 

  44. Larner AJ. Can IQCODE differentiate Alzheimer’s disease and frontotemporal dementia? Age Ageing. 2010;39:392–4.

    Article  PubMed  CAS  Google Scholar 

  45. Farias ST, Mungas D, Reed B, Haan MN, Jagust WJ. Everyday functioning in relation to cognitive functioning and neuroimaging in community-dwelling Hispanic and non-Hispanic older adults. J Int Neuropsychol Soc. 2004;10:342–54.

    Article  PubMed  Google Scholar 

  46. Jorm AF, Christensen H, Korten AE, Jacomb PA, Henderson AS. Informant ratings of cognitive decline in old age: validation against change on cognitive tests over 7 to 8 years. Psychol Med. 2000;30:981–5.

    Article  PubMed  CAS  Google Scholar 

  47. Slavin MJ, Brodaty H, Kochan NA, et al. Prevalence and predictors of “subjective cognitive complaints” in the Sydney Memory and Ageing Study. Am J Geriatr Psychiatry. 2010;18:701–10.

    Article  PubMed  Google Scholar 

  48. Cordoliani-Mackowiak MA, Henon H, Pruvo JP, Pasquier F, Leys D. Poststroke dementia: influence of hippocampal atrophy. Arch Neurol. 2003;60:585–90.

    Article  PubMed  Google Scholar 

  49. Henon H, Pasquier F, Durieu I, Pruvo JP, Leys D. Medial temporal lobe atrophy in stroke patients: relation to pre-existing dementia. J Neurol Neurosurg Psychiatry. 1998;65:641–7.

    Article  PubMed  CAS  Google Scholar 

  50. Viswanathan A, Patel P, Rahman R, et al. Tissue microstructural changes are independently associated with cognitive impairment in cerebral amyloid angiopathy. Stroke. 2008;39:1988–92.

    Article  PubMed  Google Scholar 

  51. Klimkowicz A, Dziedzic T, Polczyk R, Pera J, Slowik A, Szczudlik A. Factors associated with pre-stroke dementia: the Cracow stroke database. J Neurol. 2004;251:599–603.

    Article  PubMed  Google Scholar 

  52. Mok V, Wong A, Tang WK, et al. Determinants of prestroke cognitive impairment in stroke associated with small vessel disease. Dement Geriatr Cogn Disord. 2005;20:225–30.

    Article  PubMed  CAS  Google Scholar 

  53. de Rooij SE, Govers AC, Korevaar JC, Giesbers AW, Levi M, de Jonge E. Cognitive, functional, and quality-of-life outcomes of patients aged 80 and older who survived at least 1 year after planned or unplanned surgery or medical intensive care treatment. J Am Geriatr Soc. 2008;56:816–22.

    Article  PubMed  Google Scholar 

  54. de Jager CA, Oulhaj A, Jacoby R, Refsum H, Smith AD. Cognitive and clinical outcomes of homocysteine-lowering B-vitamin treatment in mild cognitive impairment: a randomized controlled trial. Int J Geriatr Psychiatry. 2102;27:592–600.

    Google Scholar 

  55. Aaldriks AA, Maartense E, le Cessie S, et al. Predictive value of geriatric assessment for patients older than 70 years, treated with chemotherapy. Crit Rev Oncol Hematol. 2011;79:205–12.

    Article  PubMed  CAS  Google Scholar 

  56. Henon H, Pasquier F, Durieu I, et al. Preexisting dementia in stroke patients. Baseline frequency, associated factors, and outcome. Stroke. 1997;28:2429–36.

    Article  PubMed  CAS  Google Scholar 

  57. Louis B, Harwood D, Hope T, Jacoby R. Can an informant questionnaire be used to predict the development of dementia in medical inpatients? Int J Geriatr Psychiatry. 1999;14:941–5.

    Article  PubMed  CAS  Google Scholar 

  58. Srikanth V, Thrift AG, Fryer JL, et al. The validity of brief screening cognitive instruments in the diagnosis of cognitive impairment and dementia after first-ever stroke. Int Psychogeriatr. 2006;18:295–305.

    Article  PubMed  Google Scholar 

  59. Jackson JC, Obremskey W, Bauer R, et al. Long-term cognitive, emotional, and functional outcomes in trauma intensive care unit survivors without intracranial hemorrhage. J Trauma. 2007;62:80–8.

    Article  PubMed  Google Scholar 

  60. Priner M, Jourdain M, Bouche G, Merlet-Chicoine I, Chaumier JA, Paccalin M. Usefulness of the short IQCODE for predicting postoperative delirium in elderly patients undergoing hip and knee replacement surgery. Gerontology. 2008;54:116–9.

    Article  PubMed  Google Scholar 

  61. Cordonnier C, Henon H, Derambure P, Pasquier F, Leys D. Influence of pre-existing dementia on the risk of post-stroke epileptic seizures. J Neurol Neurosurg Psychiatry. 2005;76:1649–53.

    Article  PubMed  CAS  Google Scholar 

  62. Henon H, Durieu I, Lebert F, Pasquier F, Leys D. Influence of prestroke dementia on early and delayed mortality in stroke patients. J Neurol. 2003;250:10–6.

    Article  PubMed  Google Scholar 

  63. Pasquini M, Leys D, Rousseaux M, Pasquier F, Henon H. Influence of cognitive impairment on the institutionalisation rate 3 years after a stroke. J Neurol Neurosurg Psychiatry. 2007;78:56–9.

    Article  PubMed  CAS  Google Scholar 

  64. Eramudugolla R, Cherbuin N, Easteal S, Jorm AF, Anstey KJ. Self-reported cognitive decline is associated with APOE, depression, neuroticism and decline in processing speed but not memory in a community based sample: The PATH Through Life. 2012; Submitted.

    Google Scholar 

  65. Ries ML, Jabbar BM, Schmitz TW, et al. Anosognosia in mild cognitive impairment: relationship to activation of cortical midline structures involved in self-appraisal. J Int Neuropsychol Soc. 2007;13:450–61.

    Article  PubMed  Google Scholar 

  66. Tombaugh TN, McIntyre NJ. The mini-mental state examination: a comprehensive review. J Am Geriatr Soc. 1992;40:922–35.

    PubMed  CAS  Google Scholar 

  67. Anderson TM, Sachdev PS, Brodaty H, Trollor JN, Andrews G. Effects of sociodemographic and health variables on Mini-Mental State Exam scores in older Australians. Am J Geriatr Psychiatry. 2007;15:467–76.

    Article  PubMed  Google Scholar 

  68. Christensen H, Jorm AF. Effect of premorbid intelligence on the Mini-mental State and IQCODE. Int J Geriatr Psychiatry. 1992;7:159–60.

    Article  Google Scholar 

  69. Sikkes SA, van den Berg MT, Knol DL, et al. How useful is the IQCODE for discriminating between Alzheimer’s disease, mild cognitive impairment and subjective memory complaints? Dement Geriatr Cogn Disord. 2010;30:411–6.

    Article  PubMed  Google Scholar 

  70. Bruce DG, Harrington N, Davis WA, Davis TM. Dementia and its associations in type 2 diabetes mellitus: the Fremantle Diabetes Study. Diabetes Res Clin Pract. 2001;53:165–72.

    Article  PubMed  CAS  Google Scholar 

  71. Nygaard HA, Naik M, Geitung JT. The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) is associated with informant stress. Int J Geriatr Psychiatry. 2009;24:1185–91.

    Article  PubMed  Google Scholar 

  72. Rovner BW, Casten RJ, Arenson C, Salzman B, Kornsey EB. Racial differences in the recognition of cognitive dysfunction in older persons. Alzheimer Dis Assoc Disord. 2012;26:44–9.

    Article  PubMed  Google Scholar 

  73. Potter GG, Plassman BL, Burke JR, et al. Cognitive performance and informant reports in the diagnosis of cognitive impairment and dementia in African Americans and whites. Alzheimers Dement. 2009;5:445–53.

    Article  PubMed  Google Scholar 

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Acknowledgements

Nicolas Cherbuin is funded by the National Health and Medical Research Council (NHMRC) Fellowship No. 471501. Anthony F Jorm was supported by an NHMRC Australia Fellowship.

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Cherbuin, N., Jorm, A.F. (2013). The IQCODE: Using Informant Reports to Assess Cognitive Change in the Clinic and in Older Individuals Living in the Community. In: Larner, A. (eds) Cognitive Screening Instruments. Springer, London. https://doi.org/10.1007/978-1-4471-2452-8_8

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