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Performance of the 16-Item Informant Questionnaire on Cognitive Decline for the Elderly (IQCODE) in an Arabic-Speaking Older Population

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Phung, Thien Kieu Thi, Chaaya, Monique, Asmar, Khalil, Atweh, Samir, Ghusn, Husam, Khoury, Rose Mary, Prince, Martin, Waldemar, Gunhild·2015·Dementia and Geriatric Cognitive Disorders
DOI 10.1159/000437092PMC PMC5756546
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Abstract

Background/Aim: The North African and Middle Eastern region has high illiteracy rates among older people, making direct cognitive testing challenging. Validated screening instruments for dementia in Arabic are lacking. We aimed to validate the Arabic version of the 16-item Informant Questionnaire on Cognitive Decline for the Elderly (A-IQCODE 16) for screening for dementia through an informant. Methods: 236 Lebanese participants older than 65 years, 143 with normal cognition and 93 with mild-to-moderate dementia according to the DSM-IV criteria, and their informants were recruited. Half of the participants had no formal education. Interviewers blinded to the cognitive status of the participants administered the A-IQCODE 16 to the informants. The ability of the A-IQCODE 16 to screen for dementia was evaluated against the DSM-IV diagnoses. Results: The A-IQCODE 16 had excellent overall predictive power (area under the receiver operator characteristic curve = 0.96). A cutoff point of >3.34 yielded the best sensitivity (92.5%) and specificity (94.4%) for dementia screening. At this cutoff point, the discriminatory ability of the A-IQCODE 16 was comparable between participants with and those without formal education. Conclusion: The A-IQCODE 16 is not biased by education and is therefore useful as a brief screening tool for dementia among Arabic-speaking older adults with low education.

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  • The Arabic validated IQCODE has excellent psychometric properties to screen for dementia (92.5% sensitivity, 94.4% specificity, 91.5% PPV at cutoff >3.34).

    “At the cut-off average score > 3.34, the Arabic validated IQCODE has demonstrated excellent psychometric properties: 92.5% sensitivity, 94.4% specificity, and 91.5 % PPV [9] to screen for dementia.”

    From Dementia prevalence, care arrangement and access to care in Lebanon: a pilot study (2017) · cites this paper as [9]

    The Abstract Results report that the Arabic IQCODE’s >3.34 cutoff yielded 92.5% sensitivity and 94.4% specificity for dementia screening, and the Discussion describes excellent psychometric properties. The Results discuss positive predictive value at that cutoff, but the passages in our copy do not give the claimed 91.5% PPV. (LLM, conf=0.83)

    Experimental — accuracy not yet measured

  • The prevalence of dementia in this study population was 7.4%, much lower than the 40% in previous validation studies.

    “Given that the prevalence of dementia in this study population was only 7.4%, much lower than the 40 % in the previous validation studies [8,10,9], it was expected that the PPV would be lower.”

    From Dementia prevalence, care arrangement and access to care in Lebanon: a pilot study (2017) · cites this paper as [9]

  • For the IQCODE, PPV was 43.2% compared to 91.5% from the validation study.

    “For the IQCODE, PPV was 43.2% compared to 91.5% from the validation study.”

    From Dementia prevalence, care arrangement and access to care in Lebanon: a pilot study (2017) · cites this paper as [9]

  • In this population-based study, the IQCODE did not demonstrate the same excellent psychometric properties as in the validation study.

    “As predicted, the IQCODE did not demonstrate the same excellent psychometric properties in a population-based context compared to the validation study [9].”

    From Dementia prevalence, care arrangement and access to care in Lebanon: a pilot study (2017) · cites this paper as [9]

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Metadata

Authors
Phung, T. K. T., Chaaya, M., Asmar, K., Atweh, S., Ghusn, H., Khoury, R. M., Prince, M., & Waldemar, G.
Affiliations
  • University of Copenhagen (DK)
  • American University of Beirut (LB)
  • American University of Beirut Medical Center (LB)
  • King's College London (GB)
ORCID
Venue
Dementia and Geriatric Cognitive Disorders
Publisher
S. Karger AG
Published
2015
Volume
40
Issue
5-6
Pages
276-289
ISSN
  • 1420-8008 (ISSN-L)
  • 1421-9824
DOI
10.1159/000437092
PMC
PMC5756546
OpenAlex
W1835038599
Cited by
44
References
36
Citations by year
2026: 1 · 2025: 5 · 2024: 3 · 2023: 4 · 2022: 6 · 2021: 6 · 2020: 6 · 2019: 3 · 2018: 3 · 2017: 4 · 2016: 2 · 2015: 1
FWCI
2.70
Type
journal article
Language
en
Open access
Licence
Locations
  • Dementia and Geriatric Cognitive Disorders (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (publishedVersion, other-oa)
  • PubMed Central (acceptedVersion)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
Funders
  • American University of Beirut
  • King's College London
  • Rigshospitalet
  • National Institutes of Health (1r21ag039333-01)
  • National Institute on Aging (R21 AG039333, 1R21AG039333-01)
  • Fogarty International Center (1R21AG039333-01)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
  • Health Sciences › Medicine › Oncology › Cancer-related cognitive impairment studies
Keywords
IQCODE, dementia screening, informant-based assessment, older adults, illiteracy, educational attainment, sensitivity and specificity
MeSH terms
Literacy, Aged, Cognition, Dementia, Humans, Lebanon, Psychiatric Status Rating Scales, Surveys and Questionnaires, Sensitivity and Specificity, Translations, Case-Control Studies

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