P2-094: The AD8 as a self-rating tool of dementia and depression

Abstract

Dementia may be under–diagnosed in the community. The AD8 was developed from a longitudinal research project as a brief, informant–based measure to detect dementia. To test how well the AD8 performs as a self–rating tool, compared with both informant and clinician impression of cognitive status. 317 subject–informant dyads were evaluated from a longitudinal study of memory and aging. The number of endorsed AD8 items by the subject was compared with the number endorsed by the informant, with independently derived Clinical Dementia Rating (CDR) ratings, and with ratings of depression. Strength of association was measured with Spearman (r) and intraclass (ICC) correlation coefficients. ROC curves were used to assess the discriminative properties of the AD8 given to both subjects and informants. Mean age of subjects was 72.8 y (range 43–104) and of informants was 66.4 y (range 24 – 101). The relationship of informants included spouses (56%), children (24%), relatives (8%), friends (8%) and others (4%). 87% of subjects and 94% of informants completed the questionnaire. CDR was correlated with both informant (r=0.75, p<.0001) and subject (r=0.34, p<.0001) AD8 scores. Subjects' AD8 scores had good agreement with informants' AD8 scores (ICC=0.53, 95% CI:0.41–0.62). Subjects’ AD8 scores also correlated (p's<.0001) with subjective complaints of memory problems (r=0.47), with informants’ endorsement of DSM–IV depression features (r=0.37) and the Geriatric Depression Scale (GDS) (r=0.41); and the subjects’ endorsement DSM–IV depression features (r=0.49) and GDS (r=0.56). Subjects complaints of memory problems corresponded to the presence of both dementia (CDR 0.5, r=.25, p=.0008) and depression by DSM–IV criteria (r=0.25, p=.0008) and GDS (r=.23, p=.002). The area under the ROC curve for the informant AD8 was 0.894 (95% CI:0.86–0.93); the subject AD8 was 0.779 (95% CI:0.679–0.78). The AD8 is a brief, sensitive measure that differentiates between nondemented and demented individuals and is sensitive to depression when asked of either the subject or an informant, although informants were more observant than the subject. The AD8 can be used as a general screening device to detect dementia and depression in the older adult.