Validation of AD8-Philippines (AD8-P): A Brief Informant-Based Questionnaire for Dementia Screening in the Philippines.

Jacqueline C Dominguez,Jayvee Dyne Dominguez,Macario Reandelar,Jeffrey Domingo,Ma Fe P De Guzman,Thienkieuthi Phung,Precy S Cruz,Boots P Natividad,Jem R Javier,Jhozel Kim Dominguez-Awao,John C Morris,James E Galvin,Jose Leo Jiloca,Ma Lourdes C Joson,Primitivo B Mactal,Krizelle Fowler,John Powell

doi:10.1155/2021/7750235

Abstract

Aim This study was aimed at validating the Filipino version of AD8 (AD8-P). Methods Community-dwelling Filipino older persons aged ≥60 years, together with their informants, participated in this study. Psychologists independently interviewed the informants with AD8-P and administered the Filipino-validated Mini-Mental State Examination (MMSE-P) and Montreal Cognitive Assessment (MoCA-P) to the older persons. Neurologists and geriatrician conducted physical and neurological examination and Clinical Dementia Rating™ (CDR™) to determine cognitive diagnosis and were blinded with the results of AD8-P. Dementia was diagnosed based on DSM-IV-TR criteria. AD8-P discriminatory ability to screen for dementia was evaluated according to DSM-IV-TR diagnostic criteria for dementia. Results A total of 366 community-dwelling Filipino older persons aged ≥60 years, 213 with normal cognition and 153 with dementia, and their informants were included in this study. Majority (90%) were at the mildest stage of dementia. Area under the receiver-operating-characteristic curve (AUROC) for AD8-P was 0.94 (95% CI 0.92 to 0.96), demonstrating excellent overall predictive power to screen for dementia. The optimal AD8-P cut-off score with best balance sensitivity (91.5%) and specificity (77.9%) was ≥3. Conclusion AD8-P demonstrated good psychometric properties to screen for dementia, even at the earliest stage of cognitive decline.

Highlights

Dementia is a major cause of disability and dependency among older adults worldwide
Participants were community-dwelling Filipino older adults enrolled in the Marikina Memory and Aging Project (MMAP), which was a large population-based longitudinal study of dementia epidemiology in the community [2]
We established the prevalence of dementia and cognitive impairment nondementia (CIND) in this cohort in 2011 and followed them up in 2016-2017 (5-year followup), when there were 831 (60.8%) participants left in the cohort

Summary

Introduction

Dementia is a major cause of disability and dependency among older adults worldwide. The number of older persons living with dementia is steadily increasing and projected to reach as high as 131.5 million by 2050 [1]. In the Philippines, the prevalence of dementia was found to be 10.6% among older Filipino adults aged 60 and above [2], a proportion which is higher than the estimated 7.6% prevalence for South East Asia [1] Despite this growing public health problem, screening and detection for dementia remain a major challenge. Used screening instruments for dementia in the Philippines include the Filipino-validated Mini-Mental State Examination (MMSE-P) [5] and the Montreal Cognitive Assessment (MoCA-P) [6, 7]. Both tests are strictly standardized and require training to administer and interpret. The scores on both tests are strongly influenced by educational and other sociocultural factors [8, 9]

Objectives

Methods

Results