Dementia and Neurocognitive Disorders (대한치매학회지)

Korean Dementia Association (대한치매학회)
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Re-standardization of the Korean-Instrumental Activities of Daily Living (K-IADL): Clinical Usefulness for Various Neurodegenerative Diseases

  • Chin, Juhee (Department of Neurology, Samsung Medical Center) ;
  • Park, Jaeseol (Department of Neurology, Hallym University Sacred Heart Hospital) ;
  • Yang, Soh-Jeong (Department of Neurology, Yonsei University Health System) ;
  • Yeom, Jiyoung (Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine) ;
  • Ahn, Yisuh (The BOM Brain Health Neuropsychology Center and Cognitive Rehabilitation Research Institute) ;
  • Baek, Min Jae (Cognitive Neuroscience Center, Seoul National University Bundang Hospital) ;
  • Ryu, Hui Jin (Department of Neurology, Konkuk University Medical Center) ;
  • Lee, Byung Hwa (Department of Neurology, Samsung Medical Center) ;
  • Han, Noh Eul (Department of Neurology, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ryu, Kyung Hi (Human Brain Research & Consulting) ;
  • Kang, Yeonwook (Department of Neurology, Hallym University Sacred Heart Hospital)
  • Received : 2017.12.29
  • Accepted : 2018.03.23
  • Published : 2018.03.31
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Abstract

Background and Purpose: Evaluating instrumental activities of daily living (IADL) is an important part of procedure to diagnose dementia. The Korean-Instrumental Activities of Daily Living (K-IADL) has been used extensively in Korea. However, its cut-off score has not been reformulated since 2002. The purpose of this study was to yield a new optimal cut-off score for the K-IADL and confirm the validity of this new cut-off score with various dementia groups. Methods: We retrospectively collected a total of 2,347 patients' K-IADL data from 6 general hospitals in Korea. These patients had mild cognitive impairment (MCI) or dementia with various etiologies for cognitive impairment. We also recruited a normal control group (n=254) from the community. Korean-Mini Mental State Examination, Short version of the Geriatric Depression Scale, Clinical Dementia Rating, and Global Deterioration Scale were administered to all participants. Caregivers completed K-IADL and Barthel Index. Results: K-IADL scores were significantly different among dementia subgroups, but not significantly different among MCI subgroups. Based on internal consistency, correlations with other scales, and factor analysis, K-IADL showed excellent reliability and validity. The new optimal cut-off score to diagnose dementia was 0.40, which gave a sensitivity of 0.901 and a specificity of 0.916. Positive predictive value for dementia using the new cut-off score was 94.2% for Alzheimer's disease, 100% for vascular dementia, and 84% for Parkinson's disease. Conclusions: Our results illustrate that the new K-IADL cut-off score of 0.40 is reliable and valid for screening impairments of daily functioning resulting from various etiologies.

Keywords

Acknowledgement

Supported by : Korean Dementia Association

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