Informant-based screening tools for dementia: an overview of systematic reviews

Taylor-Rowan, M. , Nafisi, S., Owen, R., Duffy, R., Patel, A., Burton, J. K. and Quinn, T. J. (2021) Informant-based screening tools for dementia: an overview of systematic reviews. Psychological Medicine, (doi: 10.1017/S0033291721002002) (PMID:34030753) (Early Online Publication)

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Abstract

Background: Informant-based questionnaires may have utility for cognitive impairment or dementia screening. Reviews describing the accuracy of respective questionnaires are available, but their focus on individual questionnaires precludes comparisons across tools. We conducted an overview of systematic reviews to assess the comparative accuracy of informant questionnaires and identify areas where evidence is lacking. Methods: We searched six databases to identify systematic reviews describing diagnostic test accuracy of informant questionnaires for cognitive impairment or dementia. We pooled sensitivity and specificity data for each questionnaire and used network approaches to compare accuracy estimates across the differing tests. We used grading of recommendations, assessment, development and evaluation (GRADE) to evaluate the overall certainty of evidence. Finally, we created an evidence ‘heat-map’, describing the availability of accurate data for individual tests in different populations and settings. Results: We identified 25 reviews, consisting of 93 studies and 13 informant questionnaires. Pooled analysis (37 studies; 11 052 participants) ranked the eight-item interview to ascertain dementia (AD8) highest for sensitivity [90%; 95% credible intervals (CrI) = 82–95; ‘best-test’ probability = 36]; while the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE) was most specific (81%; 95% CrI = 66–90; ‘best-test’ probability = 29%). GRADE-based evaluation of evidence suggested certainty was ‘low’ overall. Our heat-map indicated that only AD8 and IQCODE have been extensively evaluated and most studies have been in the secondary care settings. Conclusions: AD8 and IQCODE appear to be valid questionnaires for cognitive impairment or dementia assessment. Other available informant-based cognitive screening questionnaires lack evidence to justify their use at present. Evidence on the accuracy of available tools in primary care settings and with specific populations is required.

Item Type:Articles
Keywords:Cognitive impairment, dementia, informant, overview, screening, systematic review.
Status:Early Online Publication
Refereed:Yes
Glasgow Author(s) Enlighten ID:Burton, Dr Jenni and Taylor-Rowan, Mr Martin and Quinn, Dr Terry
Authors: Taylor-Rowan, M., Nafisi, S., Owen, R., Duffy, R., Patel, A., Burton, J. K., and Quinn, T. J.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Psychological Medicine
Publisher:Cambridge University Press
ISSN:0033-2917
ISSN (Online):1469-8978
Published Online:25 May 2021
Copyright Holders:Copyright © The Author(s) 2021
First Published:First published in Psychological Medicine 2021
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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