The influence of diversity on the measurement of functional impairment : an international validation of the Amsterdam IADL Questionnaire in eight countries
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Wiley Periodicals, Inc.
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Abstract
Introduction: To understand the potential influence of diversity on the measurement of functional impairment in dementia, we aimed to investigate possible bias caused by age, gender, education, and cultural differences. Methods: A total of 3571 individuals (67.1 ± 9.5 years old, 44.7% female) from The Netherlands, Spain, France, United States, United Kingdom, Greece, Serbia, and Finland were included. Functional impairment was measured using the Amsterdam Instrumental Activities of Daily Living (IADL) Questionnaire. Item bias was assessed using differential item functioning (DIF) analysis. Results: There were some differences in activity endorsement. A few items showed statistically significant DIF. However, there was no evidence of meaningful item bias: Effect sizes were low (ΔR2 range 0-0.03). Impact on total scores was minimal. Discussion: The results imply a limited bias for age, gender, education, and culture in the measurement of functional impairment. This study provides an important step in recognizing the potential influence of diversity on primary outcomes in dementia research
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Dubbelman, M. A., Verrijp, M., Facal, D., Sánchez-Benavides, G., Brown, L. J. E., Flier, W. M., Jokinen, H., Lee, A., Leroi, I., Lojo-Seoane, C., Milošević, V., Molinuevo, J. L., Pereiro Rozas, A. X., Ritchie, C., Salloway, S., Stringer, G., Zygouris, S., Dubois, B., Epelbaum, S., . . . Sikkes, S. A. M. (2020). The influence of diversity on the measurement of functional impairment: An international validation of the Amsterdam IADL Questionnaire in eight countries. Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring, 12(1), e12021. https://doi.org/10.1002/dad2.12021
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https://doi.org/10.1002/dad2.12021Sponsors
The development of the Amsterdam IADL Questionnaire is supported by grants from Stichting VUmc Fonds and Innovatiefonds Zorgverzekeraars. The Amsterdam Alzheimer Center is supported by Stichting Alzheimer Nederland and Stichting VUmc Fonds. The present study is supported by a grant from Memorabel (733050205), which is the research program of the Dutch Deltaplan for Dementia. The chair of WMF is supported by the Pasman stichting. The clinical database structure for the Amsterdam Dementia Cohort was developed with funding from Stichting Dioraphte. DF, CLB and AXPR are supported by FEDER grant PSI2014-55316-C3-1-R, the Spanish National Research Agency grant PSI2017-89389-C2-1-R and the Galician Government GI-1807-USC: Ref. ED431-2017/27. GSB, JLM and the ALFA+ project has received funding from “la Caixa” Foundation (ID 100010434), under agreement LCF/PR/GN17/50300004 and the Alzheimer's Association and an international anonymous charity foundation through the TriBEKa Imaging Platform project (TriBEKa-17-519007). CWR and the work for EPAD has received support from the EU/EFPIA Innovative Medicines Initiative Joint Undertaking EPAD grant agreement n° 115736. SE is supported by a joint collaborative grant by the AP-HP and Inria. LJEB, IL and GS were supported by the U.K. Engineering and Physical Sciences Research Council #EP/K015796/1. SZ is supported by the Robert Bosch Foundation Stuttgart within the Graduate Program People with Dementia in General Hospitals, located at the Network Aging Research (NAR), Heidelberg University, Germany. VM is supported by the Serbian Ministry of Education, Science and Technological Development, grant OI 173022. AL is partially supported by Institutional Development Award Number U54GM115677 from the National Institute of General Medical Sciences of the National Institutes of Health, which funds Advance Clinical and Translational Research (Advance-CTR)
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© 2020 The Authors. Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring published by Wiley Periodicals, Inc. on behalf of Alzheimer’s Association. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made