The influence of diversity on the measurement of functional impairment: An international validation of the Amsterdam IADL Questionnaire in eight countries

Mark A. Dubbelman; Merike Verrijp; David Facal; Gonzalo Sánchez-Benavides; Laura J.E. Brown; Wiesje M. van der Flier; Hanna Jokinen; Athene Lee; Iracema Leroi; Cristina Lojo-Seoane; Vuk Milošević; José Luís Molinuevo; Arturo X. Pereiro Rozas; Craig Ritchie; Stephen Salloway; Gemma Stringer; Stelios Zygouris; Bruno Dubois; Stéphane Epelbaum; Philip Scheltens; Sietske A.M. Sikkes

doi:10.1002/dad2.12021

The influence of diversity on the measurement of functional impairment: An international validation of the Amsterdam IADL Questionnaire in eight countries

Mark A. Dubbelman^*
, Merike Verrijp
, David Facal
, Gonzalo Sánchez-Benavides
, Laura J.E. Brown
, Wiesje M. van der Flier
, Hanna Jokinen
, Athene Lee
, Iracema Leroi
, Cristina Lojo-Seoane
, Vuk Milošević
, José Luís Molinuevo
, Arturo X. Pereiro Rozas
, Craig Ritchie
, Stephen Salloway
, Gemma Stringer
, Stelios Zygouris
, Bruno Dubois
, Stéphane Epelbaum
, Philip Scheltens

Sietske A.M. Sikkes

^*Corresponding author for this work

Clinical Neuropsychology

Research output: Contribution to Journal › Article › Academic › peer-review

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.

Original language	English
Article number	e12021
Pages (from-to)	1-11
Number of pages	11
Journal	Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
Volume	12
Issue number	1
Early online date	13 May 2020
DOIs	https://doi.org/10.1002/dad2.12021
Publication status	Published - 2020

Funding

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). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The other authors did not receive funding directly related to this work.

Funders	Funder number
Stichting VUmc Fonds and Innovatiefonds Zorgverzekeraars
National Institute of General Medical Sciences
Universität Heidelberg
EPAD
Advance Clinical and Translational Research
National Institutes of Health
European Commission
EU/EFPIA
AP‐HP and Inria
Robert Bosch Foundation Stuttgart
AP-HP and Inria
Dutch Deltaplan for Dementia
Spanish National Research Agency	PSI2017‐89389‐C2‐1‐R, ED431‐2017/27
Alzheimer's Association	TriBEKa‐17‐519007
Galician Government	GI-1807-USC
Seventh Framework Programme	115736
Engineering and Physical Sciences Research Council	EP/K015796/1
“la Caixa” Foundation	la Caixa” Foundation, LCF/PR/GN17/50300004
Stichting Alzheimer Nederland and Stichting VUmc Fonds	733050205
Ministarstvo Prosvete, Nauke i Tehnološkog Razvoja	U54GM115677, OI 173022
European Regional Development Fund	PSI2014‐55316‐C3‐1‐R

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 5 Gender Equality

Keywords

Alzheimer's disease
cross-cultural validation
dementia
differential item functioning
diversity
functional decline
instrumental activities of daily living
item response theory

Access to Document

10.1002/dad2.12021

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Dubbelman, M. A., Verrijp, M., Facal, D., Sánchez-Benavides, G., Brown, L. J. E., van der 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), 1-11. Article e12021. https://doi.org/10.1002/dad2.12021

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title = "The influence of diversity on the measurement of functional impairment: An international validation of the Amsterdam IADL Questionnaire in eight countries",

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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doi = "10.1002/dad2.12021",

language = "English",

volume = "12",

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Dubbelman, MA, Verrijp, M, Facal, D, Sánchez-Benavides, G, Brown, LJE, van der Flier, WM, Jokinen, H, Lee, A, Leroi, I, Lojo-Seoane, C, Milošević, V, Molinuevo, JL, Pereiro Rozas, AX, Ritchie, C, Salloway, S, Stringer, G, Zygouris, S, Dubois, B, Epelbaum, S, Scheltens, P & Sikkes, SAM 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, vol. 12, no. 1, e12021, pp. 1-11. https://doi.org/10.1002/dad2.12021

The influence of diversity on the measurement of functional impairment: An international validation of the Amsterdam IADL Questionnaire in eight countries. / Dubbelman, Mark A.; Verrijp, Merike; Facal, David et al.
In: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, Vol. 12, No. 1, e12021, 2020, p. 1-11.

Research output: Contribution to Journal › Article › Academic › peer-review

TY - JOUR

T1 - The influence of diversity on the measurement of functional impairment

T2 - An international validation of the Amsterdam IADL Questionnaire in eight countries

AU - Dubbelman, Mark A.

AU - Verrijp, Merike

AU - Facal, David

AU - Sánchez-Benavides, Gonzalo

AU - Brown, Laura J.E.

AU - van der Flier, Wiesje M.

AU - Jokinen, Hanna

AU - Lee, Athene

AU - Leroi, Iracema

AU - Lojo-Seoane, Cristina

AU - Milošević, Vuk

AU - Molinuevo, José Luís

AU - Pereiro Rozas, Arturo X.

AU - Ritchie, Craig

AU - Salloway, Stephen

AU - Stringer, Gemma

AU - Zygouris, Stelios

AU - Dubois, Bruno

AU - Epelbaum, Stéphane

AU - Scheltens, Philip

AU - Sikkes, Sietske A.M.

PY - 2020

Y1 - 2020

N2 - 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.

AB - 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.

KW - Alzheimer's disease

KW - cross-cultural validation

KW - dementia

KW - differential item functioning

KW - diversity

KW - functional decline

KW - instrumental activities of daily living

KW - item response theory

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DO - 10.1002/dad2.12021

M3 - Article

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SN - 2352-8729

VL - 12

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JO - Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring

JF - Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring

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ER -

Dubbelman MA, Verrijp M, Facal D, Sánchez-Benavides G, Brown LJE, van der Flier WM et al. 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. 2020;12(1):1-11. e12021. Epub 2020 May 13. doi: 10.1002/dad2.12021

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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Funding

UN SDGs

Keywords

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