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Instrumental activities of daily living scale for dementia screening in elderly people
Mathuranath PS, George A, Cherian PJ, Mathew R, Sarma PS.. International psychogeriatrics, 2005-09-01
Topic: Risk, prevention and care in population studies
Objective To develop and validate an Instrumental Activities of Daily Living Scale for elderly people (IADL-E) to use in conjunction with cognitive screening tests for dementia in an educationally and socioculturally heterogeneous population. Method Eleven IADL items were selected and weighted for major factors causing heterogeneity in the population--gender, education, social (rural/urban) setting and age. Each item was rated for its applicability (yes/no), degree of disability (scored from 0 to 2) and causative impairment (cognitive and/or physical). From this a composite index of cognitive (CDI) or physical (PDI) disability was derived. Validation was performed retrospectively on 240 subjects: 135 without and 105 with dementia by DSM-IV. Results The IADL-E had a high internal consistency (alpha = 0.95). The area under the receiver operating characteristic (ROC) curve was 0.97 (CI = 0.94-0.99). A cutoff score of 16 on CDI provided a sensitivity of 0.91, specificity 0.99 and positive predictive value 0.76 (at 5% base rate). IADL-E correlated highly with clinical (DSM-IV, kappa = 0.89), functional (CDR, 0.82) and cognitive (Mini-mental Status Examination, MMSE, 0.74) diagnoses. It showed good responsiveness, with the change on CDI over a median of 23 months correlating significantly with that on MMSE (coefficient = -0.382, CI = -0.667 to -0.098; p=0.009). Individual items had good interrater and test-retest reliability. Conclusions The IADL-E is a reliable, sensitive and responsive scale of functional abilities useful in dementia screening in a socioculturally heterogeneous population.
Key findings
- Results The IADL-E had a high internal consistency (alpha = 0.95).
- It showed good responsiveness, with the change on CDI over a median of 23 months correlating significantly with that on MMSE (coefficient = -0.382, CI = -0.667 to -0.098; p=0.009).
Why it matters
The Instrumental Activities of Daily Living Scale for elderly people showed high internal consistency and, at a cutoff score of 16, a sensitivity of 0.91 and specificity of 0.99 for dementia. This is a screening and disability measurement tool, not a treatment, cure, or prevention of Alzheimer's disease.
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Study details
- Participants240
- Evidence strengthLow
How this study scored 44/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (International psychogeriatrics) |
| Journal's citation record | 2 / 4 | International Psychogeriatrics: journal h-index 161 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2005 — older than 20 years, still counted |
| Sample size | 2 / 4 | 240 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 5 / 7 | Cited 112 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 4.9 citations a year over 23 year(s) since 2005 |
| Impact for its field and year | 2 / 6 | Cited 2.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 4 other studies in this library |
| Still being cited | 2 / 4 | Cited 28 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Prabhakaran Sankara Sarma: h-index 56 (OpenAlex, whole career) |
| Institution's track record | 0 / 3 | Sree Chitra Thirunal Institute for Medical Sciences and Technology: institution h-index 176 (OpenAlex) |
| Multi-centre collaboration | 0 / 3 | OpenAlex lists 1 institution(s) in 1 country — scores zero (affiliation lists can be incomplete) |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 16252378) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 44 / 100 | — |
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Read the original
- DOI: 10.1017/s1041610205001547
- PubMed: 16252378
- Original source →
- Free full text: International Psychogeriatrics →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
APA 7th
Mathuranath, P. S., George, A., Cherian, P. J., Mathew, R., & Sarma, P. S. (2005). Instrumental activities of daily living scale for dementia screening in elderly people. International psychogeriatrics. https://doi.org/10.1017/s1041610205001547
Vancouver
Mathuranath PS, George A, Cherian PJ, Mathew R, Sarma PS. Instrumental activities of daily living scale for dementia screening in elderly people. International psychogeriatrics. 2005. doi:10.1017/s1041610205001547. PMID: 16252378.
BibTeX
@article{mathuranath2005-16252378,
author = {Mathuranath, P. S. and George, A. and Cherian, P. J. and Mathew, R. and Sarma, P. S.},
title = {{Instrumental activities of daily living scale for dementia screening in elderly people}},
journal = {International psychogeriatrics},
year = {2005},
doi = {10.1017/s1041610205001547},
pmid = {16252378},
url = {https://doi.org/10.1017/s1041610205001547}
}
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