Adaptation and validations of Amsterdam instrumental activities of daily living questionnaire-short version for Peru

Abstract

Background: Instrumental Activities of Daily Living (IADL) are key indicators of functional decline in dementia, but culturally adapted tools for Latin America are scarce. Objective: This study aims to assess the validity and robustness of a new Peruvian version of the Amsterdam Instrumental Activities of Daily Living Questionnaire-Short Version (A-IADL-Q-SV-P). Methods: We recruited 171 participants from a cognitive clinic in Peru (81 Clinical Dementia Rating (CDR) = 0, 70 CDR = 1, 20 CDR = 2), including 54 with Alzheimer's disease and 36 with frontotemporal dementia. Validity of the A-IADL-Q-SV-P was assessed using quadratic discriminant analysis to classify CDR level. Spearman correlations tested robustness with demographics (age, sex, education) and associations with cognitive (Mini-Mental State Examination), mood (Generalized Anxiety Disorder-7, Geriatric Depression Scale, and Neuropsychiatric Inventory), and functionality (Pfeffer Functional Activities Questionnaire and Technology-Activities of Daily Living Questionnaire) measures. Results: The A-IADL-Q-SV-P achieved excellent accuracy for classifying dementia severity (accuracy: 0.853, AUC > 0.92). The ability to classify normal cognition had a sensitivity of 0.95 and a specificity of 0.91, and results were similar for patients with Alzheimer's disease or frontotemporal dementia (accuracy > 0.88, sensitivity > 0.95, and specificity > 0.88, AUC > 0.91). We also found weak associations with age, sex, and education (|rho| < 0.2). Furthermore, the A-IADL-Q-SV-P had strong associations with other clinical scales (|rho| > 0.4), particularly in relation to cognition (rho = −0.70) and functionality (rho > 0.87). Conclusions: A-IADL-Q-SV-P demonstrated excellent accuracy in classifying dementia severity, with strong correlations to cognitive and other functionality measures. This supports the utility of A-IADL-Q-SV-P as a culturally adapted tool for assessing functional decline in dementia.