Short Form of the Informant Questionnaire on Cognitive Decline in the Elderly (Short IQCODE)

Short Form of the Informant Questionnaire on Cognitive Decline in the Elderly (Short IQCODE)

Read to patient: Now we want you to remember what your friend or relative was like 10 years ago and to compare it with what he/she is like now. 10 years ago was the year [text size=4]. Below are situations where this person has to use his/her memory or intelligence and we want you to indicate whether this has improved, stayed the same or got worse in that situation over the past 10 years. Note the importance of comparing his/her present performance with 10 years ago. Possible answers are "Much improved," "A bit improved," "Not much change," "A bit worse," and "Much worse."  So if 10 years ago this person always forgot where he/she had left things, and he/she still does, then this would be considered "Not much change". Please indicate the changes you have observed by choosing the appropriate answer. 
 
Compared with 10 years ago how is this person at: 
[select name="Ques1" value="DECLINED=0|Chosen=1" help="Declined items are not scored"] <-- 1. Remembering things about family and friends e.g. occupations, birthdays, addresses [conditional field="Ques1" condition="(Ques1).is('Chosen=1')"]
[select name="Q1" value="Not answered=0|Much improved (1 point)=1|A bit improved (2 points)=2|Not much change (3 points)=3|A bit worse (4 points)=4|Much worse (5 points)=5"][/conditional]
 
[select name="Ques2" value="DECLINED=0|Chosen=1" help="Declined items are not scored"] <-- 2. Remembering things that have happened recently [conditional field="Ques2" condition="(Ques2).is('Chosen=1')"]
[select name="Q2" value="Not answered=0|Much improved (1 point)=1|A bit improved (2 points)=2|Not much change (3 points)=3|A bit worse (4 points)=4|Much worse (5 points)=5"][/conditional]

[select name="Ques3" value="DECLINED=0|Chosen=1" help="Declined items are not scored"] <-- 3. Recalling conversations a few days later [conditional field="Ques3" condition="(Ques3).is('Chosen=1')"]
[select name="Q3" value="Not answered=0|Much improved (1 point)=1|A bit improved (2 points)=2|Not much change (3 points)=3|A bit worse (4 points)=4|Much worse (5 points)=5"][/conditional]

[select name="Ques4" value="DECLINED=0|Chosen=1" help="Declined items are not scored"] <-- 4. Remembering his/her address and telephone number [conditional field="Ques4" condition="(Ques4).is('Chosen=1')"]
[select name="Q4" value="Not answered=0|Much improved (1 point)=1|A bit improved (2 points)=2|Not much change (3 points)=3|A bit worse (4 points)=4|Much worse (5 points)=5"][/conditional]

[select name="Ques5" value="DECLINED=0|Chosen=1" help="Declined items are not scored"] <-- 5. Remembering what day and month it is [conditional field="Ques5" condition="(Ques5).is('Chosen=1')"]
[select name="Q5" value="Not answered=0|Much improved (1 point)=1|A bit improved (2 points)=2|Not much change (3 points)=3|A bit worse (4 points)=4|Much worse (5 points)=5"][/conditional]

[select name="Ques6" value="DECLINED=0|Chosen=1" help="Declined items are not scored"] <-- 6. Remembering where things are usually kept [conditional field="Ques6" condition="(Ques6).is('Chosen=1')"]
[select name="Q6" value="Not answered=0|Much improved (1 point)=1|A bit improved (2 points)=2|Not much change (3 points)=3|A bit worse (4 points)=4|Much worse (5 points)=5"][/conditional]

[select name="Ques7" value="DECLINED=0|Chosen=1" help="Declined items are not scored"] <-- 7. Remembering where to find things which have been put in a different place from usual [conditional field="Ques7" condition="(Ques7).is('Chosen=1')"]
[select name="Q7" value="Not answered=0|Much improved (1 point)=1|A bit improved (2 points)=2|Not much change (3 points)=3|A bit worse (4 points)=4|Much worse (5 points)=5"][/conditional]

[select name="Ques8" value="DECLINED=0|Chosen=1" help="Declined items are not scored"] <-- 8. Knowing how to work familiar machines around the house [conditional field="Ques8" condition="(Ques8).is('Chosen=1')"]
[select name="Q8" value="Not answered=0|Much improved (1 point)=1|A bit improved (2 points)=2|Not much change (3 points)=3|A bit worse (4 points)=4|Much worse (5 points)=5"][/conditional]

[select name="Ques9" value="DECLINED=0|Chosen=1" help="Declined items are not scored"] <-- 9. Learning to use a new gadget or machine around the house [conditional field="Ques9" condition="(Ques9).is('Chosen=1')"]
[select name="Q9" value="Not answered=0|Much improved (1 point)=1|A bit improved (2 points)=2|Not much change (3 points)=3|A bit worse (4 points)=4|Much worse (5 points)=5"][/conditional]

[select name="Ques10" value="DECLINED=0|Chosen=1" help="Declined items are not scored"] <-- 10. Learning new things in general [conditional field="Ques10" condition="(Ques10).is('Chosen=1')"]
[select name="Q10" value="Not answered=0|Much improved (1 point)=1|A bit improved (2 points)=2|Not much change (3 points)=3|A bit worse (4 points)=4|Much worse (5 points)=5"][/conditional]

[select name="Ques11" value="DECLINED=0|Chosen=1" help="Declined items are not scored"] <-- 11. Following a story in a book or on TV [conditional field="Ques11" condition="(Ques11).is('Chosen=1')"]
[select name="Q11" value="Not answered=0|Much improved (1 point)=1|A bit improved (2 points)=2|Not much change (3 points)=3|A bit worse (4 points)=4|Much worse (5 points)=5"][/conditional]

[select name="Ques12" value="DECLINED=0|Chosen=1" help="Declined items are not scored"] <-- 12. Making decisions on everyday matters [conditional field="Ques12" condition="(Ques12).is('Chosen=1')"]
[select name="Q12" value="Not answered=0|Much improved (1 point)=1|A bit improved (2 points)=2|Not much change (3 points)=3|A bit worse (4 points)=4|Much worse (5 points)=5"][/conditional]

[select name="Ques13" value="DECLINED=0|Chosen=1" help="Declined items are not scored"] <-- 13. Handling money for shopping [conditional field="Ques13" condition="(Ques13).is('Chosen=1')"]
[select name="Q13" value="Not answered=0|Much improved (1 point)=1|A bit improved (2 points)=2|Not much change (3 points)=3|A bit worse (4 points)=4|Much worse (5 points)=5"][/conditional]

[select name="Ques14" value="DECLINED=0|Chosen=1" help="Declined items are not scored"] <-- 14. Handling financial matters e.g. the pension, dealing with the bank [conditional field="Ques14" condition="(Ques14).is('Chosen=1')"]
[select name="Q14" value="Not answered=0|Much improved (1 point)=1|A bit improved (2 points)=2|Not much change (3 points)=3|A bit worse (4 points)=4|Much worse (5 points)=5"][/conditional]

[select name="Ques15" value="DECLINED=0|Chosen=1" help="Declined items are not scored"] <-- 15. Handling other everyday arithmetic problems e.g. knowing how much food to buy, knowing how long between visits from family or friends [conditional field="Ques15" condition="(Ques15).is('Chosen=1')"]
[select name="Q15" value="Not answered=0|Much improved (1 point)=1|A bit improved (2 points)=2|Not much change (3 points)=3|A bit worse (4 points)=4|Much worse (5 points)=5"][/conditional]

[select name="Ques16" value="DECLINED=0|Chosen=1" help="Declined items are not scored"] <-- 16. Using his/her intelligence to understand what's going on and to reason things through [conditional field="Ques16" condition="(Ques16).is('Chosen=1')"]
[select name="Q16" value="Not answered=0|Much improved (1 point)=1|A bit improved (2 points)=2|Not much change (3 points)=3|A bit worse (4 points)=4|Much worse (5 points)=5"][/conditional]

Questions completed --> [calc value="score1=(Ques1)+(Ques2)+(Ques3)+(Ques4)+(Ques5)+(Ques6)+(Ques7)+(Ques8)+(Ques9)+(Ques10)+(Ques11)+(Ques12)+(Ques13)+(Ques14)+(Ques15)+(Ques16)" memo="number"] out of 16 questions.
Average –> [calc value="score4=(((Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9)+(Q10)+(Q11)+(Q12)+(Q13)+(Q14)+(Q15)+(Q16))/((Ques1)+(Ques2)+(Ques3)+(Ques4)+(Ques5)+(Ques6)+(Ques7)+(Ques8)+(Ques9)+(Ques10)+(Ques11)+(Ques12)+(Ques13)+(Ques14)+(Ques15)+(Ques16))).toFixed(2)" memo="number"] points.
Interpretation –> [calc value="score5=(((Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9)+(Q10)+(Q11)+(Q12)+(Q13)+(Q14)+(Q15)+(Q16))/((Ques1)+(Ques2)+(Ques3)+(Ques4)+(Ques5)+(Ques6)+(Ques7)+(Ques8)+(Ques9)+(Ques10)+(Ques11)+(Ques12)+(Ques13)+(Ques14)+(Ques15)+(Ques16)));score5>4?'Severe decline - Dementia evaluation is warranted':score5>3.5?'Moderate decline - Dementia evaluation is warranted':score5>3.37?'Slight decline - Dementia evaluation is warranted':score5>3?'Slight decline - Dementia evaluation may be warranted':'No decline - Dementia evaluation may be unnecessary'" memo="interpretation"]
[checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"]
reference:  
[link url="//www.ncbi.nlm.nih.gov/pubmed/2594878" memo="#1"] Jorm AF, Jacomb PA. The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): socio-demographic correlates, reliability, validity and some norms. Psychol Med. 1989;19:1015–22.
[link url="//www.alz.org/professionals_and_researchers_professional_care_providers.asp" memo="#2"] Alzheimer's Association
[/conditional]