Item-level psychometrics of the Ascertain Dementia Eight-Item Informant Questionnaire

PLoS One. 2022 Jul 5;17(7):e0270204. doi: 10.1371/journal.pone.0270204. eCollection 2022.

Abstract

The aim of this study is to evaluate the item-level psychometrics of the Ascertain Dementia Eight-Item Informant Questionnaire (AD-8) by examining its dimensionality, rating scale integrity, item fit statistics, item difficulty hierarchy, item-person match, and precision. We used confirmatory factor analysis and the Rasch rating scale model for analyzing the data extracted from the proxy versions of the 2019 and 2020 National Health and Aging Trends Study, USA. A total of 403 participants were included in the analysis. The confirmatory factor analysis with a 1-factor model using the robust weighted least squares (WLSMV) estimator indicated a unidimensional measurement structure (χ2 = 41.015, df = 20, p = 0.004; root mean square error of approximation = 0.051; comparative fit index = 0.995; Tucker-Lewis Index = 0.993;). The findings indicated that the AD-8 has no misfitting items and no differential item functioning across sex and gender. The items were evenly distributed in the item difficulty rating (range: -2.30 to 0.98 logits). While there were floor effects, the AD-8 revealed good reliability (Rasch person reliability = 0.67, Cronbach's alpha = 0.89). The Rasch analysis reveals that the AD-8 has excellent psychometric properties that can be used as a screening assessment tool in clinical settings allowing clinicians to measure dementia both quickly and efficiently. To summarize, the AD-8 could be a useful primary screening tool to be used with additional diagnostic testing, if the patient is accompanied by a reliable informant.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Dementia* / diagnosis
  • Factor Analysis, Statistical
  • Female
  • Humans
  • Male
  • Psychometrics
  • Reproducibility of Results
  • Surveys and Questionnaires

Grants and funding

This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2021S1A3A2A02096338) and the Institute of Convergence Science (ICONS) at Yonsei University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.