Diagnostic accuracy of Alzheimer's Questionnaire in identifying dementia among Filipinos in a tertiary hospital

Abstract

Background

Dementia, most often due to Alzheimer's disease, is a growing concern in the Philippines. The Alzheimer's Questionnaire (AQ), an informant-based screening tool, may be particularly useful in this setting, where strong familial and caregiving ties exist. Establishing its diagnostic accuracy in Filipinos is crucial for early detection and improved care.

Objective

To determine the diagnostic accuracy of the AQ among Filipinos by comparing it with physician diagnoses and established cognitive assessment tools.

Methods

This retrospective cohort study included 190 Filipino patients who underwent cognitive assessments, including the AQ, Mini-Mental State Examination (MMSE-F), and Montreal Cognitive Assessment (MoCA-P), between 2022 and 2024. Diagnostic accuracy was measured using sensitivity, specificity, predictive values, and area under the curve (AUC). Cohen's Kappa assessed agreement between AQ classifications and physician diagnoses.

Results

Clinico-demographic analysis suggested that age and work status may influence dementia risk, while gender and common comorbidities showed no significant associations. The AQ demonstrated high specificity (92.47%) and strong diagnostic accuracy (AUC = 0.923) in distinguishing dementia from non-dementia, performing comparably to MoCA and MMSE. However, it was less effective in detecting mild cognitive impairment (MCI).

Conclusions

The AQ is a reliable and accurate tool for dementia screening in Filipinos, though limited for MCI detection. Incorporating AQ into routine cognitive screening may enhance early dementia identification. Further studies should refine cultural adaptations and validate its role in the Philippine healthcare context.