Ersin Ersözlü, Lukas Preis, Daria Gref, Aykut Aktuz, Louise Droste, Katharina Sophie Strentz and Julian Hellmann-Regen explore the use of the Functional Activities Questionnaire (FAQ) to differentiate between mild and moderate dementia in clinical and research settings. A key challenge in dementia staging is accurately identifying when a person has progressed beyond mild dementia, particularly as some amyloid-targeting therapies are currently limited to people in the earlier stages of disease. Functional decline in instrumental activities of daily living is a key marker of this transition, yet validated FAQ cut-off scores have remained unclear.
The study was led by researchers based in Germany and drew on data from the National Alzheimer's Coordinating Center (NACC) in the United States (n=34,513), with validation in two independent multicentre cohorts: the Alzheimer’s Disease Neuroimaging Initiative (ADNI) (n=381) and the Frontotemporal Lobar Degeneration Neuroimaging Initiative (FTLDNI) (n=74). Dementia stage was defined using the Clinical Dementia Rating (CDR), while functional impairment was assessed using the 10-item FAQ.
The results showed that the FAQ differentiated mild from moderate dementia with high accuracy. An FAQ score of 18 or higher provided the best overall discrimination, with 96% sensitivity and 87% specificity in the NACC cohort. A higher threshold of 23 or higher increased specificity to 92% while maintaining 83% sensitivity. These findings were replicated in the validation cohorts.
The authors conclude that the FAQ is a robust tool for differentiating mild from moderate dementia. The proposed cut-offs may support more consistent functional staging in clinical practice and research, with the ≥18 threshold favouring sensitivity and the ≥23 threshold favouring specificity depending on the intended use.
Find the full article here: https://www.sciencedirect.com/science/article/pii/S2274580726001548?via%3Dihub
