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IQCODE
Instructions to Informant: "Compared with 10 years ago, how is the person at doing the following things? Please rate any changes you have noticed."
Score is calculated as an average. If an item does not apply (e.g. they never handled finances), leave it blank.
Rate 16 Items
1. Remembering things about family and friends e.g. occupations, birthdays
2. Remembering things that have happened recently
3. Recalling conversations a few days later
4. Remembering his/her address and telephone number
5. Remembering what day and month it is
6. Remembering where things are usually kept
7. Remembering where to find things which have been put in a different place from usual
8. Knowing how to work familiar machines around the house
9. Learning to use a new gadget or machine around the house
10. Learning new things in general
11. Following a story in a book or on TV
12. Making decisions on everyday matters
13. Handling money for shopping
14. Handling financial matters e.g. the pension, dealing with the bank
15. Handling other everyday arithmetic problems e.g. knowing how much food to buy
16. Using his/her intelligence to understand what's going on and to reason things through
Guidelines & Evidence
Clinical Details
Section 1
When to Use
When to Use
Screening for dementia when the patient is unavailable, untestable, or uncooperative.
Assessing cognitive decline in populations with low literacy or diverse cultural backgrounds.
Corroborating patient self-reports of memory loss with collateral history.
Retrospective assessment of premorbid cognition in patients presenting with acute delirium.
Bypassing Literacy Bias
Because the IQCODE asks an informant to compare the patient's current performance against their performance 10 years ago, it is entirely independent of the patient's baseline education, language skills, or premorbid intellect, avoiding the biases inherent in the MMSE or MoCA.
Section 2
Formula & Logic
Scoring
16 items (Short Form) or 26 items (Long Form). OpiCalc provides the 16-item Short Form.
Informant rates change over 10 years from 1 (Much improved) to 5 (Much worse).
Score is averaged across all completed items.
Average score > 3.3 to 3.6 (depending on population) indicates probable dementia.
Domains Assessed
Memory
Remembering things about family/friends, remembering recent conversations.
Executive Function
Handling financial matters, learning new gadgets.
Orientation
Knowing what day/month it is, finding way around familiar streets.
Intellect
Following a story in a book or on TV, reasoning.
Section 3
Pearls/Pitfalls
Premorbid Baseline in Delirium
The IQCODE is invaluable in the emergency department. If an older adult presents acutely confused, an informant IQCODE score of 3.0 suggests pure incident delirium, whereas a score of 4.2 suggests delirium superimposed on undiagnosed dementia.
Section 4
Next Steps
Management
Section 5
Evidence Appraisal
Primary Reference
The Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): socio-demographic correlates, reliability, validity and some norms.
Jorm AF et al. • Psychol Med.. 1989;19(4):1015-22. Original development and validation of the tool.
A short form of the Informant Questionnaire on Cognitive Decline in the Elderly (IQCODE): development and cross-validation.
Jorm AF. • Psychol Med.. 1994;24(1):145-53. Validation of the 16-item short form used in OpiCalc.
Section 6
Origins
Anthony Jorm
Developed by Anthony Jorm in Australia to address the critical lack of tools for diagnosing dementia in non-English speaking and low-literacy populations where standard cognitive testing was culturally inappropriate or invalid.
