The Reliability and Validity of the Korean Instrumental Activities of Daily Living (K-IADL)

BACKGROUND: The measurement of functional disabilities in patients with dementia is one of the essential parts of evaluation for dementia from the viewpoint of diagnosis and therapeutic intervention. Nevertheless, few standardized scales for the instrumental activities of daily living (IADL) are available in Korea. The purpose of this study was to test the reliability and validity of the Korean IADL (K-IADL). METHODS: K-IADL is comprised of 11 items that were selected by the Representative Committee of the Korean Dementia Research Group. These include: (1) shopping, (2) mode of transportation, (3) ability to handle finances, (4) house keeping, (5) preparing food, (6) ability to use a tele-phone, (7) responsibility for own medication, (8) recent memory, (9) hobbies, (10) watching television, and (11) fixing around the house. K-IADL was administered to informants of 114 dementia patients and age and sex matched 106 con-trols. The informants rated each item as follows: 0=normal, 1=with some assistance, 2=with much assistance, 3=unable to do, NA=not applicable. RESULTS: Internal consistency (Cronbach's alpha=0.96) and the test-retest reliability(r=0.94) of K-IADL were significant. A principle component factor analysis extracted a single factor that accounted for 70.3% of the total variance (Eigenvalue: 7.74), and K-IADL was correlated significantly with other general cognitive indices, demonstrating good validity. With a cut-off point of 0.43, the K-IADL had a sensitivity of 83% and a specificity of 82% in the diagnosis of dementia. CONCLUSIONS: Our results showed that K-IADL could be a reliable and valid tool for the quantification of functional disabilities of Korean dementia patients.

Horizontal versus Vertical Reading in Neglect Dyslexia: A Case Study

BACKGROUND: Neglect dyslexia is a type of neglect syndrome, in which patients with unilateral hemisphere injury omit or misread the contralateral side of a text or the initial letters of a word. Hangul can be arrayed vertically (vertical reading, VR) as well as horizontally (horizontal reading, HR). Thus, HR and VR can be differentially affected in neglect dyslexia. We conducted an experiment in a 66 year-old woman who suffered from neglect dyslexia after a right cerebral infarction. We compared HR with VR in terms of error frequencies and patterns. METHODS: Stimuli for neglect dyslexia consisted of 227 words. The 227 words were written horizontally or vertically (total 554 words) and were pre-sented in random order. The patient was asked to read the words and the examiner recorded the patient's responses and reaction times. RESULTS: The differences in HR and VR were as follows: 1) the error frequency in HR (59.0%) was higher than the error frequency in VR (20.3%), 2) the most frequent error in HR was syllabic deletion (79.1%) whereas phonemic substitution (89.1%) predominated in VR, 3) the error rate was highest at the first syllabic position in HR whereas no position effect was noted in VR. CONCLUSIONS: Patients with neglect dyslexia make less error in VR than in HR. The neural processing of HR may be different from that of VR. VR may be an alternative reading strategy that may be useful during the recovery stage of neglect dyslexia.