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Detailed assessment of activities of daily living in moderate to severe Alzheimer's disease

Published online by Cambridge University Press:  01 July 2005

D. GALASKO ,
F. SCHMITT ,
R. THOMAS ,
S. JIN ,
D. BENNETT  and
S. FERRIS
D. GALASKO
Affiliation:
Department of Neurosciences, University of California, San Diego
F. SCHMITT
Affiliation:
Department of Neurology, University of Kentucky, Lexington, Kentucky
R. THOMAS
Affiliation:
Department of Neurosciences, University of California, San Diego
S. JIN
Affiliation:
Department of Neurosciences, University of California, San Diego
D. BENNETT
Affiliation:
Rush Alzheimer's Disease Center, Chicago, Illinois
S. FERRIS
Affiliation:
New York University School of Medicine, New York, New York
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Abstract

Patients with Alzheimer's Disease (AD) who have reached a stage of moderate to severe dementia are capable of completing a restricted range of cognitive tests and performing a limited range of activities of daily living (ADL). As part of an initiative to develop instruments to evaluate AD, we analyzed data describing the performance of a large number of ADL and scores on cognitive and global assessment measures in a cohort of patients with AD with moderate to severe cognitive impairment, defined as a Mini-Mental State Examination score ranging from 0–15 (out of 30). From the large pool of ADL, 19 met criteria of applicability, reliability, good scaling, concordant validity, and sensitivity to detect change in performance over 6–12 months. A total score derived from these 19 ADL ratings, comprising a scale termed the Alzheimer Disease Cooperative Study ADL-sev, correlated strongly with measures of cognition and of global dementia severity. Patients with moderate to severe AD showed a decline on the ADL-sev and cognitive measures over 6 and 12 months, consistent with the progression of AD. Detailed evaluation of ADL may provide a useful index to evaluate patients with moderate to severe AD and may complement cognitive assessment, especially for characterizing change in interventional or therapeutic studies. (JINS, 2005, 11, 446–453.)

Keywords

Alzheimer diseaseDementiaActivities of daily livingSelf careFunctionally-impaired elderlyTreatment outcome
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 11 , Issue 4 , July 2005 , pp. 446 - 453
Copyright
© 2005 The International Neuropsychological Society

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References

REFERENCES

Berg, L. (1988). Clinical Dementia Rating (CDR). Psychopharmacology Bulletin, 24, 637–639.Google Scholar
Brane, G., Gottfries, G.C., & Winblad, B. (2001). The Gottfries-Brane-Steen scale: Validity, reliability and application in anti-dementia drug trials. Dementia and Geriatric Cognitive Disorders, 12, 1–14.Google Scholar
Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational Psychological Measures, 20, 37–46.CrossRefGoogle Scholar
DeJong, R., Osterlund, O.W., & Roy, G.W. (1989). Measurement of quality of life changes in patients with Alzheimer's disease. Clinical Therapy, 11, 545–554.Google Scholar
Doody, R., Wirth, Y., Schmitt, F., & Mobius, H.J. (2004). Specific functional effects of memantine treatment in patients with moderate to severe Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 18, 227–232.Google Scholar
Feinstein, A.R., Josephy, B.R., & Wells, C.K. (1986). Scientific and clinical problems in indexes of functional disability. Annals of Internal Medicine, 105, 413–420.Google Scholar
Ferris, S.E., Mackell, J.A., Mohs, R., Schneider, L.S., Galasko, D., Whitehouse, P., Schmitt, F.A., Sano, M., Thomas, R.G., Ernesto, C., Grundman, M., Schafer, K., Thal, L.J., & Alzheimer's Disease Cooperative Study (1997). A multicenter evaluation of new treatment efficacy instruments for Alzheimer's disease clinical trials: Overview and general results. Alzheimer Disease and Associated Disorders, 11(suppl 2), S1–S12.Google Scholar
Folstein, M.F., Folstein, S.E., & McHugh, P.H. (1975). “Mini-mental state”: A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle Scholar
Galasko, D., Bennett, D., Sano, M., Ernesto, C., Thomas, R., Grundman, M., Ferris, S.H., & Alzheimer's Disease Cooperative Study (1997). An inventory to assess activities of daily living for clinical trials in Alzheimer's disease. Alzheimer Disease and Associated Disorders, 11(suppl 2), S33–S39.CrossRefGoogle Scholar
Gelinas, I., Gauthier, L., McIntyre, M., & Gauthier, S. (1999). Development of a functional measure for persons with Alzheimer's disease: The disability assessment for dementia. American Journal of Occupational Therapy, 53, 471–481.CrossRefGoogle Scholar
Katz, S., Ford, A.B., & Moskowitz, R.W. (1963). The index of ADL: A standardized measure of biological and psychosocial function. Journal of the American Medical Association, 185, 914–919.Google Scholar
Lawton, M.P. & Brody, E.M. (1969). Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.Google Scholar
Panisset, M., Roudier, M., Saxton, J., & Boller, F. (1994). Severe impairment battery. A neuropsychological test for severely demented patients. Archives of Neurology, 51, 41–45.Google Scholar
Reisberg, B., Doody, R., Stoffler, A., Schmitt, F., Ferris, S., Mobius, H.J., & Memantine Study Group (2003). Memantine in moderate-to-severe Alzheimer's disease. New England Journal of Medicine, 348, 1333–1341.Google Scholar
Reisberg, B., Ferris, S.H., de Leon, M.J., & Crook, T. (1988). The Global Deterioration Scale (GDS). Psychopharmacology Bulletin, 24, 661–663.Google Scholar
Reisberg, B., Finkel, S., Overall, J., Schmidt-Gollas, N., Kanowski, S., Lehfeld, H., Hulla, F., Sclan, S.G., Wilms, H.U., Heininger, K., Hindmarch, I., Stemmler, M., Poon, L., Kluger, A., Cooler, C., Bergener, M., Hugonot-Diener, L., Robert, P.H., Antipolis, S., & Erzigkeit, H. (2001). The Alzheimer's disease activities of daily living international scale (ADL-IS). International Psychogeriatrics, 13, 163–181.CrossRefGoogle Scholar
Rosen, W.G., Mohs, R.C., & Davis, K.L. (1984). A new rating scale for Alzheimer's disease. American Journal of Psychiatry, 141, 1356–1364.Google Scholar
Sano, M., Ernesto, C., Thomas, R.G., Klauber, M.R., Shafer, K., Grundman, M., Woodbury, P., Growdon, J., Cotman, C.W., Pfeiffer, E., Schneider, L.S., & Thal, L.J. (1997). A randomized controlled trial of selegiline, α-tocopherol, or both as treatment for Alzheimer disease. New England Journal of Medicine, 336, 1216–1222.Google Scholar
Saxton, J., McGoingle-Gibson, K., Swihart, A., Miller, M., & Boller, F. (1990). Assessment of the severely impaired patient: Description and validation of a new neuropsychological test battery. Psychological Assessment, 2, 298–303.Google Scholar
Spiegel, R., Brunner, C., Ermini-Funfschilling, D., Monsch, A., Notter, M., Puxty, J., & Tremmel, L. (1991). A new behavioral assessment scale for geriatric out- and in-patients: The NOSGER (Nurses' Observation Scale for Geriatric Patients). Journal of the American Geriatric Society, 39, 339–347.Google Scholar
Streiner, D.L. & Norman, G.R. (1995). Health measurement scales: A practical guide to their development and use (2nd ed.). Oxford: Oxford Medical Publications.
Tariot, P.N., Farlow, M.R., Grossberg, G.T., Graham, S.M., McDonald, S., Gergel, I., & Memantine Study Group (2004). Memantine treatment in patients with moderate to severe Alzheimer disease already receiving donepezil: A randomized controlled trial. Journal of the American Medical Association, 291, 317–324.CrossRefGoogle Scholar