[Development of an assessment of basic care for the demented (ABCD)]

A rating scale measuring care status related to assistance with basic ADL for demented patients was developed. This instrument, named the ABCD, is designed to be completed by family and professional caregivers, and consists of two subscales assessing the level of difficulty of help with the ADL (difficulty scale) and the reasons why assistance is needed (reason category). In the difficulty scale, each of 6 items is rated with 4 possible responses corresponding to the degree of physical assistance from the caregiver and of the patient's cooperation with the assistance. In the reason category, for 5 activities excluding voiding, the reason is assessed with the following three possible responses: A; physical disability, B; disability in motivation and/or so-called apraxia, C; a combination of A and B. The ABCD was administered to 124 outpatients and 203 inpatients with dementia based on the DSM III-R criteria in order to test its reliability and validity. The data from the out- and inpatient samples were analyzed separately. The reliability study of the two subscales based on calculation of perfect agreement rates and kappa values indicated high test-retest and inter-rater reliability for both samples. The Cronbach alpha values of the difficulty scale were also high. As to the validity of the difficulty scale, there was a significantly high correlation between the score obtained with this scale and the results of two established assessment instruments. For the outpatients, logistic regression analysis revealed that the score obtained with this scale was the only predictor of institutionalization and mortality within 1 year after the baseline examination.(ABSTRACT TRUNCATED AT 250 WORDS)