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Functional decline in Alzheimer's disease: a longitudinal study
C R Green1, R C Mohs, J Schmeidler
1Department of Psychiatry, Mount Sinai School of Medicine, New York, New York.
Journal of the American Geriatrics Society
|June 1, 1993
Summary
Reliable activities of daily living (ADL) measures exist for Alzheimer's disease (AD) patients. Instrumental ADL (IADL) scores track mild to moderate AD, while Physical Self-Maintenance Scale (PSMS) scores track severe AD.
Area of Science:
- Neurology
- Gerontology
- Psychometrics
Background:
- Alzheimer's disease (AD) significantly impacts daily functioning.
- Reliable assessment of functional decline is crucial for patient care and research.
- Longitudinal tracking of activities of daily living (ADL) provides insights into disease progression.
Purpose of the Study:
- To evaluate the reliability of ADL measures in AD patients.
- To determine the rate and pattern of longitudinal ADL changes in Alzheimer's disease.
- To compare the sensitivity of different ADL scales across disease severity.
Main Methods:
- Longitudinal study design with evaluations every six months.
- Inclusion of 104 probable AD patients meeting NINCDS-ADRDA criteria.
- Utilized Physical Self-Maintenance Scale (PSMS), Instrumental Activities of Daily Living Scale (IADLS), and Blessed Test.
Main Results:
- High test-retest and inter-rater reliability for PSMS and appropriate IADLS items.
- IADL scores changed by ~2.06 points/year; PSMS scores changed by ~2.44 points/year.
- IADLS change was smaller in severe dementia; PSMS change occurred mainly in severe dementia.
Conclusions:
- PSMS and IADLS are reliable measures for AD patients.
- IADLS are sensitive to change in mild/moderate AD; PSMS are sensitive in severe AD.
- Development of improved IADLS items for males is recommended.