Measuring functioning in daily activities for persons with dementia

The author reviews scales that include independent living tasks, with a special focus on scales designed to be used with demented persons. The main focus of the paper is evaluation of dementia-specific scales, both proxy report and performance scales. Criticisms of generic independent living measures are reviewed and approaches to dementia-specific scales are assessed. The overall state of the art of measuring functional disability for persons with dementia is reviewed, with special emphasis on validity, measurement bias, and scaling properties. The author attempts to clarify whether dementia-specific scales are measuring the disability consequences of cognitive impairments or the cognitive impairments themselves.