Dependence as a unifying construct in defining Alzheimer's disease severity

Trent McLaughlin, Howard Feldman, Howard Fillit, Mary Sano, Frederick Schmitt, Paul Aisen, Christopher Leibman, Lisa Mucha, J. Michael Ryan, Sean D. Sullivan, D. Eldon Spackman, Peter J. Neumann, Joshua Cohen, Yaakov Stern

Research output: Contribution to journalComment/debate

59 Scopus citations


This article reviews measures of Alzheimer's disease (AD) progression in relation to patient dependence and offers a unifying conceptual framework for dependence in AD. Clinicians typically characterize AD by symptomatic impairments in three domains: cognition, function, and behavior. From a patient's perspective, changes in these domains, individually and in concert, ultimately lead to increased dependence and loss of autonomy. Examples of dependence in AD range from a need for reminders (early AD) to requiring safety supervision and assistance with basic functions (late AD). Published literature has focused on the clinical domains as somewhat separate constructs and has given limited attention to the concept of patient dependence as a descriptor of AD progression. This article presents the concept of dependence on others for care needs as a potential method for translating the effect of changes in cognition, function, and behavior into a more holistic, transparent description of AD progression.

Original languageEnglish
Pages (from-to)482-493
Number of pages12
JournalAlzheimer's and Dementia
Issue number6
StatePublished - Nov 2010


  • Alzheimer's disease
  • Dementia
  • Dependence
  • Disease progression
  • Functional impairment

ASJC Scopus subject areas

  • Clinical Neurology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience
  • Health Policy
  • Developmental Neuroscience
  • Epidemiology


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