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

Douglas Galasko, F. Schmitt, R. Thomas, S. Jin, D. Bennett, S. Ferris

Research output: Contribution to journalArticlepeer-review

130 Scopus citations


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.

Original languageEnglish
Pages (from-to)446-453
Number of pages8
JournalJournal of the International Neuropsychological Society
Issue number4
StatePublished - Jul 2005


  • Activities of daily living
  • Alzheimer disease
  • Dementia
  • Functionally-impaired elderly
  • Self care
  • Treatment outcome

ASJC Scopus subject areas

  • General Neuroscience
  • Clinical Psychology
  • Clinical Neurology
  • Psychiatry and Mental health


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