The Alzheimer's disease activities of daily living international scale (ADL-IS)

Barry Reisberg, Sanford Finkel, John Overall, Norbert Schmidt-Gollas, Siegfried Kanowski, Hartmut Lehfeld, Franz Hulla, Steven G. Sclan, Hans Ulrich Wilms, Kurt Heininger, Ian Hindmarch, Mark Kurt Stemmler, Leonard Poon, Alan Kluger, Carolyn Cooler, Manfred Bergener, Laurence Hugonot-Diener, Philippe H. Robert, Hellmut Erzigkeit

Research output: Contribution to journalArticle

109 Citations (Scopus)

Abstract

Background: Activities of daily living (ADL) deficits are integral components of dementia disorders, and ADL measures are among the most robust markers of the course of Alzheimer's disease (AD). Despite this acknowledged importance, no clearly useful ADL instrument for cross-cultural application in pharmacologic trials in the early stages of AD had been available. Method: An international effort was launched to develop an ADL scale for pharmacologic trials in early AD. Steps taken from 1990 to the present included: (1) international scientific working group meetings and reviews, (2) reviews of existing measures, (3) collating of existent, nonredundant items, (4) querying experts for new items, (5) interviews with informants and subjects in the USA, France, and Germany, toward the identification of potential new items, (6) identification of an item pool based upon these procedures, (7) creation of a trial instrument, (8) piloting of this instrument, and (9) refinement of the scale based upon statistical analysis of the pilot data. Final item selection was based upon: (1) relevance for ≥ 80% of subjects in severity-stratified USA and German samples; (2) absence of gender and national biases; (3) significant (p < .05) discrimination between (a) normal versus mildly impaired and (b) mildly impaired versus moderately to moderately severely impaired subjects; and (4) Global Deterioration Scale (GDS) scores accounting for ≥ 12% of variance in the item after controlling for age and gender. Results: An ADL scale consisting of 40 items that correlate with the global and cognitive progress of AD is developed for international usage in pharmacologic trials in incipient, mild, moderate, and moderately severe AD. The scale contains 40 items falling within 13 ADL categories. The 40-item scale is shown to have .81 correlation with GDS staging, .81 with mental status assessment (Mini-Mental State Examination), and .81 with a psychometric test (the SKT) (p values < .001). Conclusion: This scale can be used to measure therapeutic response in AD.

Original languageEnglish (US)
Pages (from-to)163-181
Number of pages19
JournalInternational Psychogeriatrics
Volume13
Issue number2
DOIs
StatePublished - Jan 1 2001

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Activities of Daily Living
Alzheimer Disease
Sexism
Statistical Data Interpretation
Group Processes
Psychometrics
France
Germany
Dementia
Interviews

All Science Journal Classification (ASJC) codes

  • Clinical Psychology
  • Gerontology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Cite this

Reisberg, B., Finkel, S., Overall, J., Schmidt-Gollas, N., Kanowski, S., Lehfeld, H., ... Erzigkeit, H. (2001). The Alzheimer's disease activities of daily living international scale (ADL-IS). International Psychogeriatrics, 13(2), 163-181. https://doi.org/10.1017/S1041610201007566
Reisberg, Barry ; Finkel, Sanford ; Overall, John ; Schmidt-Gollas, Norbert ; Kanowski, Siegfried ; Lehfeld, Hartmut ; Hulla, Franz ; Sclan, Steven G. ; Wilms, Hans Ulrich ; Heininger, Kurt ; Hindmarch, Ian ; Stemmler, Mark Kurt ; Poon, Leonard ; Kluger, Alan ; Cooler, Carolyn ; Bergener, Manfred ; Hugonot-Diener, Laurence ; Robert, Philippe H. ; Erzigkeit, Hellmut. / The Alzheimer's disease activities of daily living international scale (ADL-IS). In: International Psychogeriatrics. 2001 ; Vol. 13, No. 2. pp. 163-181.
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Reisberg, B, Finkel, S, Overall, J, Schmidt-Gollas, N, Kanowski, S, Lehfeld, H, Hulla, F, Sclan, SG, Wilms, HU, Heininger, K, Hindmarch, I, Stemmler, MK, Poon, L, Kluger, A, Cooler, C, Bergener, M, Hugonot-Diener, L, Robert, PH & Erzigkeit, H 2001, 'The Alzheimer's disease activities of daily living international scale (ADL-IS)', International Psychogeriatrics, vol. 13, no. 2, pp. 163-181. https://doi.org/10.1017/S1041610201007566

The Alzheimer's disease activities of daily living international scale (ADL-IS). / Reisberg, Barry; Finkel, Sanford; Overall, John; Schmidt-Gollas, Norbert; Kanowski, Siegfried; Lehfeld, Hartmut; Hulla, Franz; Sclan, Steven G.; Wilms, Hans Ulrich; Heininger, Kurt; Hindmarch, Ian; Stemmler, Mark Kurt; Poon, Leonard; Kluger, Alan; Cooler, Carolyn; Bergener, Manfred; Hugonot-Diener, Laurence; Robert, Philippe H.; Erzigkeit, Hellmut.

In: International Psychogeriatrics, Vol. 13, No. 2, 01.01.2001, p. 163-181.

Research output: Contribution to journalArticle

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T1 - The Alzheimer's disease activities of daily living international scale (ADL-IS)

AU - Reisberg, Barry

AU - Finkel, Sanford

AU - Overall, John

AU - Schmidt-Gollas, Norbert

AU - Kanowski, Siegfried

AU - Lehfeld, Hartmut

AU - Hulla, Franz

AU - Sclan, Steven G.

AU - Wilms, Hans Ulrich

AU - Heininger, Kurt

AU - Hindmarch, Ian

AU - Stemmler, Mark Kurt

AU - Poon, Leonard

AU - Kluger, Alan

AU - Cooler, Carolyn

AU - Bergener, Manfred

AU - Hugonot-Diener, Laurence

AU - Robert, Philippe H.

AU - Erzigkeit, Hellmut

PY - 2001/1/1

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N2 - Background: Activities of daily living (ADL) deficits are integral components of dementia disorders, and ADL measures are among the most robust markers of the course of Alzheimer's disease (AD). Despite this acknowledged importance, no clearly useful ADL instrument for cross-cultural application in pharmacologic trials in the early stages of AD had been available. Method: An international effort was launched to develop an ADL scale for pharmacologic trials in early AD. Steps taken from 1990 to the present included: (1) international scientific working group meetings and reviews, (2) reviews of existing measures, (3) collating of existent, nonredundant items, (4) querying experts for new items, (5) interviews with informants and subjects in the USA, France, and Germany, toward the identification of potential new items, (6) identification of an item pool based upon these procedures, (7) creation of a trial instrument, (8) piloting of this instrument, and (9) refinement of the scale based upon statistical analysis of the pilot data. Final item selection was based upon: (1) relevance for ≥ 80% of subjects in severity-stratified USA and German samples; (2) absence of gender and national biases; (3) significant (p < .05) discrimination between (a) normal versus mildly impaired and (b) mildly impaired versus moderately to moderately severely impaired subjects; and (4) Global Deterioration Scale (GDS) scores accounting for ≥ 12% of variance in the item after controlling for age and gender. Results: An ADL scale consisting of 40 items that correlate with the global and cognitive progress of AD is developed for international usage in pharmacologic trials in incipient, mild, moderate, and moderately severe AD. The scale contains 40 items falling within 13 ADL categories. The 40-item scale is shown to have .81 correlation with GDS staging, .81 with mental status assessment (Mini-Mental State Examination), and .81 with a psychometric test (the SKT) (p values < .001). Conclusion: This scale can be used to measure therapeutic response in AD.

AB - Background: Activities of daily living (ADL) deficits are integral components of dementia disorders, and ADL measures are among the most robust markers of the course of Alzheimer's disease (AD). Despite this acknowledged importance, no clearly useful ADL instrument for cross-cultural application in pharmacologic trials in the early stages of AD had been available. Method: An international effort was launched to develop an ADL scale for pharmacologic trials in early AD. Steps taken from 1990 to the present included: (1) international scientific working group meetings and reviews, (2) reviews of existing measures, (3) collating of existent, nonredundant items, (4) querying experts for new items, (5) interviews with informants and subjects in the USA, France, and Germany, toward the identification of potential new items, (6) identification of an item pool based upon these procedures, (7) creation of a trial instrument, (8) piloting of this instrument, and (9) refinement of the scale based upon statistical analysis of the pilot data. Final item selection was based upon: (1) relevance for ≥ 80% of subjects in severity-stratified USA and German samples; (2) absence of gender and national biases; (3) significant (p < .05) discrimination between (a) normal versus mildly impaired and (b) mildly impaired versus moderately to moderately severely impaired subjects; and (4) Global Deterioration Scale (GDS) scores accounting for ≥ 12% of variance in the item after controlling for age and gender. Results: An ADL scale consisting of 40 items that correlate with the global and cognitive progress of AD is developed for international usage in pharmacologic trials in incipient, mild, moderate, and moderately severe AD. The scale contains 40 items falling within 13 ADL categories. The 40-item scale is shown to have .81 correlation with GDS staging, .81 with mental status assessment (Mini-Mental State Examination), and .81 with a psychometric test (the SKT) (p values < .001). Conclusion: This scale can be used to measure therapeutic response in AD.

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Reisberg B, Finkel S, Overall J, Schmidt-Gollas N, Kanowski S, Lehfeld H et al. The Alzheimer's disease activities of daily living international scale (ADL-IS). International Psychogeriatrics. 2001 Jan 1;13(2):163-181. https://doi.org/10.1017/S1041610201007566