Galasko Douglas, Bennett David A, Sano Mary, Marson Daniel, Kaye Jeff, Edland Steven D
Department of Neurosciences, University of California, San Diego, La Jolla, CA 92093-0624, USA.
Alzheimer Dis Assoc Disord. 2006 Oct-Dec;20(4 Suppl 3):S152-69. doi: 10.1097/01.wad.0000213873.25053.2b.
In primary prevention trials for Alzheimer disease, the inception cohort typically has normal or minimally impaired complex activities of daily living (ADL). ADL change during a trial could trigger detailed evaluation or serve as an outcome measure. A brief, easily administered, and reliable ADL rating scale would assist prevention studies.
To develop an ADL scale for prevention trials that allows self-rating or completion by informants.
The Activities of Daily Living-Prevention Instrument (ADL-PI) was developed, comprising 15 ADL and 5 physical function questions. Six hundred forty-four elderly subjects participating in the Prevention Instrument Project completed a self-rated version of the ADL-PI, and informants for 632 subjects completed an informant version. Informants also completed a Mild Cognitive Impairment (MCI) ADL questionnaire to allow comparisons.
Subjects performed well on all ADL scales at baseline. Completion of the ADL-PI questionnaires at home or in-clinic yielded comparable information. Scores from baseline to 3 months had good reliability. The ADL-PI, obtained from either self-report or informants, discriminated between subjects rated as CDR 0 and CDR 0.5. Subjects with worse baseline cognitive performance also had slightly worse ADL-PI scores. Preliminary analysis indicates that subjects who triggered cognitive evaluations had slightly lower baseline ADL-PI scores by both self and informant reports.
The ADL-PI can be completed at home or in clinic, and has adequate reliability. The utility of self-administered and informant versions and predictive value of reported deficits requires further follow-up.
在阿尔茨海默病的一级预防试验中，起始队列的日常生活活动能力（ADL）通常正常或仅有轻微受损。试验期间ADL的变化可能会引发详细评估或作为一项结局指标。一个简短、易于实施且可靠的ADL评定量表将有助于预防研究。
开发一种用于预防试验的ADL量表，该量表允许自我评定或由 informant 完成。
开发了日常生活活动预防工具（ADL-PI），包括15个ADL问题和5个身体功能问题。644名参与预防工具项目的老年受试者完成了ADL-PI的自我评定版本，632名受试者的 informant 完成了 informant 版本。Informant 还完成了一份轻度认知障碍（MCI）ADL问卷以便进行比较。
受试者在基线时所有ADL量表上表现良好。在家中或诊所完成ADL-PI问卷可获得可比信息。从基线到3个月的评分具有良好的信度。通过自我报告或 informant 获得的ADL-PI能够区分评定为CDR 0和CDR 0.5的受试者。基线认知表现较差的受试者的ADL-PI评分也略低。初步分析表明，触发认知评估的受试者通过自我和 informant 报告的基线ADL-PI评分略低。
ADL-PI可在家中或诊所完成，且具有足够的信度。自我施测版和 informant 版的效用以及报告缺陷的预测价值需要进一步随访。
