The purpose of this project is to determine the reliability and validity of an instrument designed to assess functional ability of patients with Alzheimer's Disease (AD) enrolled in clinical treatment trials. At present functional scales measuring activities of daily living (ADLs) are often used as secondary but rarely as primary outcome measures either in trials of antidementia drugs or in trials of drugs for the treatment of ancillary symptoms such as agitation. Existing instruments are limited first because there is no consensus that they measure all of the major functional limitations found in AD patients and more importantly, that no existing instrument has been shown to be suitable for assessing functional change over a broad spectrum of dementia severity. Previously we have conducted reliability and longitudinal validity studies of the two most widely used instruments for assessing activities of daily living (ADLs) in AD patients, the Physical and Self-Maintenance Scale (PSMS) and Instrumental Activities of Daily Living Scale (IADLS) of Lawton and Brodie (1969). These studies have determined that many but not all of the items on these two scales have adequate reliability and longitudinal validity. We propose to modify some of the PSMS items to enhance reliability and to modify or replace several IADLS items so that they are less gender and location specific. Then we propose to assess the inter-rater, test-retest and alternate source reliability of each item; those with poor reliability will be eliminated or modified. Then a group of at least 50 AD patients with a wide range of baseline severity will be evaluated every six months for a minimum of 12 months. The ability of each item to measure longitudinal change for each level of dementia severity will be determined, and the reliability and sensitivity of the scale will be compared with other clinician rating scales used in clinical trials. The ultimate aim of the project is to produce an instrument for measuring activities of daily living (ADLs) in AD patients that can be used to evaluate the efficacy of drug treatments or other interventions.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Specialized Center (P50)
Project #
2P50AG005138-11
Application #
3745754
Study Section
Project Start
Project End
Budget Start
Budget End
Support Year
11
Fiscal Year
1994
Total Cost
Indirect Cost
Name
Mount Sinai School of Medicine
Department
Type
DUNS #
City
New York
State
NY
Country
United States
Zip Code
10029
Alosco, Michael L; Sugarman, Michael A; Besser, Lilah M et al. (2018) A Clinicopathological Investigation of White Matter Hyperintensities and Alzheimer's Disease Neuropathology. J Alzheimers Dis 63:1347-1360
Kinnunen, Kirsi M; Cash, David M; Poole, Teresa et al. (2018) Presymptomatic atrophy in autosomal dominant Alzheimer's disease: A serial magnetic resonance imaging study. Alzheimers Dement 14:43-53
Brent, Robert J (2018) Estimating the monetary benefits of medicare eligibility for reducing the symptoms of dementia. Appl Econ 50:6327-6340
Moreno, Cesar L; Della Guardia, Lucio; Shnyder, Valeria et al. (2018) iPSC-derived familial Alzheimer's PSEN2 N141I cholinergic neurons exhibit mutation-dependent molecular pathology corrected by insulin signaling. Mol Neurodegener 13:33
Deming, Yuetiva; Dumitrescu, Logan; Barnes, Lisa L et al. (2018) Sex-specific genetic predictors of Alzheimer's disease biomarkers. Acta Neuropathol 136:857-872
Gallagher, Damien; Kiss, Alex; Lanctot, Krista L et al. (2018) Toward Prevention of Mild Cognitive Impairment in Older Adults With Depression: An Observational Study of Potentially Modifiable Risk Factors. J Clin Psychiatry 80:
Tse, Kai-Hei; Cheng, Aifang; Ma, Fulin et al. (2018) DNA damage-associated oligodendrocyte degeneration precedes amyloid pathology and contributes to Alzheimer's disease and dementia. Alzheimers Dement 14:664-679
Toker, Lilah; Mancarci, Burak Ogan; Tripathy, Shreejoy et al. (2018) Transcriptomic Evidence for Alterations in Astrocytes and Parvalbumin Interneurons in Subjects With Bipolar Disorder and Schizophrenia. Biol Psychiatry 84:787-796
Gandal, Michael J; Haney, Jillian R; Parikshak, Neelroop N et al. (2018) Shared molecular neuropathology across major psychiatric disorders parallels polygenic overlap. Science 359:693-697
Barnes, Josephine; Bartlett, Jonathan W; Wolk, David A et al. (2018) Disease Course Varies According to Age and Symptom Length in Alzheimer's Disease. J Alzheimers Dis 64:631-642

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