title: Assessing patient dependence in Alzheimer's disease.
abstract: BACKGROUND
  While cognitive and functional deficits are the hallmark of Alzheimer's disease (AD), loss of social function (and the dependence this implies) is also critical, especially in early stages of disease. Little attention has been directed to this facet of dementing disease. We describe a scale for assessing dependency in AD and present a baseline profile of dependency in a cohort of AD patients.
  
  
  METHODS
  In a study of the predictors of the course of AD, 233 patients in early stages of disease (modified MMS > or = 30) were assessed. Psychometric properties of the dependence scale were established. To validate the scale, dependence scores at baseline were correlated with a series of measures assessing cognition and function. The course of dependency over 18 months of follow-up was also analyzed.
  
  
  RESULTS
  The scale shows adequate reliability (test-retest, intraclass correlation). Dependence stage was related to other measures of disease severity. Scalogram analysis shows that the dependence scale is consistent with the course of functional loss established for dementing disease. Prospective data indicate sensitivity of the scale to disease progression.
  
  
  CONCLUSIONS
  Dependency is a distinct, measurable component of dementing disease and should be considered an important outcome in studies of AD.
authors.affiliation: Department of Neurology, Columbia University College of Physicians and Surgeons.
authors.forename: Y
authors.initials: Y
authors.lastname: Stern
authors.forename: S M
authors.initials: SM
authors.lastname: Albert
authors.forename: M
authors.initials: M
authors.lastname: Sano
authors.forename: M
authors.initials: M
authors.lastname: Richards
authors.forename: L
authors.initials: L
authors.lastname: Miller
authors.forename: M
authors.initials: M
authors.lastname: Folstein
authors.forename: M
authors.initials: M
authors.lastname: Albert
authors.forename: F W
authors.initials: FW
authors.lastname: Bylsma
authors.forename: G
authors.initials: G
authors.lastname: Lafleche
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires