title: Functional disability in Alzheimer disease: a validation study of the Brazilian version of the Disability Assessment for Dementia (DAD-Br).
abstract: BACKGROUND
  The assessment of activities of daily living (ADL) is important both for the diagnosis and staging of dementia. The objective of this study was to verify the applicability and validity of the Brazilian version of the Disability Assessment for Dementia (DAD-Br).
  
  
  METHODS
  The DAD was applied to caregivers of 89 patients with probable Alzheimer disease (AD) and to 40 elderly individuals without cognitive impairment (controls). We assessed the construct validity of the scale and its diagnostic accuracy (sensitivity, specificity, and predictive value). In addition, intergroup and intragroup analyses were conducted to characterize patient performance on basic and instrumental ADL and to determine underlying deficits (initiation, planning, or effective execution).
  
  
  RESULTS
  AD patients and controls had mean ages of 76.4+/-6.9 years and 74.5+/-7.3 years (P=0.08), respectively. Mean Mini-Mental State Examination scores were 17.4+/-5.0 and 26.1+/-5.1 (P<0.001) and scores on the DAD were 68.4+/-19.0 and 99.8+/-0.9 (P<0.001), for patients and controls, respectively. The DAD scale showed good internal consistency (Cronbach alpha=0.77) and correlation with the Mini-Mental State Examination (r=0.44; P<0.001). The AD group did better on basic ADL than on instrumental ADL (P<0.001). As expected, controls did not exhibit significant deficits on the items evaluated.
  
  
  CONCLUSIONS
  The Brazilian version of the DAD is an adequate and reliable tool for assessing functional ability in AD patients.
authors.affiliation: Behavioral and Cognitive Neurology Unit, Department of Neurology, Hospital das Clínicas, University of São Paulo School of Medicine, São Paulo, Brazil. vs.bahia@uol.com.br
authors.forename: Valéria Santoro
authors.initials: VS
authors.lastname: Bahia
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Carthery-Goulart
authors.forename: Márcia M
authors.initials: MM
authors.lastname: Novelli
authors.forename: Eliane M
authors.initials: EM
authors.lastname: Kato-Narita
authors.forename: Renata
authors.initials: R
authors.lastname: Areza-Fegyveres
authors.forename: Paulo
authors.initials: P
authors.lastname: Caramelli
authors.forename: Ricardo
authors.initials: R
authors.lastname: Nitrini
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D001938:Brazil / Q000453:epidemiology; D017028:Caregivers; D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires