title: The Lawton Instrumental Activities Daily Living/Activities Daily Living Scales: A Sensitive Test to Alzheimer Disease in Community-Dwelling Elderly People?
abstract: OBJECTIVE
  To examine the diagnostic ability of the Lawton Instrumental Activities Daily Living (IADLs) scale and the Activities Daily Living (ADLs) scale as a sensitive tool to Alzheimer's disease (AD) in community-dwelling elderly people.
  
  
  METHODS
  In an old age memory outpatient center, among patients with a clinical diagnosis of AD dementia or no dementia supported by at least 6 months of follow-up, we looked back at the baseline Lawton IADL scale (short version IADL-4 item), ADL scale, Mini-Mental State Examination (MMSE), and Montreal Cognitive Assessment (MOCA) values.
  
  
  RESULTS
  There were 109 patients with AD and 53 nondemented individuals (81.4 ± 4.6 years). The sensitivity of ADL scale or IADL-4 item or the MMSE was low (52%-57%). The most efficient AD classification used both the IADLs-4 item and the MOCA with a threshold score of 20. Besides age and memory scores, the main correlates of IADLs scale or ADLs scale were executive, neuropsychiatric, vascular, and extrapyramidal scores.
  
  
  CONCLUSIONS
  Our results suggest that the Lawton IADLs-4 item scale and ADLs scale lack sensitivity to AD dementia in elderly people and support a better sensitivity of MOCA rather than MMSE and IADLs-4 item/ADLs at the expense of specificity.
authors.affiliation: Memory Center, Bretonneau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France pierre.koskas@brt.aphp.fr.
authors.forename: Pierre
authors.initials: P
authors.lastname: Koskas
authors.affiliation: Department of Radiology, Bichat Claude Bernard University Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Marie Cécile
authors.initials: MC
authors.lastname: Henry-Feugeas
authors.affiliation: UMR U722 INSERM Faculté de Médecine Xavier Bichat, Paris Diderot University, Paris, France.
authors.forename: Jean Paul
authors.initials: JP
authors.lastname: Feugeas
authors.affiliation: Department of Geriatrics, Bretonneau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Aurore
authors.initials: A
authors.lastname: Poissonnet
authors.affiliation: Department of Psycho-Geriatrics, Bretonneau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Pons-Peyneau
authors.affiliation: Department of Geriatrics, Bretonneau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Wolmark
authors.affiliation: Department of Psycho-Geriatrics, Bretonneau Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Drunat
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000523:psychology; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008568:Memory; D009483:Neuropsychological Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: ADLs; Alzheimer disease; IADLs; MMSE; MOCA; old people