ADCS-ADL Scale, Scoring and Manual - Dementia Outcomes ...

terviewed with the ADL Inventory. Controls acted as
their own informants. ADL interviews were conducted in
person at baseline. To increase follow-up participation, if
informants were unable to travel to a center's clinic site,
interviews were conducted by telephone. A representative
from each participating center attended a training
se~sion at which use of the inventory was described, and
ea~h site received a procedural manual describing each
question in the ADL Inventory. The personnel who carried
out ADL interviews were psychometrists or clinicians
with experience in assessment of patients with AD.
The ADL Inventory took from 30 to 45 min to administer.
Data Analysis
Data were analyzed using SPSS (version 6.1). We
used several criteria to determine which ADL in the inventory
were likely to be best suited for use in monitoring
patients in clinical trials. These included wide applicability,
good test-retest reliability, ability of the ADL to
show stepwise scaling and to correlate with dementia
severity, and decline of ADL performance in an appreciable
percentage of patients with AD over 12 months
(Feinstein et aI., 1986; Streiner and Norman, 1995). Applicability
was measured as the percentage of subjects
who attempted each ADL at baseline, or premorbidly in
the case of AD patients who did not attempt specific
ADL. As an index of short-term (test-retest) reliability
for each ADL, the extent of agreement between ratings at
baseline, one and two months was calculated using a K
statistic (O'Connell and Dobson, 1984). To determine
whether the levels of performing each ADL related to
dementia severity, we compared MMSE scores between
patients who carried out the ADL in each specified manner
at baseline by ANOVA. If MMSE scores of patients
performing an ADL at different descriptors or "levels"
of ADL performance did not differ significantly (p