Original Research Article
Patterns of Loss of Basic Activities of Daily Living in Alzheimer Patients: A Cross-Sectional Study of the French REAL CohortLechowski L.a, b · Van Pradelles S.a · Le Crane M.a · d’Arailh L.a · Tortrat D.a, b · Teillet L.a, b · Vellas B.c–e
aService de Médecine Gériatrique, AP-HP, Hôpital Sainte-Périne, et bLaboratoire ‘Santé-Vieillissement’, EA 2506, Hôpital Sainte-Périne, Université Versailles St-Quentin-en-Yvelines, Paris, et cService de Médecine Interne et de Gérontologie Clinique, CHU Purpan-Casselardit, dGérontopôle, Centre de Recherche Clinique, Hôpital La Grave, et eINSERM U558, Faculté de Médecine, Toulouse, France
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Background/Aims: To characterize loss of basic activities of daily living (BADL) in 687 Alzheimer’s disease (AD) community-dwelling patients included in the French REAL cohort. Methods: Patients had mild to moderately severe AD, and the mean age was 77.8 years. Patterns of loss of the 6 BADL were described at inclusion using the Lawton scale. Results: With 6 binary BADL scores, each patient presented at inclusion a set of losses. For 53% of women, the sets of losses were included within each other or were identical, adding losses in physical ambulation, grooming, bathing, dressing, toilet and feeding, respectively. For 47% of men, a similar sequence was identified, with loss of dressing occurring secondly. A global cohesion of sets of losses was found for 87% of women and 86% of men. The Lawton scale is very useful for the assessment of AD patients.
© 2010 S. Karger AG, Basel
- Zhu CW, Scarmeas N, Torgan R, Albert M, Brandt J, Blacker D, et al: Clinical characteristics and longitudinal changes of informal cost of Alzheimer’s disease in the community. J Am Geriatr Soc 2006;54:1596–1602.
- Andersen CK, Wittrup-Jensen KU, Lolk A, Andersen K, Kragh-Sorensen P: Ability to perform activities of daily living is the main factor affecting quality of life in patients with dementia. Health Qual Life Outcomes 2004;2:52.
- Mucha L, Shaohung S, Cuffel B, McRae T, Mark TL, Del Valle M: Comparison of cholinesterase inhibitor utilization patterns and associated health care costs in Alzheimer’s disease. J Manag Care Pharm 2008;14:451–461.
- Galasko D, Kershaw PR, Schneider L, Zhu Y, Tariot PN: Galantamine maintains ability to perform activities of daily living in patients with Alzheimer’s disease. J Am Geriatr Soc 2004;52:1070–1076.
- Paulino Ramirez Diaz S, Gil Gregorio P, Manuel Ribera Casado J, Reynish E, Jean Ousset P, Vellas B, et al: The need for a consensus in the use of assessment tools for Alzheimer’s disease: the Feasibility Study (assessment tools for dementia in Alzheimer Centres across Europe), a European Alzheimer’s Disease Consortium’s (EADC) survey. Int J Geriatr Psychiatry 2005;20:744–748.
- Green CR, Mohs RC, Schmeidler J, Aryan M, Davis KL: Functional decline in Alzheimer’s disease: a longitudinal study. J Am Geriatr Soc 1993;41:654–661.
- Barberger-Gateau P, Fabrigoule C, Helmer C, Rouch I, Dartigues JF: Functional impairment in instrumental activities of daily living: an early clinical sign of dementia? J Am Geriatr Soc 1999;47:456–462.
- Lechowski L, de Stampa M, Denis B, Tortrat D, Chassagne P, Robert P, et al: Patterns of loss of abilities in instrumental activities of daily living in Alzheimer’s disease: the REAL cohort study. Dement Geriatr Cogn Disord 2008;25:46–53.
- Gillette-Guyonnet S, Nourhashemi F, Andrieu S, Cantet C, Micas M, Ousset PJ, et al: The REAL.FR research program on Alzheimer’s disease and its management: methods and preliminary results. J Nutr Health Aging 2003;7:91–96.
- McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM: Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984;34:939–944.
APA: Diagnostic and Statistical Manual of Mental Disorders. Washington, APA, 1994.
- Zec RF, Landreth ES, Vicari SK, Feldman E, Belman J, Andrise A, et al: Alzheimer disease assessment scale: useful for both early detection and staging of dementia of the Alzheimer type. Alzheimer Dis Assoc Disord 1992;6:89–102.
- Cummings JL, Mega M, Gray K, Rosenberg-Thompson S, Carusi DA, Gornbein J: The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994;44:2308–2314.
- Morris JC: The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology 1993;43:2412–2414.
- Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW: Studies of illness in the aged – the index of ADL: a standardized measure of biological and psychosocial function. JAMA 1963;185:914–919.
- Lawton MP, Brody EM: Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969;9:179–186.
- Njegovan V, Hing MM, Mitchell SL, Molnar FJ: The hierarchy of functional loss associated with cognitive decline in older persons. J Gerontol A Biol Sci Med Sci 2001;56:M638–M643.
- Fillenbaum GG, Smyer MA: The development, validity, and reliability of the OARS multidimensional functional assessment questionnaire. J Gerontol 1981;36:428–234.
- Derouesne C, Thibault S, Lozeron P, Baudouin-Madec V, Piquard A, Lacomblez L: Perturbations of activities of daily living in Alzheimer’s disease: a study of 172 patients using a questionnaire completed by caregivers (in French). Rev Neurol (Paris) 2002;158:684–700.
- Hinton L, Tomaszewski Farias S, Wegelin J: Neuropsychiatric symptoms are associated with disability in cognitively impaired Latino elderly with and without dementia: results from the Sacramento Area Latino study on Aging. Int J Geriatr Psychiatry 2008;23:102–108.
- Bouwens SF, van Heugten CM, Aalten P, Wolfs CA, Baarends EM, van Menxel DA, et al: Relationship between measures of dementia severity and observation of daily life functioning as measured with the Assessment of Motor and Process Skills (AMPS). Dement Geriatr Cogn Disord 2008;25:81–87.
- Hsiung GY, Alipour S, Jacova C, Grand J, Gauthier S, Black SE, et al: Transition from cognitively impaired not demented to Alzheimer’s disease: an analysis of changes in functional abilities in a dementia clinic cohort. Dement Geriatr Cogn Disord 2008;25:483–490.
- Formiga F, Lopez-Soto A, Navarro M, Riera-Mestre A, Bosch X, Pujol R: Hospital deaths of people aged 90 and over: end-of-life palliative care management. Gerontology 2008;54:148–152.
- Atti AR, Palmer K, Volpato S, Winblad B, De Ronchi D, Fratiglioni L: Late-life body mass index and dementia incidence: nine-year follow-up data from the Kungsholmen Project. J Am Geriatr Soc 2008;56:111–116.
- Stout JC, Wyman MF, Johnson SA, Peavy GM, Salmon DP: Frontal behavioral syndromes and functional status in probable Alzheimer disease. Am J Geriatr Psychiatry 2003;11:683–686.
- Lechowski L, De Stampa M, Tortrat D, Teillet L, Benoit M, Robert PH, et al: Predictive factors of rate of loss of autonomy in Alzheimer’s disease patients: a prospective study of the REAL.FR cohort. J Nutr Health Aging 2005;9:100–104.
- Lechowski L, Benoit M, Chassagne P, Vedel I, Tortrat D, Teillet L, et al: Persistent apathy in Alzheimer’s disease as an independent factor of rapid functional decline: the REAL longitudinal cohort study. Int J Geriatr Psychiatry 2008;24:341–346.
- Boyle PA, Malloy PF, Salloway S, Cahn-Weiner DA, Cohen R, Cummings JL: Executive dysfunction and apathy predict functional impairment in Alzheimer disease. Am J Geriatr Psychiatry 2003;11:214–221.
- Marshall GA, Fairbanks LA, Tekin S, Vinters HV, Cummings JL: Neuropathologic correlates of activities of daily living in Alzheimer disease. Alzheimer Dis Assoc Disord 2006;20:56–59.
- Santillan CE, Fritsch T, Geldmacher DS: Development of a scale to predict decline in patients with mild Alzheimer’s disease. J Am Geriatr Soc 2003;51:91–95.
- Perneczky R, Pohl C, Sorg C, Hartmann J, Tosic N, Grimmer T, et al: Impairment of activities of daily living requiring memory or complex reasoning as part of the MCI syndrome. Int J Geriatr Psychiatry 2006;21:158–162.
- Atchison TB, Massman PJ, Doody RS: Baseline cognitive function predicts rate of decline in basic-care abilities of individuals with dementia of the Alzheimer’s type. Arch Clin Neuropsychol 2007;22:99–107.
- Courtney C, Farrell D, Gray R, Hills R, Lynch L, Sellwood E, et al: Long-term donepezil treatment in 565 patients with Alzheimer’s disease (AD2000): randomised double-blind trial. Lancet 2004;363:2105–2115.
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