The Disability Assessment for Dementia Scale: A 12-Month Study of Functional Ability in Mild to Moderate Severity Alzheimer Disease

Feldman, Howard; Sauter, Agnes; Donald, Alan; Gélinas, Isabelle; Gauthier, Serge; Torfs, Koen; Parys, Wim; Mehnert, A.

doi:10.1097/00002093-200104000-00008

Cited by 113 publications

(96 citation statements)

References 10 publications

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“…In summary, previous studies have shown that individuals with greater global cognitive dysfunction at baseline experience a more rapid rate of decline in IADLs than individuals with milder impairment overall (Feldman et al, 2001;Schmeidler et al, 1998). The current results extend these findings to show that in particular, those patients with a greater degree of executive dysfunction at initial assessment tend to experience a more rapid decline in ratings of their functional status over time.…”

Section: Discussionsupporting

confidence: 82%

Cognitive and neuroimaging predictors of instrumental activities of daily living

Cahn-Weiner

Farias

Julián

et al. 2007

J. Inter. Neuropsych. Soc.

187

167

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Impaired ability to conduct daily activities is a diagnostic criterion for dementia and a determinant of healthcare services utilization and caregiver burden. What predicts decline in instrumental activities of daily living (IADLs) is not well understood. This study examined measures of episodic memory, executive function, and MRI brain volumes in relation to baseline IADLs and as predictors of rate of IADL change. Participants were 124 elderly persons with cognitive function between normal and moderate dementia both with and without significant small vessel cerebrovascular disease. Random effects modeling showed that baseline memory and executive function (EXEC) were associated with baseline IADL scores, but only EXEC was independently associated with rate of change in IADLs. Whereas hippocampal and cortical gray matter volumes were significantly associated with baseline IADL scores, only hippocampal volume was associated with IADL change. In a model including cognitive and neuroimaging predictors, only EXEC independently predicted rate of decline in IADL scores. These findings indicate that greater executive dysfunction at initial assessment is associated with more rapid decline in IADLs. Perhaps executive function is particularly important with respect to maintaining IADLs. Alternatively, executive dysfunction may be a sentinel event indicating widespread cortical involvement and poor prognosis.

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Section: Discussionsupporting

confidence: 82%

Cognitive and neuroimaging predictors of instrumental activities of daily living

Cahn-Weiner

Farias

Julián

et al. 2007

J. Inter. Neuropsych. Soc.

187

167

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“…4) (42). In comparison, after 12 months, untreated patients would be expected to deteriorate by 11 to 13 points on the DAD scale (17,60). The effect of galantamine in maintaining DAD scores at baseline levels provides important benefits in stabilizing patients with AD.…”

Section: Benefits Of Galantamine On Adlmentioning

confidence: 99%

Galantamine — a Novel Cholinergic Drug with a Unique Dual Mode of Action for the Treatment of Patients with Alzheimer's Disease

2002

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Galantamine hydrobromide is a tertiary alkaloid drug that has been developed and approved in a number of countries including the USA and several countries in Europe as a treatment for mild-to-moderate Alzheimer's disease (AD). Galantamine has a unique, dual mode of action. It is a reversible, competitive inhibitor of acetylcholinesterase (AChE), and is the only drug actively marketed for the treatment of AD with proven activity as an allosteric modulator of nicotinic acetylcholine receptors (nAChRs). This latter activity is thought to be particularly important since decreases in the expression and activity of nAChRs make a large contribution to the reduction in central cholinergic neurotransmission in patients with AD. Galantamine exhibits favorable pharmacokinetic characteristics including predictable linear elimination kinetics at the recommended maintenance doses (16 and 24 mg/day), a relatively short half-life (approximately 7 h) and high bioavailability. It is extensively metabolized in numerous pathways, mainly in the liver via cytochrome P450 enzymes CYP2D6 and CYP3A4, and has a low potential for clinically significant drug-drug interactions. During four large randomized, double-blind, placebocontrolled trials of up to 6 months duration, galantamine 16 and 24 mg/day significantly benefited cognitive and global function, ability to perform activities of daily living (ADL) and behavior, relative to placebo and baseline, for up to 6 months. Caregiver burden (time spent by caregivers supervising patients or assisting them with ADL), and caregiver distress (related to patients' behavioral symptoms) were also reduced. Cognitive and functional abilities were preserved at or near baseline for at least 12 months in patients who re- 159CNS Drug Reviews Vol. 8, No.2, pp. 159-176 © 2002 Neva Press, Branford, Connecticut Address correspondence and reprint requests to: Sean Lilienfeld, MBBCh, FCP(SA), MMed(Neuro), Janssen Pharmaceutica Inc, Janssen Research Foundation, Div of Janssen Pharmaceutica Ltd, 1125 Trenton Harbourton Road, Titusville NJ 08560. Tel.: +1 (609) 730-3414; Fax: +1 (609) 730-2441; E-mail: slilien1@janus.jnj.com ceived galantamine 24 mg/day for 12 months in a long-term US study. These benefits were maximized by early and continued galantamine treatment and, again, were associated with significant reductions in caregiver burden. Trials of the efficacy of galantamine in dementia related to cerebrovascular disease have also yielded positive results. There are no safety concerns associated with the use of galantamine. The incidence of adverse events, particularly cholinergically mediated events affecting the gastrointestinal system, is generally low and can be minimized using the recommended slow dose-escalation scheme. Galantamine may, therefore, help to reduce the overall burden and cost involved in caring for dementia patients. Taking all evidence into account, galantamine has the potential to become a first-line therapy for dementia.

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“…A incapacidade nas AvD tem um grande impacto sobre a qualidade de vida dos pacientes e de seus cuidadores 7 , sendo um aspecto que prediz mais fortemente o uso de serviços de saúde e a institucionalização, mais do que outras medidas de gravidade 25 . Na amostra estudada, o questionário sensibilizou alguns cuidadores quanto a questões preservadas, permitindo orientações para o aumento da autonomia e qualidade de vida do paciente.…”

Section: Discussionunclassified

“…Além de avaliar a realização efetiva de atividades de lazer, a escala inclui questões sobre o interesse mostrado por elas. A DAD tem sido utilizada em ensaios clíni-cos, tendo sido capaz de evidenciar o efeito positivo de drogas sobre o desempenho funcional dos pacientes (manutenção ou melhora nas AvD após tratamento) [7][8][9][10][11][12][13][14][15][16][17] . considerando esses aspectos, realizamos a tradução e adaptação deste instrumento para a lín-gua portuguesa, verificando a confiabilidade interexaminadores e teste-reteste da versão traduzida e adaptada.…”

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Adaptação transcultural da escala de avaliação de incapacidade em demência (Disability Assessment For Dementia - DAD)

Carthery‐Goulart

Areza-Fegyveres

Schultz

et al. 2007

Arq. Neuro-Psiquiatr.

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Resumo -A versão original da escala de Avaliação de Incapacidade em Demência (Disability Assessment for Dementia, DAD) foi traduzida para a língua portuguesa e retrotraduzida para o inglês. Divergências de tradução foram identificadas e discutidas, chegando-se a uma versão que foi submetida a pré-teste para adaptação sócio-cultural. A versão final foi administrada a amostra de 29 pacientes com doença de Alzheimer provável de leve a moderada. os coeficientes de correlação da DAD foram 0,929 e 0,932 nas avaliações inter e intra-examinadores respectivamente. os índices de confiabilidade também foram elevados (Kappa=0,72; p<0,001 inter-examinadores e Kappa=0,85; p<0,001 intra-examinadores). A versão brasileira da escala DAD mostrou-se um instrumento de fácil aplicação e boa confiabilidade para avaliação funcional de pacientes com demência e poderá contribuir para o acompanhamento desses pacientes em nosso meio. esta versão também poderá ser utilizada em estudos transculturais sobre habilidades funcionais de pacientes com demência.PAlAvRAs-chAve: demência, doença de Alzheimer, incapacidade, atividades de vida diária, diagnóstico. Cross-cultural adaptation of the disability assessment for dementia (DAD)ABstRAct -the original version of the Disability Assessment for Dementia (DAD) was translated into Portuguese and back translated to english. the divergences of translation were identified and discussed, resulting in a version that was used in a preliminary investigation for cross-cultural adaptation. the final version was administered to 29 patients with mild to moderate probable Alzheimer's disease. the correlation coefficients of DAD were 0.929 and 0.932 for the inter-examiner and test-retest evaluations respectively. the reliability indexes were also high (Kappa 0.72 p<0.001 inter-examiners and 0.85 p<0.001 test-retest). the Brazilian version of DAD was easy to administer and had good reliability to assess the functional status of demented patients. It will contribute to the follow-up of these patients in our population. moreover, it can be used in transcultural studies on functional abilities in dementia.Key woRDs: dementia, Alzheimer's disease, disability, activities of daily living, diagnosis. Além do comprometimento das funções cognitivas, a doença de Alzheimer (DA) também se caracteriza pelo declínio no desempenho funcional, condição necessária para o diagnóstico de acordo com os critérios do National Institute of Neurologic, Communicative Disorders and Stroke-Alzheimer´s Disease and Related Disorders Association (NINcDs-ADRDA) 1 e do manual de Diagnóstico estatístico dos transtornos mentais-quarta edição (Dsm-Iv) 2 . muitas escalas têm sido usadas para medir o desempenho nas atividades da vida diária (AvD) na população idosa e com DA, entre elas a Avaliação de Incapacidade para Demência (DAD-Disability Assessment for Dementia), desenvolvida por Gauthier e Gélinas em 1994 3 . No estudo inicial, a escala demonstrou alto grau de concordância interna (0,96), inter-examinadores (0,95) e teste-reteste (0,96) 4 .A DA...

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The Disability Assessment for Dementia Scale: A 12-Month Study of Functional Ability in Mild to Moderate Severity Alzheimer Disease

Cited by 113 publications

References 10 publications

Cognitive and neuroimaging predictors of instrumental activities of daily living

Cognitive and neuroimaging predictors of instrumental activities of daily living

Galantamine — a Novel Cholinergic Drug with a Unique Dual Mode of Action for the Treatment of Patients with Alzheimer's Disease

Adaptação transcultural da escala de avaliação de incapacidade em demência (Disability Assessment For Dementia - DAD)

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