VALIDITY OF DIRECT ASSESSMENT OF FUNCTIONAL STATUS AS A TOOL FOR MEASURING ALZHEIMERS-DISEASE SEVERITY

Objective: to assess the validity of the Direct Assessment of Function al Status (DAFS) performance-based functional scale for the staging of dementia severity by comparing it with established clinical, function al and cognitive scales.Patients and methods: 93 consecutive Alzheimer 's disease patients underwent DAFS. Socio-demographic variables, cogni tive status (Mini-Mental State Examination; MMSE), global disease seve rity (Clinical Dementia Rating; CDR), disease duration, physical perfo rmance (Physical Performance Test, PPT) and functional status (as repo rted by the primary caregiver) were also recorded and basic (B) and in strumental (I) activities of daily living (ADL) assessed. Results: a s ignificant correlation was found between DAFS and MMSE (Pearson's r = 0.60; P < 0.01), PPT (r = 0.54; P < 0.01) and CDR (Spearman correlatio n coefficient: -0.48; P < 0.01). A mild, significant correlation was f ound between DAFS score and daily function as reported by the primary caregiver (r= -0.30 for BADL and r= - 0.27 for IADL). On multiple regr ession analysis, only MMSE and PPT were independently associated with the DAFS score, explaining 56% of DAFS total variance. ADL scales did not independently contribute to DAFS variance. A multivariate regressi on model of the association of DAFS with CDR showed that the associati on was significant even after adjustment for MMSE and PPT, suggesting that DAFS scores provide additional information on dementia severity. Conclusion: DAFS is a valid tool for the assessment of dementia severi ty, capturing cognitive and physical aspects of disability.