ASSESSING PATIENT DEPENDENCE IN ALZHEIMERS-DISEASE

Background. While cognitive and functional deficits are the hallmark o f Alzheimer's disease (AD), loss of social function (and the dependenc e this implies) is also critical, especially in early stages of diseas e. Little attention has been directed to this facet of dementing disea se. We describe a scale for assessing dependency in AD and present a b aseline profile of dependency in a cohort of AD patients. Methods. In a study of the predictors of the course of AD, 233 patients in early s tages of disease (modified MMS greater than or equal to 30) were asses sed. Psychometric properties of the dependence scale were established. To validate the scale, dependence scores at baseline were correlated with a series of measures assessing cognition and function. The course of dependency over 18 months of follow-up was also analyzed. Results, The scale shows adequate reliability (test-retest, intraclass correla tion). Dependence stage was related to other measures of disease sever ity. Scalogram analysis shows that the dependence scale is consistent with the course of functional loss established for dementing disease. Prospective data indicate sensitivity of the scale to disease progress ion. Conclusion, Dependency is a distinct, measurable component of dem enting disease and should be considered an important outcome in studie s of AD.