The sensitivity to change over time of the Bristol Activities of Daily Living Scale in Alzheimer's disease

Activities of daily living scales can be a useful tool in assessing change in people with dementia, either as the disease progresses or in response to treatment. However, little data exist as to the sensitivity to change of i nstruments used. The Bristol Activities of Daily Living Scale was developed with assistance from the carers of community dwelling people with dementia to be completed by such people and has been shown to have internal consist ency as well as face and construct validity. This study aimed to analyse th e sensitivity to change of the Bristol Activities of Daily Living Scale in people with Alzheimer's disease receiving anticholinesterase medication. Us ing the Clinician's Global Rating of Change as a gold standard for change, differences between Bristol Activities of Daily Living Scale scores before and after medication were compared with change in Mini-Mental State Examina tion, Alzheimer's Disease Assessment Scale-Cognitive and the Nurses Observa tion Scale for Geriatric Patients, in 61 older adults receiving anticholine sterase medication for Alzheimer's disease. Both the Bristol Activities of Daily Living Scale and the Nurses Observation Scale for Geriatric Patients are sensitive and specific in predicting improvement or stability as measur ed by the clinician's global rating of change. However, unlike the Nurses O bservation Scale for Geriatric Patients, change over time in the Bristol Ac tivities of Daily Living Scale significantly correlates with change in the Mini-Mental State Examination and the Alzheimer's Disease Assessment Scale- Cognitive. The Bristol Activities of Daily Living Scale is sensitive to cha nge in activities of daily living and shows the expected and desirable rela tionship with measures of cognition. Copyright (C) 2000 John Wiley & Sons, Ltd.