Assessing outcomes in Alzheimer disease

To gain a better overview of the effectiveness of treatment of patients wit h Alzheimer disease (AD), areas such as cognition, activities of daily livi ng (ADL), behavior, caregiver burden, quality of life and economics need to be assessed. A number of instruments are available for assessing these dom ains, many of which are reviewed in this article. These include the cogniti ve subscale of the Alzheimer's Disease Assessment Scale (the standard instr ument for the measurement of efficacy in dementia trials), scales that asse ss AD patients' abilities to perform ADL (including the Disability Assessme nt for Dementia scale and the Alzheimer's Disease Cooperative Study - Activ ities of Daily Living), scales to assess behavioral symptoms in dementia (i ncluding the Neuropsychiatric Inventory and the Behavioral Pathology in Alz heimer's Disease Rating Scale), scales for assessing global clinical change , and methods for assessing caregiver time, quality of life and health econ omics. Each instrument has its own advantages and disadvantages. However, t he instruments used need to be selected carefully to provide credible and i nformative outcome data.