Definitions and Diagnosis

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Definitions and Diagnosis

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Definitions and Diagnosis
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Definitions​
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What is dementia?​
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References

The term ‘dementia’ was used in the early eighteenth century to imply an incompetence in managing one’s affairs.1 Early in the nineteenth century, the word dementia began to be used in medicine to describe patients with a mental disability that was due to some form of brain damage, distinguishing the condition from other mental disorders, such as schizophrenia, mania, or depression.1

Dementia is a degenerative and progressive brain disorder, characterized by the deterioration of cognitive function (memory, thinking, orientation, comprehension, calculation, learning capacity, language, and judgement), commonly accompanied by a deterioration in emotional control, social behavior, or motivation.[WHO Factsheet, 2016] These changes lead to impaired functioning and an inability to perform daily activities until, eventually, people with dementia cannot live independently and require constant care.2

 

  1. McKeith I, Fairbairn A. Biomedical and clinical perspectives. In: Cantley C (ed). A handbook of dementia care. Buckingham: Open University Press, 2001.​
  2. World Health Organization (WHO). Media Centre. Dementia. Factsheet No. 362. April 2016.​
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Age-specific prevalence of dementia​
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References

Across worldwide regions, the age-specific prevalence of dementia shows a similar pattern, increasing with age, but showing considerable heterogeneity among the oldest age group (≥90 years old).2

The prevalence of AD is greater for women than men, which may be due to the longer lifespan of women, biological or genetic variations between women and men, or may even be a result of different life experiences.1 There is evidence to suggest that, in the US, the prevalence of AD is greater in older African–Americans and Hispanics than in older White people, which may be accounted for by variations in health, lifestyle and socioeconomic risk factors.[Alzheimer’s Association, 2016] ​

 

  1. Alzheimer’s Association. Alzheimer’s Association Report. 2016 Alzheimer’s disease facts and figures. Alzheimers Dement 2016; 12: 459–509.​
  2. Winblad B, Amouyel P, Andrieu S, et al. Defeating Alzheimer’s disease and other dementias: a priority for European science and society. Lancet Neurol 2016; 15: 455–532.​

Other references used on slide:​

  • Ferri CP, Prince M, Brayne C, et al.; Alzheimer’s Disease International. Global prevalence of dementia: a Delphi consensus study. Lancet 2005; 366 (9503): 2112–2117.​
  • Prince M, Bryce R, Albanese E, et al. The global prevalence of dementia: a systematic review and metaanalysis. Alzheimers Dement 2013; 9 (1): 63–75.
  • Russ TC, Batty GD, Hearnshaw GF, et al. Geographical variation in dementia: systematic review with meta-analysis. Int J Epidemiol 2012; 41 (4): 1012–1032. ​
  • Wu YT, Lee HY, Norton S, et al. Prevalence studies of dementia in mainland China, Hong Kong and Taiwan: a systematic review and meta-analysis. PLoS One 2013; 8 (6): e66252. ​
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Main types of dementia​
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References

Estimates vary, but there is a general consensus that AD accounts for approximately 60–80% of dementias; dementia with Lewy bodies (DLB) may account for 10–15% of dementias, and vascular dementia (VaD), and fronto-temporal dementia (FTD) each make a contribution of approximately 10% to all cases of dementia.1,2 However, it should be noted that more than one type of dementia may be present in a given patient, which is termed ‘mixed dementia’.1 Approximately half of AD cases involve only Alzheimer’s pathology; the remaining cases show evidence of mixed dementia.1

  1. Alzheimer’s Association. Alzheimer’s Association Report. 2016 Alzheimer’s disease facts and figures. Alzheimers Dement 2016; 12 (4): 459–509.​
  2. Alzheimer’s Society. What is dementia with Lewy bodies (DLB)? Factsheet 403LP. June 2016. Available at: www.alzheimers.org.uk
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What is Alzheimer’s disease?​
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References

Alzheimer’s disease (AD) is the most common cause of dementia, accounting for approximately 60–80% of all dementia cases.[Alzheimer’s Association, 2016] AD is a degenerative and progressive disorder, associated with cognitive, functional and behavioral symptoms.1

The most common initial symptom of AD is impaired short-term memory, but individuals with AD may also experience difficulties in planning, a reduced understanding of time and spatial relationships, and poor judgement.1 Functional impairment can manifest as problems performing daily activities, such as eating, getting dressed, and maintaining personal hygiene, which continue to deteriorate as the disease progresses.1 In the end, the individual is completely dependent on caregivers.1 Behavioral symptoms include withdrawal from social activities, apathy, depressed mood, anxiety, and agitation.1

AD is characterized by dementia; disease duration is typically 8–10 years, but ranges from 1–25 years.[Bird, 2015] The median survival from the onset of AD dementia to death has been estimated as 7.1 years.5 The Mini Mental State Examination (MMSE) is a test commonly used by physicians to help diagnose dementia and assess its progression and severity.2 A lower MMSE score indicates a greater degree of cognitive impairment; for example, an MMSE score of 20–26 represents mild AD, an MMSE score of 10–19 represents moderate AD, and a score of <10 represents severe AD.6

 

  1. Alzheimer’s Association. Alzheimer’s Association Report. 2016 Alzheimer’s disease facts and figures. Alzheimers Dement 2016; 12 (4): 459–509.​
  2. Alzheimer’s Society. The Mini Mental State Examination (MMSE). https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=121. Accessed July 2016.​
  3. Bird TD. Alzheimer Disease Overview. In: Pagon RA, Adam MP, Ardinger HH, et al., editors. GeneReviews® [Internet]. Seattle (WA): University of Washington, Seattle; 1993–2016. http://www.ncbi.nlm.nih.gov/books/NBK1161/. Accessed 15 September 2016.​
  4. Clinicaltrials.gov. Progress of mild Alzheimer’s disease in participants on solanezumab versus placebo (EXPEDITION 3). NCT01900665. Accessed September 2016.​
  5. Fitzpatrick AL, Kuller LH, Lopez OL, et al. Survival following dementia onset: Alzheimer’s disease and vascular dementia. J Neurol Sci 2005; 229–230: 43–49. ​
  6. Maher-Edwards G, Watson C, Ascher J, et al. Two randomized controlled trials of SB742457 in mild-to-moderate Alzheimer’s disease. Alzheimers Dement: Transl Res Clin Int 2015;1:23–36. ​

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Diagnosis, Signs and Symptoms​
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Diagnosis of Alzheimer’s disease​
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References

One of the core criteria for a diagnosis of dementia is the presence of cognitive or behavioral (neuropsychiatric) symptoms that represent a decline from previous levels of functioning and performing.1

Once a clinical diagnosis of dementia has been made, a differential diagnosis is required to determine which subtype is present.1 A diagnosis of ‘definite AD’ is determined from brain biopsy or autopsy.1 For most patients presenting with dementia, the clinical workup involves careful consideration of the medical history of the patient to unravel which components may indicate dementia of the AD subtype.1 It is preferable to gain this information not only from the patient, but also from someone in their close network (e.g., relative) to get the best account of the patient’s function at home or in the workplace.1 The clinical history is supplemented by a physical examination to ascertain whether or not there is evidence of peripheral vascular disease and systemic conditions that could interfere with cognition and/or functional autonomy, and a neurological examination looking for evidence to suggest a focal lesion (stroke or tumor).1 Neuropsychological testing is performed to obtain an objective assessment of cognitive and behavioral symptoms.1 Biomarker evidence from cerebrospinal fluid (CSF) testing and neuroimaging, for example, may be used to increase the certainty that the dementia is of the AD subtype.2

  1. Gauthier S, Ballard B. Diagnosis. In: Management of Dementia: Second edition. New York: Informa Healthcare USA, Inc. 2009.​
  2. McKhann GM, Knopman DS, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7 (3): 263–269. ​
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Examples of symptoms of Alzheimer’s disease​
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References

In general, the symptoms of AD can be divided into three categories – cognitive, functional, and neuropsychiatric.​

Cognitive symptoms – the main areas of cognition that can be impaired over the course of AD include memory, language, attention and executive functions, visuospatial skills and praxis (processing).3 These impairments can manifest as memory loss (repeating oneself, losing items), aphasia (language impairment), poor organization, impaired spatial and temporal orientation, apraxia (inability to perform purposeful actions), and agnosia (inability to recognize objects or persons).1,3,4

Functional symptoms – a decline in function is a predominant feature of AD, the effects of which become more disabling as the disease progresses.2 The ability to perform activities of daily living (ADLs) deteriorates with advancing disease severity; initial difficulties may become apparent in work or social situations, progressing to problems dealing with finances or making meals, and eventually to a complete loss of independent functioning.2

Neuropsychiatric symptoms – specific behavioral symptoms of AD include depression/dysphoria, apathy/indifference, elation/euphoria, anxiety, irritability, agitation/aggression, aberrant motor behavior, disinhibition, delusions, hallucinations, sleep disturbances, and appetite/eating disturbances.5 Behavioral changes increase the burden of care for individuals with AD, and can be difficult for carers to deal with, often becoming the cause of institutionalization.5

 

 

  1. Alzheimer’s Association. Alzheimer’s Association Report. 2016 Alzheimer’s disease facts and figures. Alzheimers Dement 2016; 12 (4): 459–509.​
  2. Gélinas I. Functional autonomy. In: Gauthier S (ed.). Clinical Diagnosis and Management of Alzheimer’s Disease, Third Edition. Oxon: Informa Healthcare, 2007.​
  3. Joubert S, Joncas S, Barbeau E, et al. Cognition. In: Gauthier S (ed.). Clinical Diagnosis and Management of Alzheimer’s Disease, Third Edition. Oxon: Informa Healthcare, 2007.​
  4. Rainville C, Caza N, Belleville S, Gilbert B. Neuropsychological assessment. In: Gauthier S (ed.). Clinical Diagnosis and Management of Alzheimer’s Disease, Third Edition. Oxon: Informa Healthcare, 2007.​
  5. Teng E, Cummings JL. Behaviour. In: Gauthier S (ed.). Clinical Diagnosis and Management of Alzheimer’s Disease, Third Edition. Oxon: Informa Healthcare, 2007.​
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Hypothetical model for the pathological–clinical continuum of Alzheimer’s disease​
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References

The slide represents a hypothetical model for the pathological-clinical continuum of AD.1

The ‘preclinical’ stage precedes mild cognitive impairment (MCI) and includes individuals who have evidence of early AD pathological changes, but do not meet clinical criteria for MCI or dementia.1 It is likely that even this preclinical stage of the disease represents a continuum from completely asymptomatic individuals with biomarker evidence suggestive of AD-pathophysiological process at risk for progression to AD dementia to biomarker-positive individuals who are already demonstrating very subtle decline but not yet meeting standardized criteria for MCI.1 This continuum of preclinical AD would also encompass:​

individuals who carry one or more apolipoprotein E (APOE) 4 alleles who are known to have an increased risk of developing AD dementia, at the point they are AD-P biomarker-positive​

carriers of autosomal-dominant mutations, who are in the presymptomatic biomarker-positive stage of their illness, and who will almost certainly manifest clinical symptoms and progress to dementia.1

Emerging evidence from both genetic at-risk and aging cohorts suggests that there may be a time lag of a decade or more between the beginning of the pathological cascade of AD and the onset of clinically evident impairment.1 It has been proposed that AD begins with a long asymptomatic period, during which the pathophysiological process is progressing, and that individuals with biomarker evidence of early AD-pathophysiological process are at increased risk for developing cognitive and behavioral impairment and progression to clinically manifest AD dementia.1

  1. Sperling RA, Aisen PS, Beckett LA, et al. Toward defining the preclinical stages of Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7 (3): 280–292. ​
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Conclusion​
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AD is a complex disease of multifactorial etiology that, despite a wealth of clinical research, is not yet completely understood. Among various genetic and environmental factors implicated in AD, age is the most important risk factor for the disease. As the aging population grows, the prevalence of AD is increasing (more so after the age of 65 years), as is the burden of the disease on patients, caregivers, healthcare systems, and on society as a whole. While clinical research continues to search for a cure, it is important to remember those individuals who are currently living with AD, for whom more effective symptomatic treatments would make a big difference to their lives.​

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The diagnosis of AD​
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The diagnosis of AD​
References
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA: American Psychiatric Association, 2013.​
  2. Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol 2014; 13 (6): 614–629.​
  3. McKhann G, Drachman D, Folstein M, et al. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984; 34 (7): 939–944.​
  4. McKhann G, Knopman D, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging – Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7 (3): 263–269.​
  5. National Collaborating Centre for Mental Health. Quick reference guide. Dementia. Supporting people with dementia and their carers in health and social care. NICE clinical guideline 42. November 2006. http://www.scie.org.uk/publications/misc/dementia/dementia-qrg.pdf. Accessed 25 August 2016.​
  6. Scheltens P, Blennow K, Breteler MM, et al. Alzheimer’s disease. Lancet 2016; 388 (10043): 505–517.​
  7. Scott KR, Barrett AM. Dementia syndromes: evaluation and treatment. Expert Rev Neurother 2007; 7 (4): 407–422.​
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The diagnosis of AD​
References
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA: American Psychiatric Association, 2013.​
  2. Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol 2014; 13 (6): 614–629.​
  3. McKhann G, Drachman D, Folstein M, et al. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984; 34 (7): 939–944.​
  4. McKhann G, Knopman D, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging – Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7 (3): 263–269.​
  5. National Collaborating Centre for Mental Health. Quick reference guide. Dementia. Supporting people with dementia and their carers in health and social care. NICE clinical guideline 42. November 2006. http://www.scie.org.uk/publications/misc/dementia/dementia-qrg.pdf. Accessed 25 August 2016.​
  6. Scheltens P, Blennow K, Breteler MM, et al. Alzheimer’s disease. Lancet 2016; 388 (10043): 505–517.​
  7. Scott KR, Barrett AM. Dementia syndromes: evaluation and treatment. Expert Rev Neurother 2007; 7 (4): 407–422.​
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The diagnosis of AD​
References
  1. Full reference details:​
  2. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA: American Psychiatric Association, 2013.​
  3. Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol 2014; 13 (6): 614–629.​
  4. McKhann G, Drachman D, Folstein M, et al. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984; 34 (7): 939–944.​
  5. McKhann G, Knopman D, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging – Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7 (3): 263–269.​
  6. National Collaborating Centre for Mental Health. Quick reference guide. Dementia. Supporting people with dementia and their carers in health and social care. NICE clinical guideline 42. November 2006. http://www.scie.org.uk/publications/misc/dementia/dementia-qrg.pdf. Accessed 25 August 2016.​
  7. Scheltens P, Blennow K, Breteler MM, et al. Alzheimer’s disease. Lancet 2016; 388 (10043): 505–517.​
  8. Scott KR, Barrett AM. Dementia syndromes: evaluation and treatment. Expert Rev Neurother 2007; 7 (4): 407–422.​
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The diagnosis of AD​
References
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA: American Psychiatric Association, 2013.​
  2. Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol 2014; 13 (6): 614–629.​
  3. McKhann G, Drachman D, Folstein M, et al. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984; 34 (7): 939–944.​
  4. McKhann G, Knopman D, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging – Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7 (3): 263–269.​
  5. National Collaborating Centre for Mental Health. Quick reference guide. Dementia. Supporting people with dementia and their carers in health and social care. NICE clinical guideline 42. November 2006. http://www.scie.org.uk/publications/misc/dementia/dementia-qrg.pdf. Accessed 25 August 2016.​
  6. Scheltens P, Blennow K, Breteler MM, et al. Alzheimer’s disease. Lancet 2016; 388 (10043): 505–517.​
  7. Scott KR, Barrett AM. Dementia syndromes: evaluation and treatment. Expert Rev Neurother 2007; 7 (4): 407–422.​
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The diagnosis of AD​
References
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA: American Psychiatric Association, 2013.​
  2. Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol 2014; 13 (6): 614–629.​
  3. McKhann G, Drachman D, Folstein M, et al. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984; 34 (7): 939–944.​
  4. McKhann G, Knopman D, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging – Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7 (3): 263–269.​
  5. National Collaborating Centre for Mental Health. Quick reference guide. Dementia. Supporting people with dementia and their carers in health and social care. NICE clinical guideline 42. November 2006. http://www.scie.org.uk/publications/misc/dementia/dementia-qrg.pdf. Accessed 25 August 2016.​
  6. Scheltens P, Blennow K, Breteler MM, et al. Alzheimer’s disease. Lancet 2016; 388 (10043): 505–517.​
  7. Scott KR, Barrett AM. Dementia syndromes: evaluation and treatment. Expert Rev Neurother 2007; 7 (4): 407–422.​
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The diagnosis of AD​
References
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA: American Psychiatric Association, 2013.​
  2. Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol 2014; 13 (6): 614–629.​
  3. McKhann G, Drachman D, Folstein M, et al. Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology 1984; 34 (7): 939–944.​
  4. McKhann G, Knopman D, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging – Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7 (3): 263–269.​
  5. National Collaborating Centre for Mental Health. Quick reference guide. Dementia. Supporting people with dementia and their carers in health and social care. NICE clinical guideline 42. November 2006. http://www.scie.org.uk/publications/misc/dementia/dementia-qrg.pdf. Accessed 25 August 2016.​
  6. Scheltens P, Blennow K, Breteler MM, et al. Alzheimer’s disease. Lancet 2016; 388 (10043): 505–517.​
  7. Scott KR, Barrett AM. Dementia syndromes: evaluation and treatment. Expert Rev Neurother 2007; 7 (4): 407–422.​
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Diagnostic criteria for AD​
References
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA: American Psychiatric Association; 2013.​
  2. Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol 2014; 13 (6): 614–629.​
  3. McKhann G, Knopman D, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging – Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7 (3): 263–269.​
  4. World Health Organization. Pocket Guide to the ICD-10 Classification of Mental and Behavioural Disorders. Geneva, Switzerland: World Health Organization, 1994.​
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Diagnostic criteria for AD​
References
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA: American Psychiatric Association; 2013.​
  2. Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol 2014; 13 (6): 614–629.​
  3. McKhann G, Knopman D, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging – Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7 (3): 263–269.​
  4. World Health Organization. Pocket Guide to the ICD-10 Classification of Mental and Behavioural Disorders. Geneva, Switzerland: World Health Organization, 1994.​
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Diagnostic criteria for AD​
References
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA: American Psychiatric Association; 2013.​
  2. Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol 2014; 13 (6): 614–629.​
  3. McKhann G, Knopman D, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging – Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7 (3): 263–269.​
  4. World Health Organization. Pocket Guide to the ICD-10 Classification of Mental and Behavioural Disorders. Geneva, Switzerland: World Health Organization, 1994.​
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Diagnostic criteria for AD​
References
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA: American Psychiatric Association; 2013.​
  2. Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol 2014; 13 (6): 614–629.​
  3. McKhann G, Knopman D, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging – Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7 (3): 263–269.​
  4. World Health Organization. Pocket Guide to the ICD-10 Classification of Mental and Behavioural Disorders. Geneva, Switzerland: World Health Organization, 1994.​
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Diagnostic criteria for AD​
References
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA: American Psychiatric Association; 2013.​
  2. Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol 2014; 13 (6): 614–629.​
  3. McKhann G, Knopman D, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging – Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7 (3): 263–269.​
  4. World Health Organization. Pocket Guide to the ICD-10 Classification of Mental and Behavioural Disorders. Geneva, Switzerland: World Health Organization, 1994.​
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Diagnostic criteria for AD​
References
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA: American Psychiatric Association; 2013.​
  2. Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol 2014; 13 (6): 614–629.​
  3. McKhann G, Knopman D, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging – Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7 (3): 263–269.​
  4. World Health Organization. Pocket Guide to the ICD-10 Classification of Mental and Behavioural Disorders. Geneva, Switzerland: World Health Organization, 1994.​
1 / 8
Diagnostic criteria for AD​
References
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA: American Psychiatric Association; 2013.​
  2. Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol 2014; 13 (6): 614–629.​
  3. McKhann G, Knopman D, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging – Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7 (3): 263–269.​
  4. World Health Organization. Pocket Guide to the ICD-10 Classification of Mental and Behavioural Disorders. Geneva, Switzerland: World Health Organization, 1994.​
1 / 8
Diagnostic criteria for AD​
References
  1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Arlington, VA: American Psychiatric Association; 2013.​
  2. Dubois B, Feldman HH, Jacova C, et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol 2014; 13 (6): 614–629.​
  3. McKhann G, Knopman D, Chertkow H, et al. The diagnosis of dementia due to Alzheimer’s disease: Recommendations from the National Institute on Aging – Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimers Dement 2011; 7 (3): 263–269.​
  4. World Health Organization. Pocket Guide to the ICD-10 Classification of Mental and Behavioural Disorders. Geneva, Switzerland: World Health Organization, 1994.​
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Key points​
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Examples of Scales in Alzheimer’s Disease​
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Mini–Mental State Examination (MMSE)​
References
  1. ClinicalTrials.gov. Progress of mild Alzheimer’s disease in participants on solanezumab versus placebo (EXPEDITION 3). Identifier: NCT01900665. https://clinicaltrials.gov/ct2/show/NCT01900665. Accessed 26 September 2016.​
  2. Folstein MF, Folstein SE, McHugh PR. “Mini–mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiat Res 1975; 12 (3): 189–198.​
  3. Gauthier S, Ballard C. Management of Dementia, 2nd edition. New York, USA: Informa Healthcare USA, 2009.​
  4. Maher-Edwards G, Watson C, Ascher J, et al. Two randomized controlled trials of SB742457 in mild-to-moderate Alzheimer’s disease. Alzheimers Dement: Transl Res Clin Interven 2015; 1 (1): 23–36.​
  5. Sheehan B. Assessment scales in dementia. Ther Adv Neurol Disord 2012; 5 (6): 349–358.​
  6. Tombaugh TN, McIntyre NJ. The mini–mental state examination: a comprehensive review. J Am Geriatr Soc 1992; 40 (9): 922–935.​
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Mini–Mental State Examination (MMSE)
References
  1. ClinicalTrials.gov. Progress of mild Alzheimer’s disease in participants on solanezumab versus placebo (EXPEDITION 3). Identifier: NCT01900665. https://clinicaltrials.gov/ct2/show/NCT01900665. Accessed 26 September 2016.​
  2. Folstein MF, Folstein SE, McHugh PR. “Mini–mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiat Res 1975; 12 (3): 189–198.​
  3. Gauthier S, Ballard C. Management of Dementia, 2nd edition. New York, USA: Informa Healthcare USA, 2009.​
  4. Maher-Edwards G, Watson C, Ascher J, et al. Two randomized controlled trials of SB742457 in mild-to-moderate Alzheimer’s disease. Alzheimers Dement: Transl Res Clin Interven 2015; 1 (1): 23–36.​
  5. Sheehan B. Assessment scales in dementia. Ther Adv Neurol Disord 2012; 5 (6): 349–358.​
  6. Tombaugh TN, McIntyre NJ. The mini–mental state examination: a comprehensive review. J Am Geriatr Soc 1992; 40 (9): 922–935.​
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Mini–Mental State Examination (MMSE)
References
  1. ClinicalTrials.gov. Progress of mild Alzheimer’s disease in participants on solanezumab versus placebo (EXPEDITION 3). Identifier: NCT01900665. https://clinicaltrials.gov/ct2/show/NCT01900665. Accessed 26 September 2016.​
  2. Folstein MF, Folstein SE, McHugh PR. “Mini–mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiat Res 1975; 12 (3): 189–198.​
  3. Gauthier S, Ballard C. Management of Dementia, 2nd edition. New York, USA: Informa Healthcare USA, 2009.​
  4. Maher-Edwards G, Watson C, Ascher J, et al. Two randomized controlled trials of SB742457 in mild-to-moderate Alzheimer’s disease. Alzheimers Dement: Transl Res Clin Interven 2015; 1 (1): 23–36.​
  5. Sheehan B. Assessment scales in dementia. Ther Adv Neurol Disord 2012; 5 (6): 349–358.​
  6. Tombaugh TN, McIntyre NJ. The mini–mental state examination: a comprehensive review. J Am Geriatr Soc 1992; 40 (9): 922–935.​
1 / 8
Mini–Mental State Examination (MMSE)
References
  1. ClinicalTrials.gov. Progress of mild Alzheimer’s disease in participants on solanezumab versus placebo (EXPEDITION 3). Identifier: NCT01900665. https://clinicaltrials.gov/ct2/show/NCT01900665. Accessed 26 September 2016.​
  2. Folstein MF, Folstein SE, McHugh PR. “Mini–mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiat Res 1975; 12 (3): 189–198.​
  3. Gauthier S, Ballard C. Management of Dementia, 2nd edition. New York, USA: Informa Healthcare USA, 2009.​
  4. Maher-Edwards G, Watson C, Ascher J, et al. Two randomized controlled trials of SB742457 in mild-to-moderate Alzheimer’s disease. Alzheimers Dement: Transl Res Clin Interven 2015; 1 (1): 23–36.​
  5. Sheehan B. Assessment scales in dementia. Ther Adv Neurol Disord 2012; 5 (6): 349–358.​
  6. Tombaugh TN, McIntyre NJ. The mini–mental state examination: a comprehensive review. J Am Geriatr Soc 1992; 40 (9): 922–935.​
1 / 8
Mini–Mental State Examination (MMSE)
References
  1. ClinicalTrials.gov. Progress of mild Alzheimer’s disease in participants on solanezumab versus placebo (EXPEDITION 3). Identifier: NCT01900665. https://clinicaltrials.gov/ct2/show/NCT01900665. Accessed 26 September 2016.​
  2. Folstein MF, Folstein SE, McHugh PR. “Mini–mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiat Res 1975; 12 (3): 189–198.​
  3. Gauthier S, Ballard C. Management of Dementia, 2nd edition. New York, USA: Informa Healthcare USA, 2009.​
  4. Maher-Edwards G, Watson C, Ascher J, et al. Two randomized controlled trials of SB742457 in mild-to-moderate Alzheimer’s disease. Alzheimers Dement: Transl Res Clin Interven 2015; 1 (1): 23–36.​
  5. Sheehan B. Assessment scales in dementia. Ther Adv Neurol Disord 2012; 5 (6): 349–358.​
  6. Tombaugh TN, McIntyre NJ. The mini–mental state examination: a comprehensive review. J Am Geriatr Soc 1992; 40 (9): 922–935.​
1 / 8
Mini–Mental State Examination (MMSE)
References
  1. ClinicalTrials.gov. Progress of mild Alzheimer’s disease in participants on solanezumab versus placebo (EXPEDITION 3). Identifier: NCT01900665. https://clinicaltrials.gov/ct2/show/NCT01900665. Accessed 26 September 2016.​
  2. Folstein MF, Folstein SE, McHugh PR. “Mini–mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiat Res 1975; 12 (3): 189–198.​
  3. Gauthier S, Ballard C. Management of Dementia, 2nd edition. New York, USA: Informa Healthcare USA, 2009.​
  4. Maher-Edwards G, Watson C, Ascher J, et al. Two randomized controlled trials of SB742457 in mild-to-moderate Alzheimer’s disease. Alzheimers Dement: Transl Res Clin Interven 2015; 1 (1): 23–36.​
  5. Sheehan B. Assessment scales in dementia. Ther Adv Neurol Disord 2012; 5 (6): 349–358.​
  6. Tombaugh TN, McIntyre NJ. The mini–mental state examination: a comprehensive review. J Am Geriatr Soc 1992; 40 (9): 922–935.​
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Alzheimer’s Disease Assessment Scale – Cognitive subscale (ADAS-Cog)​
References
  1. Alzheimer’s Disease Cooperative Study. ADAS – Administration Manual for the Alzheimer’s Disease Assessment Scale. The Mount Sinai School of Medicine, 1994. http://www.dementia-assessment.com.au/cognitive/adas_packet.pdf. Accessed 25 August 2016.​
  2. Gauthier S, Ballard C. Management of Dementia, 2nd edition. New York, USA: Informa Healthcare USA, 2009.​
  3. Rosen WG, Mohs RC, Davis KL. A new rating scale for Alzheimer’s disease. Am J Psychiatry 1984; 141 (11): 1356–1364.​
  4. Skinner J, Carvalho JO, Potter GG, et al.; Alzheimer’s Disease Neuroimaging Initiative. The Alzheimer’s Disease Assessment Scale-Cognitive-Plus (ADAS-Cog-Plus): an expansion of the ADAS-Cog to improve responsiveness in MCI. Brain Imaging Behav 2012; 6 (4): 489–501.​
  5. Stern RG, Mohs RC, Davidson M, et al. A longitudinal study of Alzheimer’s disease: measurement, rate and predictors of cognitive deterioration. Am J Psychiatry 1994; 151 (3): 390–396.​
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Alzheimer’s Disease Assessment Scale – Cognitive subscale (ADAS-Cog)​
References
  1. Alzheimer’s Disease Cooperative Study. ADAS – Administration Manual for the Alzheimer’s Disease Assessment Scale. The Mount Sinai School of Medicine, 1994. http://www.dementia-assessment.com.au/cognitive/adas_packet.pdf. Accessed 25 August 2016.​
  2. Gauthier S, Ballard C. Management of Dementia, 2nd edition. New York, USA: Informa Healthcare USA, 2009.​
  3. Rosen WG, Mohs RC, Davis KL. A new rating scale for Alzheimer’s disease. Am J Psychiatry 1984; 141 (11): 1356–1364.​
  4. Skinner J, Carvalho JO, Potter GG, et al.; Alzheimer’s Disease Neuroimaging Initiative. The Alzheimer’s Disease Assessment Scale-Cognitive-Plus (ADAS-Cog-Plus): an expansion of the ADAS-Cog to improve responsiveness in MCI. Brain Imaging Behav 2012; 6 (4): 489–501.​
  5. Stern RG, Mohs RC, Davidson M, et al. A longitudinal study of Alzheimer’s disease: measurement, rate and predictors of cognitive deterioration. Am J Psychiatry 1994; 151 (3): 390–396.​
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Alzheimer’s Disease Assessment Scale – Cognitive subscale (ADAS-Cog)​
References
  1. Alzheimer’s Disease Cooperative Study. ADAS – Administration Manual for the Alzheimer’s Disease Assessment Scale. The Mount Sinai School of Medicine, 1994. http://www.dementia-assessment.com.au/cognitive/adas_packet.pdf. Accessed 25 August 2016.​
  2. Gauthier S, Ballard C. Management of Dementia, 2nd edition. New York, USA: Informa Healthcare USA, 2009.​
  3. Rosen WG, Mohs RC, Davis KL. A new rating scale for Alzheimer’s disease. Am J Psychiatry 1984; 141 (11): 1356–1364.​
  4. Skinner J, Carvalho JO, Potter GG, et al.; Alzheimer’s Disease Neuroimaging Initiative. The Alzheimer’s Disease Assessment Scale-Cognitive-Plus (ADAS-Cog-Plus): an expansion of the ADAS-Cog to improve responsiveness in MCI. Brain Imaging Behav 2012; 6 (4): 489–501.​
  5. Stern RG, Mohs RC, Davidson M, et al. A longitudinal study of Alzheimer’s disease: measurement, rate and predictors of cognitive deterioration. Am J Psychiatry 1994; 151 (3): 390–396.​
1 / 8
Alzheimer’s Disease Assessment Scale – Cognitive subscale (ADAS-Cog)​
References
  1. Alzheimer’s Disease Cooperative Study. ADAS – Administration Manual for the Alzheimer’s Disease Assessment Scale. The Mount Sinai School of Medicine, 1994. http://www.dementia-assessment.com.au/cognitive/adas_packet.pdf. Accessed 25 August 2016.​
  2. Gauthier S, Ballard C. Management of Dementia, 2nd edition. New York, USA: Informa Healthcare USA, 2009.​
  3. Rosen WG, Mohs RC, Davis KL. A new rating scale for Alzheimer’s disease. Am J Psychiatry 1984; 141 (11): 1356–1364.​
  4. Skinner J, Carvalho JO, Potter GG, et al.; Alzheimer’s Disease Neuroimaging Initiative. The Alzheimer’s Disease Assessment Scale-Cognitive-Plus (ADAS-Cog-Plus): an expansion of the ADAS-Cog to improve responsiveness in MCI. Brain Imaging Behav 2012; 6 (4): 489–501.​
  5. Stern RG, Mohs RC, Davidson M, et al. A longitudinal study of Alzheimer’s disease: measurement, rate and predictors of cognitive deterioration. Am J Psychiatry 1994; 151 (3): 390–396.​
1 / 8
Alzheimer’s Disease Assessment Scale – Cognitive subscale (ADAS-Cog)​
References
  1. Alzheimer’s Disease Cooperative Study. ADAS – Administration Manual for the Alzheimer’s Disease Assessment Scale. The Mount Sinai School of Medicine, 1994. http://www.dementia-assessment.com.au/cognitive/adas_packet.pdf. Accessed 25 August 2016.​
  2. Gauthier S, Ballard C. Management of Dementia, 2nd edition. New York, USA: Informa Healthcare USA, 2009.​
  3. Rosen WG, Mohs RC, Davis KL. A new rating scale for Alzheimer’s disease. Am J Psychiatry 1984; 141 (11): 1356–1364.​
  4. Skinner J, Carvalho JO, Potter GG, et al.; Alzheimer’s Disease Neuroimaging Initiative. The Alzheimer’s Disease Assessment Scale-Cognitive-Plus (ADAS-Cog-Plus): an expansion of the ADAS-Cog to improve responsiveness in MCI. Brain Imaging Behav 2012; 6 (4): 489–501.​
  5. Stern RG, Mohs RC, Davidson M, et al. A longitudinal study of Alzheimer’s disease: measurement, rate and predictors of cognitive deterioration. Am J Psychiatry 1994; 151 (3): 390–396.​
1 / 8
Alzheimer’s Disease Assessment Scale – Cognitive subscale (ADAS-Cog)​
References
  1. Alzheimer’s Disease Cooperative Study. ADAS – Administration Manual for the Alzheimer’s Disease Assessment Scale. The Mount Sinai School of Medicine, 1994. http://www.dementia-assessment.com.au/cognitive/adas_packet.pdf. Accessed 25 August 2016.​
  2. Gauthier S, Ballard C. Management of Dementia, 2nd edition. New York, USA: Informa Healthcare USA, 2009.​
  3. Rosen WG, Mohs RC, Davis KL. A new rating scale for Alzheimer’s disease. Am J Psychiatry 1984; 141 (11): 1356–1364.​
  4. Skinner J, Carvalho JO, Potter GG, et al.; Alzheimer’s Disease Neuroimaging Initiative. The Alzheimer’s Disease Assessment Scale-Cognitive-Plus (ADAS-Cog-Plus): an expansion of the ADAS-Cog to improve responsiveness in MCI. Brain Imaging Behav 2012; 6 (4): 489–501.​
  5. Stern RG, Mohs RC, Davidson M, et al. A longitudinal study of Alzheimer’s disease: measurement, rate and predictors of cognitive deterioration. Am J Psychiatry 1994; 151 (3): 390–396.​
1 / 8
Alzheimer’s Disease Cooperative Study – Activities of Daily Living (ADCS-ADL)​
References
  1. Alzheimer’s Disease Cooperative Study (ADCS). Activities of Daily Living Inventory. http://www.dementia-assessment.com.au/function/adcs-adl_scale.pdf. Accessed 15 June 2016.​
  2. Galasko D, Bennett D, Sano M, et al. An inventory to assess activities of daily living for clinical trials in Alzheimer’s disease. Alzheimer Dis Assoc Disord 1997; 11 (Suppl 2): S33–S39.​
  3. Robert P, Ferris S, Gauthier S, et al. Review of Alzheimer’s disease scales: is there a need for a new multi-domain scale for therapy evaluation in medical practice? Alzheimers Res Ther 2010; 2 (4): 24.​
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Alzheimer’s Disease Cooperative Study – Activities of Daily Living (ADCS-ADL)​
References
  1. Alzheimer’s Disease Cooperative Study (ADCS). Activities of Daily Living Inventory. http://www.dementia-assessment.com.au/function/adcs-adl_scale.pdf. Accessed 15 June 2016.​
  2. Galasko D, Bennett D, Sano M, et al. An inventory to assess activities of daily living for clinical trials in Alzheimer’s disease. Alzheimer Dis Assoc Disord 1997; 11 (Suppl 2): S33–S39.​
  3. Robert P, Ferris S, Gauthier S, et al. Review of Alzheimer’s disease scales: is there a need for a new multi-domain scale for therapy evaluation in medical practice? Alzheimers Res Ther 2010; 2 (4): 24.​
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Alzheimer’s Disease Cooperative Study – Activities of Daily Living (ADCS-ADL)
References
  1. Alzheimer’s Disease Cooperative Study (ADCS). Activities of Daily Living Inventory. http://www.dementia-assessment.com.au/function/adcs-adl_scale.pdf. Accessed 15 June 2016.​
  2. Galasko D, Bennett D, Sano M, et al. An inventory to assess activities of daily living for clinical trials in Alzheimer’s disease. Alzheimer Dis Assoc Disord 1997; 11 (Suppl 2): S33–S39.​
  3. Robert P, Ferris S, Gauthier S, et al. Review of Alzheimer’s disease scales: is there a need for a new multi-domain scale for therapy evaluation in medical practice? Alzheimers Res Ther 2010; 2 (4): 24.​
1 / 8
Alzheimer’s Disease Cooperative Study – Activities of Daily Living (ADCS-ADL)
References
  1. Alzheimer’s Disease Cooperative Study (ADCS). Activities of Daily Living Inventory. http://www.dementia-assessment.com.au/function/adcs-adl_scale.pdf. Accessed 15 June 2016.​
  2. Galasko D, Bennett D, Sano M, et al. An inventory to assess activities of daily living for clinical trials in Alzheimer’s disease. Alzheimer Dis Assoc Disord 1997; 11 (Suppl 2): S33–S39.​
  3. Robert P, Ferris S, Gauthier S, et al. Review of Alzheimer’s disease scales: is there a need for a new multi-domain scale for therapy evaluation in medical practice? Alzheimers Res Ther 2010; 2 (4): 24.​
1 / 8
Alzheimer’s Disease Cooperative Study – Activities of Daily Living (ADCS-ADL)
References
  1. Alzheimer’s Disease Cooperative Study (ADCS). Activities of Daily Living Inventory. http://www.dementia-assessment.com.au/function/adcs-adl_scale.pdf. Accessed 15 June 2016.​
  2. Galasko D, Bennett D, Sano M, et al. An inventory to assess activities of daily living for clinical trials in Alzheimer’s disease. Alzheimer Dis Assoc Disord 1997; 11 (Suppl 2): S33–S39.​
  3. Robert P, Ferris S, Gauthier S, et al. Review of Alzheimer’s disease scales: is there a need for a new multi-domain scale for therapy evaluation in medical practice? Alzheimers Res Ther 2010; 2 (4): 24.​
1 / 8
Alzheimer’s Disease Cooperative Study – Activities of Daily Living (ADCS-ADL)​
References
  1. Alzheimer’s Disease Cooperative Study (ADCS). Activities of Daily Living Inventory. http://www.dementia-assessment.com.au/function/adcs-adl_scale.pdf. Accessed 15 June 2016.​
  2. Galasko D, Bennett D, Sano M, et al. An inventory to assess activities of daily living for clinical trials in Alzheimer’s disease. Alzheimer Dis Assoc Disord 1997; 11 (Suppl 2): S33–S39.​
  3. Robert P, Ferris S, Gauthier S, et al. Review of Alzheimer’s disease scales: is there a need for a new multi-domain scale for therapy evaluation in medical practice? Alzheimers Res Ther 2010; 2 (4): 24.​
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Alzheimer’s Disease Cooperative Study – Clinical Global Impression of Change (ADCS-CGIC)​
References
  1. Quinn J, Moore M, Benson DF, et al. A videotaped CIBIC for dementia patients: validity and reliability in a simulated clinical trial. Neurology 2002; 58 (3): 433–437.​
  2. Reisberg B, Schneider L, Doody R, et al. Clinical global measures of dementia. Position paper from the International Working Group on Harmonization of Dementia Drug Guidelines. Alzheimer Dis Assoc Disord 1997; 11 (Suppl 3): 8–18.​
  3. Schneider LS, Olin JT, Doody RS, et al. Validity and reliability of the Alzheimer’s Disease Cooperative Study-Clinical Global Impression of Change. The Alzheimer’s Disease Cooperative Study. Alzheimer Dis Assoc Disord 1997; 11 (Suppl 2): S22–S32.​
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Alzheimer’s Disease Cooperative Study – Clinical Global Impression of Change (ADCS-CGIC)
References
  1. Quinn J, Moore M, Benson DF, et al. A videotaped CIBIC for dementia patients: validity and reliability in a simulated clinical trial. Neurology 2002; 58 (3): 433–437.​
  2. Reisberg B, Schneider L, Doody R, et al. Clinical global measures of dementia. Position paper from the International Working Group on Harmonization of Dementia Drug Guidelines. Alzheimer Dis Assoc Disord 1997; 11 (Suppl 3): 8–18.​
  3. Schneider LS, Olin JT, Doody RS, et al. Validity and reliability of the Alzheimer’s Disease Cooperative Study-Clinical Global Impression of Change. The Alzheimer’s Disease Cooperative Study. Alzheimer Dis Assoc Disord 1997; 11 (Suppl 2): S22–S32.​
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Alzheimer’s Disease Cooperative Study – Clinical Global Impression of Change (ADCS-CGIC)
References
  1. Quinn J, Moore M, Benson DF, et al. A videotaped CIBIC for dementia patients: validity and reliability in a simulated clinical trial. Neurology 2002; 58 (3): 433–437.​
  2. Reisberg B, Schneider L, Doody R, et al. Clinical global measures of dementia. Position paper from the International Working Group on Harmonization of Dementia Drug Guidelines. Alzheimer Dis Assoc Disord 1997; 11 (Suppl 3): 8–18.​
  3. Schneider LS, Olin JT, Doody RS, et al. Validity and reliability of the Alzheimer’s Disease Cooperative Study-Clinical Global Impression of Change. The Alzheimer’s Disease Cooperative Study. Alzheimer Dis Assoc Disord 1997; 11 (Suppl 2): S22–S32.​
1 / 8
Alzheimer’s Disease Cooperative Study – Clinical Global Impression of Change (ADCS-CGIC)​
References
  1. Quinn J, Moore M, Benson DF, et al. A videotaped CIBIC for dementia patients: validity and reliability in a simulated clinical trial. Neurology 2002; 58 (3): 433–437.​
  2. Reisberg B, Schneider L, Doody R, et al. Clinical global measures of dementia. Position paper from the International Working Group on Harmonization of Dementia Drug Guidelines. Alzheimer Dis Assoc Disord 1997; 11 (Suppl 3): 8–18.​
  3. Schneider LS, Olin JT, Doody RS, et al. Validity and reliability of the Alzheimer’s Disease Cooperative Study-Clinical Global Impression of Change. The Alzheimer’s Disease Cooperative Study. Alzheimer Dis Assoc Disord 1997; 11 (Suppl 2): S22–S32.​

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Alzheimer’s Disease Cooperative Study – Clinical Global Impression of Change (ADCS-CGIC)
References
  1. Quinn J, Moore M, Benson DF, et al. A videotaped CIBIC for dementia patients: validity and reliability in a simulated clinical trial. Neurology 2002; 58 (3): 433–437.​
  2. Reisberg B, Schneider L, Doody R, et al. Clinical global measures of dementia. Position paper from the International Working Group on Harmonization of Dementia Drug Guidelines. Alzheimer Dis Assoc Disord 1997; 11 (Suppl 3): 8–18.​
  3. Schneider LS, Olin JT, Doody RS, et al. Validity and reliability of the Alzheimer’s Disease Cooperative Study-Clinical Global Impression of Change. The Alzheimer’s Disease Cooperative Study. Alzheimer Dis Assoc Disord 1997; 11 (Suppl 2): S22–S32.​
1 / 8
Alzheimer’s Disease Cooperative Study – Clinical Global Impression of Change (ADCS-CGIC)
References
  1. Quinn J, Moore M, Benson DF, et al. A videotaped CIBIC for dementia patients: validity and reliability in a simulated clinical trial. Neurology 2002; 58 (3): 433–437.​
  2. Reisberg B, Schneider L, Doody R, et al. Clinical global measures of dementia. Position paper from the International Working Group on Harmonization of Dementia Drug Guidelines. Alzheimer Dis Assoc Disord 1997; 11 (Suppl 3): 8–18.​
  3. Schneider LS, Olin JT, Doody RS, et al. Validity and reliability of the Alzheimer’s Disease Cooperative Study-Clinical Global Impression of Change. The Alzheimer’s Disease Cooperative Study. Alzheimer Dis Assoc Disord 1997; 11 (Suppl 2): S22–S32.​
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Neuropsychiatric Inventory (NPI)​
References
  1. Cummings JL, Mega M, Gray K, et al. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994; 44 (12): 2308–2314.​
  2. Cummings JL. The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology 1997; 48 (Suppl 6): S10–S16.​
  3. npiTEST.net. What is the Neuropsychiatric Inventory? http://npitest.net/npi/about-npi.html. Accessed 15 June 2016.​
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Neuropsychiatric Inventory (NPI)
References
  1. Cummings JL, Mega M, Gray K, et al. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994; 44 (12): 2308–2314.​
  2. Cummings JL. The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology 1997; 48 (Suppl 6): S10–S16.​
  3. npiTEST.net. What is the Neuropsychiatric Inventory? http://npitest.net/npi/about-npi.html. Accessed 15 June 2016.​
1 / 8
Neuropsychiatric Inventory (NPI)
References
  1. Cummings JL, Mega M, Gray K, et al. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994; 44 (12): 2308–2314.​
  2. Cummings JL. The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology 1997; 48 (Suppl 6): S10–S16.​
  3. npiTEST.net. What is the Neuropsychiatric Inventory? http://npitest.net/npi/about-npi.html. Accessed 15 June 2016.​
1 / 8
Neuropsychiatric Inventory (NPI)
References
  1. Cummings JL, Mega M, Gray K, et al. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994; 44 (12): 2308–2314.​
  2. Cummings JL. The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology 1997; 48 (Suppl 6): S10–S16.​
  3. npiTEST.net. What is the Neuropsychiatric Inventory? http://npitest.net/npi/about-npi.html. Accessed 15 June 2016.​
1 / 8
Neuropsychiatric Inventory (NPI)
References
  1. Cummings JL, Mega M, Gray K, et al. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994; 44 (12): 2308–2314.​
  2. Cummings JL. The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology 1997; 48 (Suppl 6): S10–S16.​
  3. npiTEST.net. What is the Neuropsychiatric Inventory? http://npitest.net/npi/about-npi.html. Accessed 15 June 2016.​
1 / 8
Neuropsychiatric Inventory (NPI)
References
  1. Cummings JL, Mega M, Gray K, et al. The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology 1994; 44 (12): 2308–2314.​
  2. Cummings JL. The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology 1997; 48 (Suppl 6): S10–S16.​
  3. npiTEST.net. What is the Neuropsychiatric Inventory? http://npitest.net/npi/about-npi.html. Accessed 15 June 2016.​
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Key points​
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Scales to assess pharmaco-economic outcomes​
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European Quality of Life – 5 Dimensions (3 Levels) (EQ-5D-3L)​
References
  1. The EuroQoL Group. EuroQoL – a new facility for the measurement of health-related quality of life. Health Policy 1990; 16 (3): 199–208.​
  2. Orgeta V, Edwards RT, Hounsome B, et al. The use of the EQ-5D as a measure of health-related quality of life in people with dementia and their carers. Qual Life Res 2015; 24 (2): 315–324.​
  3. van Agt HM, Essink-Bot ML, Krabbe PF, Bonsel GJ. Test–retest reliability of health state valuations collected with the EuroQoL questionnaire. Soc Sci Med 1994; 39 (11): 1537–1544.​
  4. van Reenen M, Oppe M. EQ-5D-3L User Guide. Basic information on how to use the EQ-5D-3L instrument. Version 5.1, April 2015. http://www.euroqol.org/fileadmin/user_upload/Documenten/PDF/Folders_Flye.... Accessed 15 June 2016.​
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European Quality of Life – 5 Dimensions (3 Levels) (EQ-5D-3L)
References
  1. The EuroQoL Group. EuroQoL – a new facility for the measurement of health-related quality of life. Health Policy 1990; 16 (3): 199–208.​
  2. Orgeta V, Edwards RT, Hounsome B, et al. The use of the EQ-5D as a measure of health-related quality of life in people with dementia and their carers. Qual Life Res 2015; 24 (2): 315–324.​
  3. van Agt HM, Essink-Bot ML, Krabbe PF, Bonsel GJ. Test–retest reliability of health state valuations collected with the EuroQoL questionnaire. Soc Sci Med 1994; 39 (11): 1537–1544.​
  4. van Reenen M, Oppe M. EQ-5D-3L User Guide. Basic information on how to use the EQ-5D-3L instrument. Version 5.1, April 2015. http://www.euroqol.org/fileadmin/user_upload/Documenten/PDF/Folders_Flyers/EQ-5D-3L_UserGuide_2015.pdf. Accessed 15 June 2016.​
1 / 8
European Quality of Life – 5 Dimensions (3 Levels) (EQ-5D-3L)
References
  1. The EuroQoL Group. EuroQoL – a new facility for the measurement of health-related quality of life. Health Policy 1990; 16 (3): 199–208.​
  2. Orgeta V, Edwards RT, Hounsome B, et al. The use of the EQ-5D as a measure of health-related quality of life in people with dementia and their carers. Qual Life Res 2015; 24 (2): 315–324.​
  3. van Agt HM, Essink-Bot ML, Krabbe PF, Bonsel GJ. Test–retest reliability of health state valuations collected with the EuroQoL questionnaire. Soc Sci Med 1994; 39 (11): 1537–1544.​
  4. van Reenen M, Oppe M. EQ-5D-3L User Guide. Basic information on how to use the EQ-5D-3L instrument. Version 5.1, April 2015. http://www.euroqol.org/fileadmin/user_upload/Documenten/PDF/Folders_Flyers/EQ-5D-3L_UserGuide_2015.pdf. Accessed 15 June 2016.​
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European Quality of Life – 5 Dimensions (3 Levels) (EQ-5D-3L)
References
  1. The EuroQoL Group. EuroQoL – a new facility for the measurement of health-related quality of life. Health Policy 1990; 16 (3): 199–208.​
  2. Orgeta V, Edwards RT, Hounsome B, et al. The use of the EQ-5D as a measure of health-related quality of life in people with dementia and their carers. Qual Life Res 2015; 24 (2): 315–324.​
  3. van Agt HM, Essink-Bot ML, Krabbe PF, Bonsel GJ. Test–retest reliability of health state valuations collected with the EuroQoL questionnaire. Soc Sci Med 1994; 39 (11): 1537–1544.​
  4. van Reenen M, Oppe M. EQ-5D-3L User Guide. Basic information on how to use the EQ-5D-3L instrument. Version 5.1, April 2015. http://www.euroqol.org/fileadmin/user_upload/Documenten/PDF/Folders_Flyers/EQ-5D-3L_UserGuide_2015.pdf. Accessed 15 June 2016.​
1 / 8
European Quality of Life – 5 Dimensions (3 Levels) (EQ-5D-3L)
References
  1. The EuroQoL Group. EuroQoL – a new facility for the measurement of health-related quality of life. Health Policy 1990; 16 (3): 199–208.​
  2. Orgeta V, Edwards RT, Hounsome B, et al. The use of the EQ-5D as a measure of health-related quality of life in people with dementia and their carers. Qual Life Res 2015; 24 (2): 315–324.​
  3. van Agt HM, Essink-Bot ML, Krabbe PF, Bonsel GJ. Test–retest reliability of health state valuations collected with the EuroQoL questionnaire. Soc Sci Med 1994; 39 (11): 1537–1544.​
  4. van Reenen M, Oppe M. EQ-5D-3L User Guide. Basic information on how to use the EQ-5D-3L instrument. Version 5.1, April 2015. http://www.euroqol.org/fileadmin/user_upload/Documenten/PDF/Folders_Flyers/EQ-5D-3L_UserGuide_2015.pdf. Accessed 15 June 2016.​
1 / 8
European Quality of Life – 5 Dimensions (3 Levels) (EQ-5D-3L)
References
  1. The EuroQoL Group. EuroQoL – a new facility for the measurement of health-related quality of life. Health Policy 1990; 16 (3): 199–208.​
  2. Orgeta V, Edwards RT, Hounsome B, et al. The use of the EQ-5D as a measure of health-related quality of life in people with dementia and their carers. Qual Life Res 2015; 24 (2): 315–324.​
  3. van Agt HM, Essink-Bot ML, Krabbe PF, Bonsel GJ. Test–retest reliability of health state valuations collected with the EuroQoL questionnaire. Soc Sci Med 1994; 39 (11): 1537–1544.​
  4. van Reenen M, Oppe M. EQ-5D-3L User Guide. Basic information on how to use the EQ-5D-3L instrument. Version 5.1, April 2015. http://www.euroqol.org/fileadmin/user_upload/Documenten/PDF/Folders_Flyers/EQ-5D-3L_UserGuide_2015.pdf. Accessed 15 June 2016.​
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Resource Utilization in Dementia Lite (RUD Lite)​
References
  1. Wimo A, Winblad B. Resource utilization in dementia: RUD Lite©. Brain Aging 2003; 3 (1): 48–59.​
  2. Wimo A, Nordberg G. Validity and reliability of assessments of time. Comparisons of direct observations and estimates of time by the use of the Resource Utilization in Dementia (RUD)-instrument. Arch Gerontol Geriatr 2007; 44 (1): 71–81.​
  3. Wimo A, Jonsson L, Zbrozek A. The Resource Utilization in Dementia (RUD) instrument is valid for assessing informal care time in community-living patients with dementia. J Nutr Health Aging 2010; 14 (8): 685–690.​
1 / 8
Resource Utilization in Dementia Lite (RUD Lite)
References
  1. Wimo A, Winblad B. Resource utilization in dementia: RUD Lite©. Brain Aging 2003; 3 (1): 48–59.​
  2. Wimo A, Nordberg G. Validity and reliability of assessments of time. Comparisons of direct observations and estimates of time by the use of the Resource Utilization in Dementia (RUD)-instrument. Arch Gerontol Geriatr 2007; 44 (1): 71–81.​
  3. Wimo A, Jonsson L, Zbrozek A. The Resource Utilization in Dementia (RUD) instrument is valid for assessing informal care time in community-living patients with dementia. J Nutr Health Aging 2010; 14 (8): 685–690.​
1 / 8
Resource Utilization in Dementia Lite (RUD Lite)
References
  1. Wimo A, Winblad B. Resource utilization in dementia: RUD Lite©. Brain Aging 2003; 3 (1): 48–59.​
  2. Wimo A, Nordberg G. Validity and reliability of assessments of time. Comparisons of direct observations and estimates of time by the use of the Resource Utilization in Dementia (RUD)-instrument. Arch Gerontol Geriatr 2007; 44 (1): 71–81.​
  3. Wimo A, Jonsson L, Zbrozek A. The Resource Utilization in Dementia (RUD) instrument is valid for assessing informal care time in community-living patients with dementia. J Nutr Health Aging 2010; 14 (8): 685–690.​
1 / 8
Resource Utilization in Dementia Lite (RUD Lite)
References
  1. Wimo A, Winblad B. Resource utilization in dementia: RUD Lite©. Brain Aging 2003; 3 (1): 48–59.​
  2. Wimo A, Nordberg G. Validity and reliability of assessments of time. Comparisons of direct observations and estimates of time by the use of the Resource Utilization in Dementia (RUD)-instrument. Arch Gerontol Geriatr 2007; 44 (1): 71–81.​
  3. Wimo A, Jonsson L, Zbrozek A. The Resource Utilization in Dementia (RUD) instrument is valid for assessing informal care time in community-living patients with dementia. J Nutr Health Aging 2010; 14 (8): 685–690.​
1 / 8
Resource Utilization in Dementia Lite (RUD Lite)
References
  1. Wimo A, Winblad B. Resource utilization in dementia: RUD Lite©. Brain Aging 2003; 3 (1): 48–59.​
  2. Wimo A, Nordberg G. Validity and reliability of assessments of time. Comparisons of direct observations and estimates of time by the use of the Resource Utilization in Dementia (RUD)-instrument. Arch Gerontol Geriatr 2007; 44 (1): 71–81.​
  3. Wimo A, Jonsson L, Zbrozek A. The Resource Utilization in Dementia (RUD) instrument is valid for assessing informal care time in community-living patients with dementia. J Nutr Health Aging 2010; 14 (8): 685–690.​
1 / 8
Resource Utilization in Dementia Lite (RUD Lite)
References
  1. Wimo A, Winblad B. Resource utilization in dementia: RUD Lite©. Brain Aging 2003; 3 (1): 48–59.​
  2. Wimo A, Nordberg G. Validity and reliability of assessments of time. Comparisons of direct observations and estimates of time by the use of the Resource Utilization in Dementia (RUD)-instrument. Arch Gerontol Geriatr 2007; 44 (1): 71–81.​
  3. Wimo A, Jonsson L, Zbrozek A. The Resource Utilization in Dementia (RUD) instrument is valid for assessing informal care time in community-living patients with dementia. J Nutr Health Aging 2010; 14 (8): 685–690.​
1 / 8
Dependence scale (DS)​
References
  1. Brickman AM, Riba A, Bell K, et al. Longitudinal assessment of patient dependence in Alzheimer disease. Arch Neurol 2002; 59 (8): 1304–1308.​
  2. Manasco MH. Introduction to Neurogenic Communication Disorders, 2nd edition. Burlington MA: Jones and Bartlett Learning, 2016.​
  3. Stern Y, Albert SM, Sano M, et al. Assessing patient dependence in Alzheimer’s disease. J Gerontol 1994; 49 (5): M216–M222.​
1 / 8
Dependence scale (DS)
References
  1. Brickman AM, Riba A, Bell K, et al. Longitudinal assessment of patient dependence in Alzheimer disease. Arch Neurol 2002; 59 (8): 1304–1308.​
  2. Manasco MH. Introduction to Neurogenic Communication Disorders, 2nd edition. Burlington MA: Jones and Bartlett Learning, 2016.​
  3. Stern Y, Albert SM, Sano M, et al. Assessing patient dependence in Alzheimer’s disease. J Gerontol 1994; 49 (5): M216–M222.​
1 / 8
Dependence scale (DS)
References
  1. Brickman AM, Riba A, Bell K, et al. Longitudinal assessment of patient dependence in Alzheimer disease. Arch Neurol 2002; 59 (8): 1304–1308.​
  2. Manasco MH. Introduction to Neurogenic Communication Disorders, 2nd edition. Burlington MA: Jones and Bartlett Learning, 2016.​
  3. Stern Y, Albert SM, Sano M, et al. Assessing patient dependence in Alzheimer’s disease. J Gerontol 1994; 49 (5): M216–M222.​
1 / 8
Dependence scale (DS)
References
  1. Brickman AM, Riba A, Bell K, et al. Longitudinal assessment of patient dependence in Alzheimer disease. Arch Neurol 2002; 59 (8): 1304–1308.​
  2. Manasco MH. Introduction to Neurogenic Communication Disorders, 2nd edition. Burlington MA: Jones and Bartlett Learning, 2016.​
  3. Stern Y, Albert SM, Sano M, et al. Assessing patient dependence in Alzheimer’s disease. J Gerontol 1994; 49 (5): M216–M222.​
1 / 8
Dependence scale (DS)
References
  1. Brickman AM, Riba A, Bell K, et al. Longitudinal assessment of patient dependence in Alzheimer disease. Arch Neurol 2002; 59 (8): 1304–1308.​
  2. Manasco MH. Introduction to Neurogenic Communication Disorders, 2nd edition. Burlington MA: Jones and Bartlett Learning, 2016.​
  3. Stern Y, Albert SM, Sano M, et al. Assessing patient dependence in Alzheimer’s disease. J Gerontol 1994; 49 (5): M216–M222.​
1 / 8
Dependence scale (DS)
References
  1. Brickman AM, Riba A, Bell K, et al. Longitudinal assessment of patient dependence in Alzheimer disease. Arch Neurol 2002; 59 (8): 1304–1308.​
  2. Manasco MH. Introduction to Neurogenic Communication Disorders, 2nd edition. Burlington MA: Jones and Bartlett Learning, 2016.​
  3. Stern Y, Albert SM, Sano M, et al. Assessing patient dependence in Alzheimer’s disease. J Gerontol 1994; 49 (5): M216–M222.​
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