According to Giacobini ( 2000), under current treatment conditions, AChEI may yield a maximal effect of ∼3.6 points (ADAS-cog) compared to placebo, with an average 1.2 point difference at the end of those studies that lasted 26–30 weeks. AD progression in mild to moderate stages of the disease (CDR stages 1–2) is assumed at a rate of approximately nine points per year on the 70 points ADAS-cog scale. The effects, however, are limited in terms of quantity and time. 1994, Ringman and Cummings 1999, Rogers et al. For all AChEI that are currently on the market, significant beneficial effects on various cognitive domains and behavioral function have been shown compared to placebo (Knapp et al. Clinician-Based Impression of Change, CIBIC Reisberg et al. 1994) as well as activities of daily living or global clinical functioning (e.g. Neuropsychiatric Inventory, NPI, Cummings et al. 1984 Mini-Mental State Examination, MMSE, Folstein et al. Hock, in International Encyclopedia of the Social & Behavioral Sciences, 2001 2 EfficacyĬontrolled clinical trials used standardized and validated scales as outcome measures for cognitive (Alzheimer's Disease Assessment Scale-cognitive scale, ADAS-cog, Rosen et al. Alzheimer disease researchers, especially those involved in pharmaceutical trials, routinely use the ADAS-Cog to monitor the course of Alzheimer disease and measure the effect of medication.
The testing usually requires 45 to 60 minutes. Test-givers need not be physicians but must undergo special training.
However, it is more complex and subjective. Patients obtain scores of 0 to 70 higher scores indicate poorer performance.Ĭompared to the MMSE, the ADAS-Cog is more sensitive, reliable, and less influenced by educational level and language skills. 7.2) includes not only standard tests of language, comprehension, memory, and orientation, but also tests of visual-spatial ability, such as drawing geometric figures, and physical tasks that reflect ideational praxis, such as folding a paper into an envelope. The Alzheimer Disease Assessment Scale (ADAS) consists of cognitive and noncognitive sections. Milstein MD, in Kaufman's Clinical Neurology for Psychiatrists (Eighth Edition), 2017 Alzheimer Disease Assessment Scale. Similar to all cognitive measures reviewed in this chapter, ADAS-Cog outcome scores are shown to negatively correlate with age and education.ĭavid Myland Kaufman MD. Test–retest reliability is also excellent, reported at 0.91 over a six-week period ( Talwalker, Overall, Srirama, & Gracon, 1996). Inter-rater reliability coefficients are high for the ADAS-Cog (0.82–0.91) following increased standardization of test administration and examiner training. The addition of word learning with a delayed recall component has been recommended to increase the ADAS-Cog's ability to identify more mild forms of dementia. In its current form, the ADAS-Cog has been shown successful in not only identifying Alzheimer's patients from healthy elderly controls, but it has also shown to be effective in rating severity between moderate and late stage dementia based on decreasing performance on the orientation items.Ĭritics charge that the test is less effective in rating severity in MCI and mild dementia cases although it does a better job than the MMSE ( Lezak et al., 2004). The total ADAS-Cog score ranges from 0–70 with higher scores suggesting greater impairment. The test takes 30–35 minutes to administer and the item scores generally range from 1–5.
The ADAS-Cog consists of items from the following areas chosen for their sensitivity to Alzheimer's disease: language memory praxis and orientation. The ADAS-Cog is one of two primary cognitive outcome measures required in all current Food and Drug Administration (FDA) clinical drug trials for Alzheimer's disease in the United States. The ADAS-Cog is more frequently utilized and will be the focus for this discussion. The Alzheimer's Disease Assessment Scale (ADAS Rosen, Mohs, & Davis, 1984) is made up of two parts: cognitive and non-cognitive testing. Ducharme, in Handbook of Assessment in Clinical Gerontology (Second Edition), 2010 Alzheimer's Disease Assessment Scale (ADAS)
0 kommentar(er)
