Health-related resource use and costs in elderly adults with and without mild cognitive impairment.

Objectives: To assess differences in resource use and cost between older adults with and without mild cognitive impairment (MCI) over time.

Design: Multicenter, longitudinal study.

Setting: Sixty-eight Alzheimer's Disease Cooperative Study (ADCS) sites in the United States.

Health state valuation in mild to moderate cognitive impairment: feasibility of computer-based, direct patient utility assessment.

Background: Most patients with dementia will, at some point, need a proxy health care decision maker. It is unknown whether persons with various degrees of cognitive impairment can reliably report their health-related preferences.

Methods: The authors performed health state valuations (HSVs) of current and hypothetical future health states on 47 pairs of patients with mild to moderate cognitive impairment and their caregivers using computer-based standard gamble, time tradeoff, and rating scale techniques.

Empirical assessment of a research advance directive for persons with dementia and their proxies.

Objectives: To evaluate a research advance directive for persons with established dementia diagnoses and their family caregivers or proxies.

Design: Prospective randomized, controlled trial.

Setting: Three clinics, one each in Ohio, Kentucky, and Illinois.

ADCS Prevention Instrument Project: pilot testing of a book club as a psychosocial intervention and recruitment and retention strategy.

Both psychosocial and biologic interventions may delay or prevent Alzheimer disease. Staying mentally active may help older people maintain their cognitive abilities. In the Alzheimer Disease Cooperative Study Prevention Instrument Project a book club was introduced as a recruitment and retention device.

ADCS Prevention Instrument Project: quality of life assessment (QOL).

Information about quality of life (QOL) is valuable in evaluating pharmaceutical agents but it is not adequately assessed in many dementia drug trials. In prevention trials, following participants to conversion to AD requires QOL scales appropriate for both normal and cognitively impaired individuals. Our objective was to evaluate the utility of several scales for subject or informant QOL assessment: Quality of Life-AD; Quality of Life Activity Inventory; SF-36; SF-12 (a shortened version of the SF-36); and Satisfaction with Life Scale.

An empirical basis for domains in the analysis of dependency in the activities of daily living (ADL): results of a confirmatory factor analysis of the Cleveland Scale for Activities of Daily Living (CSADL).

This study examines the empirical basis for dividing activities of daily living (ADLs) into broad behavioral domains. Following an exploratory factor analysis of results from the Cleveland Scale for Activities of Daily Living (CSADL), a two-factor model of ADLs was tested in a confirmatory factor analysis using two groups of demented patients. The model, which included a Basic and an Instrumental factor, was confirmed.

Independence of changes in behavior from cognition and function in community-dwelling persons with Alzheimer's disease: a factor analytic approach.

The authors' main objective was to investigate the relationship between changes in psychopathological, cognitive and activity of daily living (ADL) instrument scores over 12 months in community-dwelling persons with Alzheimer's disease (AD). A secondary objective was to evaluate the validity of dividing the Clinical Dementia Rating (CDR), a global dementia staging instrument into cognitive and functional subscores. Changes in measures of psychopathology, cognition and function between the baseline and 12-month visits were entered into these post hoc analyses of data from a one-year clinical trial to evaluate behavioral, cognitive and functional assessment instruments for use in clinical trials with AD patients.

Comorbidity of psychopathological domains in community-dwelling persons with Alzheimer's disease.

In this post hoc analysis of baseline responses to the CERAD Behavior Rating Scale for Dementia in a clinical trial of interventions for agitation in Alzheimer's disease (AD), the authors investigated the distribution of, and relationships between, agitation, depression, and psychosis in 148 individuals with AD. Prevalence of depressive symptoms was highest (78.4%), followed by agitation (77.

Emergent psychopathology in Alzheimer's disease patients over 12 months associated with functional, not cognitive, changes.

In a large, well-characterized population of community-dwelling persons with Alzheimer's disease (AD), we investigated the emergence of behavioral symptomatology and its association with changes in cognitive, global-clinical, and functional status. Behavioral Rating Scale for Dementia (BRSD) item responses from 235 AD patients with varying levels of dementia severity and without significant behavioral disturbance were taken from the baseline and 12-month visits in a study of cognitive and behavioral instruments. Item-level analysis revealed new symptoms at every dementia severity level.