Broad spectrum assessment of psychopathology and adaptive functioning with the Older Adult Behavior Checklist: a validation and diagnostic discrimination study.

Objective: Self-administered by spouses and other collateral informants, the nationally normed Older Adult Behavior Checklist (OABCL) provides standardized data on diverse aspects of older adult psychopathology and adaptive functioning. We tested the validity of the Older Adult Behavior Checklist (OABCL) scale scores in terms of associations with diagnoses of dementia of the Alzheimer's type (DAT) and mood disorders (MD) and with nine measures of psychopathology, cognitive performance, and adaptive functioning.

Method: Informants completed OABCLs for 727 60-97-year-olds recruited from a memory disorders clinic, geriatric psychiatry clinic, and community-dwelling seniors. OABCL scale scores were tested for associations with DAT and MD diagnoses, as well as with scores on the Neuropsychiatric Inventory, Mini-Mental State Exam (MMSE), Clock Drawing Test, Alzheimer's Disease Assessment Scale, Geriatric Depression Scale, Clinical Dementia Rating, Dementia Severity Rating Scale, Trail Making Test Part A, and Instrumental Activities of Daily Living.

Results: OABCL scales had medium to large correlations with the nine other indices of functioning and significantly augmented MMSE discrimination between patients with DAT versus MD. OABCL scales also discriminated significantly between patients diagnosed with DAT versus MD and both these groups versus nonclinical subjects.

Conclusions: Multiple OABCL scales had medium to large associations with diverse indices of functioning based on other kinds of data. The nationally normed OABCL provides new ways to integrate informant and self-report data to improve assessment of older adults. Specifically, the OABCL can provide discrimination between those who qualify for diagnoses of DAT versus MD versus neither diagnosis.