Cross-sectional and Longitudinal Assessments of Function in Prodromal-to-mild Alzheimer's Disease: A Comparison of the ADCS-ADL and A-IADL-Q Scales

Overview

Journal Alzheimers Dement (Amst)

Date 2023 Jun 16

PMID 37325545

Authors

Edmond Teng

Yihao Li

Paul T Manser

Karen Pickthorn

Brandon D Butcher

Mira Blendstrup

Christopher Randolph

Sietske A M Sikkes

Affiliations

Soon will be listed here.

Abstract

Introduction: Prior observational work in a heterogeneous cohort of participants with mild cognitive impairment suggests the Amsterdam Instrumental Activities of Daily Living Questionnaire (A-IADL-Q) may have greater sensitivity for functional decline than the more established Alzheimer's Disease Cooperative Study-Activities of Daily Living (ADCS-ADL) scale. However, the relative utility of the A-IADL-Q versus the ADCS-ADL for clinical trials in early Alzheimer's disease (AD) remains uncertain.

Methods: We compared baseline and longitudinal performance of the A-IADL-Q and ADCS-ADL in participants with biomarker-confirmed prodromal (pAD; = 158) or mild (mAD; = 283) AD enrolled in the 18-month Tauriel study of semorinemab (NCT03289143).

Results: The A-IADL-Q exhibited numerically stronger discrimination between pAD and mAD participants at baseline per Cohen's analyses and similar sensitivity to longitudinal decline across cohorts over 18 months relative to the ADCS-ADL.

Discussion: The comparable performance of the ADCS-ADL and A-IADL-Q supports the utility of the A-IADL-Q in early AD clinical trials.

Highlights: The Amsterdam Instrumental Activities of Daily Living Questionnaire (A-IADL-Q) may be more sensitive than the Alzheimer's Disease Cooperative Study-Activities of Daily Living Scale (ADCS-ADL) for distinguishing prodromal and mild Alzheimer's disease (AD).A-IADL-Q and ADCS-ADL are similarly sensitive to decline in early AD over 18 months.Comparable performance of these indices supports A-IADL-Q use in future AD trials.Additional AD clinical trial data could extend findings across more diverse cohorts.

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