Assessing outcomes in Alzheimer disease

To gain a better overview of the effectiveness of treatment of patients with Alzheimer disease (AD), areas such as cognition, activities of daily living (ADL), behavior, caregiver burden, quality of life and economics need to be assessed. A number of instruments are available for assessing these domains, many of which are reviewed in this article. These include the cognitive subscale of the Alzheimer's Disease Assessment Scale (the standard instrument for the measurement of efficacy in dementia trials), scales that assess AD patients' abilities to perform ADL (including the Disability Assessment for Dementia scale and the Alzheimer's Disease Cooperative Study - Activities of Daily Living), scales to assess behavioral symptoms in dementia (including the Neuropsychiatric Inventory and the Behavioral Pathology in Alzheimer's Disease Rating Scale), scales for assessing global clinical change, and methods for assessing caregiver time, quality of life and health economics. Each instrument has its own advantages and disadvantages. However, the instruments used need to be selected carefully to provide credible and informative outcome data.