Background: The need to detect early changes in instrumental activities of daily life led us to modify the Disability Assessment for Dementia Scale (DAD) by focusing on executive components of 6 instrumental items (DAD-6). Aim: To evaluate the relevance of the DAD-6 for detecting early impairment in a nondemented population. Methods: The DAD-6 was administered to informants of 84 patients: 31 with mild dementia (MD), 53 with mild cognitive impairment (MCI) and 55 healthy controls. Results: DAD-6 scores gradually decreased with increasing severity of the cognitive status [18 in healthy controls vs. 15.1 ± 3.2 in MCI versus 9.6 ± 3.5 in MD, p < 0.0001). Receiver-operating characteristic curve analyses yielded an optimal cut score of 14 to distinguish MCI from MD with a sensitivity of 0.83 (95% confidence interval 0.74–0.92) and a specificity of 0.84 (0.71–0.94), and a cut score of 15 to distinguish single-domain MCI from multi-domain MCI with a sensitivity of 0.96 (0.90–0.99) and a specificity of 0.54 (0.33–0.75). Conclusion: The DAD-6 reliably detects early loss of autonomy due to cognitive impairment.

Keywords:
Executive function, Instrumental activities of daily living, Mild cognitive impairment, Early diagnosis of Alzheimer’s disease, Instrumental functional impairment assessment, Cognitive decline
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© 2012 S. Karger AG, Basel
2012
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