Development and Piloting of a Performance Test to determine Capabilities of Everyday Living in People with Mild Dementia

• Applicant: Privatdozentin Dr. Katharina Luttenberger
• Subject Area: Public Health, Healthcare Research, Social and Occupational Medicine
• Term: from 2012 to 2015
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 231855120

Background: Impairments in cognition and capabilities of everyday living are the main symptoms of degenerative dementias. Practical capabilities in everyday living (ADL capabilities) are decisive for the independence of the individual. Thus far, there is no performance test which can measure the capabilities of everyday living economically, validly and reliably in mild dementia. Rather, impairments in the everyday activities among dementia patients are usually recorded as observer ratings, and available performance tests have serious drawbacks with respect to their economy and/or validity. Objective: The objective of this project is therefore to develop and conduct a pilot study of a performance test to measure capabilities of everyday living in patients with mild dementia (mild dementia Erlangen test of Activities of Daily Living (mE-ADL)), which offers the following advantages over available instruments: quick performance and valid recording of relevant impairments in mild dementia and validation in appropriate sample size. The new test is based theoretically on the ICF (area: Activities and Participation).Preparation: The applicant's research group, in focus groups consisting of experts and family members, has already compiled a set if 12 ICF-based tasks. The set is currently being tested for feasibility and acceptance on 30 persons with mild dementia. Design: The mE-ADL as well as the Bayer ADL-Scale (B-ADL), the Mini-Mental-Status-Test (MMST) and the Geriatric Depression Scale (GDS) will be performed by a sample of 120 people with mild dementia. 14 days after the first test session, the mE-ADL will be repeated to check the test-retest reliability. As item parameters, difficulty and selectivity (corrected-item-total-correlation) will be calculated. In an iterative reduction to ca 5 items (maximal total test time 15 minutes), the items with the best parameter values will be chosen, whereby care is taken that each item comes from another of the areas of communication, mobility, self-care and domestic life in the ICF. The test-retest reliability after 2 weeks will be checked with Pearson's correlation, and Cronbach's alpha will be calculated as a measure of internal consistency. To check content validity, the selected items of the final mE-ADL will again be submitted for evaluation to a group of experts who were not involved in creating the test. Hypotheses concerning the relation of the mE-ADL to the other instruments recorded will be defined and checked to examine the congruent and discriminant validity. Moreover, a factor analysis will be performed.

• DFG Programme: Research Grants
• Participating Person: Professor Dr. Elmar Gräßel