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BMC Geriatrics

, 6:7

First Online: 03 April 2006Received: 26 October 2005Accepted: 03 April 2006


BackgroundThe objective of this study was to assess the responsiveness of the Minimum Data Set Activities of Daily Living MDS-ADL Scale to change over time by examining the change in physical function in adults with moderate to severe dementia with no comorbid illness who had been resident in a nursing home for over 90 days.

MethodsLongitudinal data were collected on nursing home residents with moderate n = 7001 or severe n = 4616 dementia in one US state from the US national Minimum Data Set MDS. Severity of dementia was determined by the MDS Cognitive Performance Scale CPS. Physical function was assessed by summing the seven items bed mobility, transfer, locomotion, dressing, eating, toilet use, personal hygiene on the MDS activities of daily living ADL Long Form scale. Mean change over time of MDS-ADL scores were estimated at three and six months for residents with moderate CPS score of 3 and severe CPS score of 4 or 5 dementia.

ResultsPhysical function in residents with moderate cognitive impairment deteriorated over six months by an average of 1.78 points on the MDS-ADL Long Form scale, while those with severe cognitive impairment declined by an average of 1.70 points. Approximately one quarter of residents in both groups showed some improvement in physical function over the six month period. Residents with moderate cognitive impairment experienced the greatest deterioration in early-loss and mid-loss ADL items personal hygiene, dressing, toilet use and residents with severe cognitive impairment showed the greatest deterioration in activities related to eating, a late loss ADL.

ConclusionThe MDS-ADL Long Form scale detected clinically meaningful change in physical function in a large cohort of long-stay nursing home residents with moderate to severe dementia, supporting its use as a research tool in future studies.

AbbreviationsADLActivity of Daily Living

MDSMinimum Data Set

CPSCognitive Performance Scale

MMSEMini-Mental Status Examination

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2318-6-7 contains supplementary material, which is available to authorized users.

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Autor: G Iain Carpenter - Charlotte L Hastie - John N Morris - Brant E Fries - Joel Ankri


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