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The limitation of existing scales for assessing residual ADL of patients with severe dementia Hiroyuki Tanaka 1,2 , Yuma Nagata 1,3 , Daiki Ishimaru 1,3 , Takashi Nishikawa 2 1Medical Corporation Seifuen Imai Hospital 2Osaka Prefecture University Graduate School of Comprehensive Rehabilitation 3Students at Osaka Prefecture University Graduate School of Comprehensive Rehabilitation Keyword: 認知症 , ADL , 評価尺度 , (床効果) , Dementia , Activities of daily living , Assessment scale , Floor effect pp.105-108
Published Date 2017/2/15
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 Existing ADL scales exhibit a floor effect for patients with moderately severe to extremely severe dementia, and their inability to assess residual ADL in dementia patients has been criticized. This study examined if existing scales can appropriately measure the residual ADL of patients with severe dementia without such floor effects. We used the Functional Independence Measure (FIM), Disability Assessment for Dementia (DAD), Self-Care Rating for Dementia Extended (SCR-DE) Scale, Hyogo Activities of Daily Living Scale (HADLS), and Nishimura's Activities of Daily Living Scale (N-ADL) to rate ADL in severe dementia patients admitted to medical facilities for long-term care. We examined a floor effect of both the scores of each item and the total scores by indicating the ratio of the subjects showing minimum scores in these scales. 108 subjects were included in the analysis. Only the following items or scores did not exhibit a floor effect: “total score”, “eating”, “posture”, and “washing” on the HADLS, and “total score” and “eating” on the N-ADL. We therefore consider that the existing ADL scales are not valid for assessing the ADL of hospitalized elderly patients with moderately severe to extremely severe dementia. The development of a new ADL scale that examines cooperative attitudes towards ADL in detail is deemed necessary for severe dementia.


Copyright © 2017, Japanese Association of Occupational Therapists. All rights reserved.

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電子版ISSN 印刷版ISSN 0289-4920 日本作業療法士協会

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