![]() However, even this standardized version has shown modification over time (personal communication). In 1998, the Alzheimer’s Disease Cooperative Study group (ADCS), under the guidance of Kimberly Schafer, developed an ADAS-Cog kit that included high-quality items for the naming task, card sets for the word lists, and a revision of the original manual that attempted to operationalize much of the ADAS-Cog administration and scoring procedures. This may lead to some raters utilizing their individual judgments, thus reducing the inter-rater reliability. Further, the responses to situations that are often encountered when working with a demented population were not well operationalized and seldom addressed in the training sessions at clinical trial meetings. The issue of sensitivity to very mild impairments and MCI has been addressed in some versions of the instrument by adding a delayed free recall of the first word list (short-term memory).ĭespite being the gold standard in clinical dementia trials since the early tacrine studies, the administration procedures, work sheets, and scoring procedures of the ADAS-Cog were not precisely defined in the original article. The ADAS-Cog has been shown to be sensitive to change across various levels of dementia, with minimal floor effects, but some question of ceiling effects. A final subjective scale measuring concentration and distractibility is sometimes added. The test usually includes three additional subjective scales containing impression of spoken language ability, word finding difficulty, and comprehension. It was designed to measure cognitive areas commonly seen to decline in Alzheimer’s disease (AD), specifically learning (word list), naming (objects), following commands (1 to 5 elements), constructional Praxis (copy 4 figures), ideational Praxis (mail a letter), orientation (person, time and place), recognition memory (from a second word list), and remembering test instructions (from the recognition subtest). In clinical trials on dementia, the Alzheimer’s Disease Assessment Scale-Cognitive section (ADAS-Cog) is the most commonly used objective measure of cognitive change.
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