ABSTRACT
Deterioration in functional abilities of daily living (ADL) has a major impact on quality of life of an individual with Alzheimer’s disease (AD).1-4 Feelings of incompetence and loss of control are often expressed by the patient in the earlier stages of the disease. Frustration and the feeling of insult are expressed by patients in the later stages of the disease. Because the decline in functional abilities is such a predominant feature in AD, it is included as a criterion for the diagnosis of ‘probable dementia of the Alzheimer’s type’ as recommended by the NINCDS-ADRDA work group,5,6 in the DSM-IV7 criteria for ‘Dementia of the Alzheimer’s Type’ and the International Classification of Disease and Related Health Problems (ICD-10).8 In addition, the rate of decline in the performance of ADL was identified as being a useful index for following the progression of the disease.9,10 Furthermore, deterioration in functional activities has been found to be a critical predictor of institutionalization for the cognitively impaired.11,12
Changes of functional abilities over the course of AD, their relationship to cognition, the nature of difficulties in performing daily activities, consequences of functional loss and the assessment of functional abilities will be discussed in this chapter.
