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Rehab Measures: Bayer Activities of Daily Living Scale

Link to instrument

 

Title of Assessment

Bayer Activities of Daily Living Scale 

Acronym

B-ADL

Instrument Reviewer(s)

Initially reviewed by Murtaza Khumri, PT, MHS-PT on 12/5/2014

Summary Date

5/17/2015 

Purpose

A 25-item informant-rated questionnaire to assess functional disabilities for early diagnoses of dementia

Description

B – ADL scale is developed for assess functional disability in the cognitively impaired elderly.

Informant is the primary caregiver or a relative who has adequate knowledge of the patient’s condition.

The informant rates a person’s ability to perform an activity on a scale of 1 to 10 for each of the 25-items, where 1 indicates ‘never’ and 10 indicates ‘always’ have difficulty.

In instances where an activity is not appropriate, not relevant, or unknown, the rater rates a ‘not applicable’ or ‘unknown’.

Individual item scores are summed up. Items rated ‘not applicable’ and ‘unknown’ are not used for the computation of this sum score.

The total is then divided by the number of items rated between ‘1’ and ‘10’

Thus, the scale’s sum score is corrected for the number of irrelevant items and missing scores

Total scores of the B-ADL range between values 1.00 and 10.00

Higher score predicts an increased severity of dementia

Area of Assessment

 

Body Part

 

ICF Domain

Activity 

Domain

 

Assessment Type

 

Length of Test

06 to 30 Minutes 

Time to Administer

10-15 minutes

Number of Items

25 items 

Equipment Required

  • Score sheet
  • Pen

Training Required

None necessary

Type of training required

No Training 

Cost

Not Free 

Actual Cost

Cost of equipment; Cost of procuring the B-ADL Scale directly is USD $ 38

Age Range

 

Administration Mode

 

Diagnosis

 

Populations Tested

Older adults with mild to moderate dementia or mild cognitive impairment

Standard Error of Measurement (SEM)

Not Established

Minimal Detectable Change (MDC)

Not Established

Minimally Clinically Important Difference (MCID)

Not Established

Cut-Off Scores

Not Established

Normative Data

Not Established

Test-retest Reliability

Alzheimer’s Dementia: Choi S et al, 2003, Alzheimer’s Dementia; n= 129; age 60 – 87 years; 54 patients with Alzheimer’s dementia (AD), 31 vascular dementia (VaD), 44 non-demented patients; Severity of dementia as per Global Deterioration Scale (GDS) Stages 1 to 5 evaluated by MMSE; Korean

  • Excellent: ICC > 0.9

Interrater/Intrarater Reliability

Dementia: Nagaratnam et al, 2013, Dementia; n = 66; (mild dementia n=33; moderated dementia n=33)

  • Excellent: Cronbach’s alpha > 0.8 (.94)

Internal Consistency

  • Dementia: Erzigkeit H et al, 2001, Dementia; n = 1433; minimum age 60 years; Severity of dementia as per Global Deterioration Scale (GDS) Stages 1 to 5 evaluated by MMSE; English, German, Spanish and French
    • Excellent: Cronbach’s alpha > 0.8 (.98)
  • Dementia: Folquitto J et al, 2007, Dementia; n = 92; 65 – 65 years or older; (33 patients with mild to severe dementia, 59 controls); severity of dementia as per Clinical dementia rating scale (CDR); Spanish
  • Excellent: Cronbach’s alpha > 0.8 (.98)

Alzheimer’s Dementia: Choi S et al, 2003, Alzheimer’s Dementia

  • Excellent: Cronbach’s alpha > 0.8 (.98)

Criterion Validity (Predictive/Concurrent)

Alzheimer’s Dementia: Sánchez-Benavides G, et al; n= 277 (78 mild cognitive impairment, 199 alzheimer’s dementia); severity of dementia diagnosed by MMSE, Blessed Dementia Rating Scale (BDRS) and Interview for Deterioration of Daily Living in dementia (IDDD); Spanish

  • Cut-off point of 3.3 to discriminate mild cognitive impairment and mild alzheimer’s disease. (Sensitivity 0.81; Specificity 0.72)

Construct Validity (Convergent/Discriminant)

Alzheimer’s Dementia: Sánchez-Benavides G, et al, 2009, Alzheimer’s Dementia

  • Excellent: correlation with BDRS (r ≥ 0.6)
  • Excellent: correlation with IDDD (r ≥ 0.6)

Content Validity

Not Established

Face Validity

Not Established

Floor/Ceiling Effects

Not Established

Responsiveness

Not Established


Professional Association Recommendations

Considerations

  • Intercultural differences require a reference or a gold standard, which can serve as a reliable and valid measure to match patient group across countries, which is lacking.
  • Applicability of the B-ADL in different languages other than the ones researched needs to be assessed.
  • Caregiver rating bias should be considered when implementing this scale.
  • A study by Pfeifer et al, 2013, dementia, studied caregiver burden and depression as predictors of bias for mild cognitive impairment and mild alzheimer’s disease. Results showed negative 23.35 discrepancy between patient self-rating and caregiver rating of the patient for B-ADL suggesting a caregiver bias while assessing for dementia.

Bibliography

The Bayer activities of daily living scale (B-ADL). Available at: Full Text Accessed on October 10th, 2014.

Hindmarch I, Lehfeld H, de Jongh P, Erzigkeit H. The Bayer Activities of Daily Living Scale (B-ADL). Dementia And Geriatric Cognitive Disorders . July 1998;9(Suppl 2):20-26. Available at: Find it on Medline

Nagaratnam N, Nagaratnam K, O’Mara D. Bayer-Activities of Daily Living scale in mild and moderate dementia of the Alzheimer type. American Journal Of Alzheimer's Disease And Other Dementias. December 2013;28(8):784-789. Available at: Find it on Medline

Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-198. Available at: Find it on Medline

Hughes CP, Berg L, Daneringer WL, Coben LA, Martin RL. A new clinical scale for the staging of dementia. Brit J Psychiatry. 1982;140:566-572. Available at: Find it on Medline

Erzigkeit H, Lehfeld H, Hindmarch I, et al. The Bayer-Activities of Daily Living Scale (B-ADL): Results from a validation study in three European countries. Dementia And Geriatric Cognitive Disorders. September 2001;12(5):348-358. Available at: Find it on Medline

Folquitto J, Bustamante S, Bottino C, et al. The Bayer - Activities of Daily Living Scale (B-ADL) in the differentiation between mild to moderate dementia and normal aging. Revista Brasileira De Psiquiatria. December 2007;29(4):350-353. Available at: Find it on Medline

Choi S, Na D, Erzigkeit H, et al. Validation of the Korean version of the Bayer activities of daily living scale. Human Psychopharmacology. August 2003;18(6):469-475. Available at: Find it on Medline

Sánchez-Benavides G, Manero R, Quiñones-Ubeda S, de Sola S, Quintana M, Peña-Casanova J. Spanish version of the Bayer Activities of Daily Living scale in mild cognitive impairment and mild Alzheimer disease: discriminant and concurrent validity. Dementia And Geriatric Cognitive Disorders. 2009;27(6):572-578. Available at: Find it on Medline

Pfeifer L, Drobetz R, Fankhauser S, Mortby M, Maercker A, Forstmeier S. Caregiver rating bias in mild cognitive impairment and mild Alzheimer's disease: Impact of caregiver burden and depression on dyadic rating discrepancy across domains. International Psychogeriatrics. August 2013;25(8):1345-1355. Available at: Find it on Medline

Year published

 

Instrument in PDF Format

Yes 
Approval Status Approved 
 
Attachments
Created at 5/13/2015 5:41 PM  by Jason Raad 
Last modified at 2/16/2016 8:42 AM  by Jason Raad