Bayer Activities of Daily Living Scale
Construct: Cognitive deficits and impairment in activities of daily living
Description of Measure: The Bayer Activities of Daily Living Scale (B-ADL) consists of 25 items that are answered by the caregiver. The first items evaluate the patient’s ability to handle the ADL and capacity for self-care. Other items evaluate specific tasks. The last items assess cognitive functions that are important for performing activities of daily living.
Folquitto et al. (2007) evaluated the applicability of the B-ADL in a Brazilian outpatient sample for discriminating between healthy elderly individuals and demented patients, as well as between mild and moderate dementia cases. Ninety-two participants were selected (33 demented patients and 59 controls). The Folstein Mini-Mental State Exam (MMSE) and the Clinical Dementia Rating Scale (CDR) were also used in this study for reliability and validity purposes (Folquitto et al., 2007, pg 351).
Internal consistency of the B-ADL according to the Cronbach’s alpha coefficient, was 0.981. The patients were significantly different from the controls in terms of the MMSE (MWU = 117.00; p < 0.001) and the B-ADL (MWU = 51.00, p < 0.001) scores. Regarding the sample of 59 controls and 33 patients, the area under the ROC curve for the B-ADL was 0.97 (p < 0.0001, 95% Confidence Interval: 0.94-1.00), and for the MMSE it was 0.94 (p < 0.0001, 95% Confidence Interval: 0.89-0.98). The difference between the areas was 0.034, non-significant (p = 0.19). Two cutoff points were selected (based on sensitivity, specificity, positive predictive value and negative predictive value) for the B-ADL: 2.58 and 3.12 (Folquitto et al. 2007, pg 351-352).
The Brazilian version of the B-ADL showed good applicability and high internal consistency in the outpatient sample of elderly subjects. The scale discriminated patients with mild to moderate dementia from normal elderly controls and differentiated subjects classified according to the CDR scale at various levels of cognitive impairment (Folquitto et al., 2007, pg 353).
A Korean version of the B-ADL (Choi et al., 2003) was found to have high test-retest reliability. The internal consistency,--considered to be an essential aspect of the scale’s reliability--was found to be excellent in the sample studied. The Cronbach’s alpha coefficient was above 0.98, indicating high inter-correlation among items. Pearson correlation coefficients were r = -0.77 (p< 0.001) for B-ADL and MMSE, and r = 0.70 (p < 0.001) for B-ADL and Syndrom Kurztest (SKT), a short test for the assessment of memory and attention (Choi et al., 2003, pg 473).
Choi, S.H., Na, D.L., Lee, B.H., Kang, S.J., Ha, C.K., Han, S.H., & Erzigkeit, H. (2003). Validation of the Korean version of the Bayer activities of daily living scale. Human Psychopharmacology: Clinical and Experimental, 18, 469-475.
Folquitto, J.C., Bustamante, S.E.Z., Barros, S.B., Azevedo, D., Lopes, M.A., Hototian, S.R., Filho, W.J., Litvoc, J., & Bottino, C.M.C. (2007). The Bayer – Activities of Daily Living Scale (B-ADL) in the differentiation between mild to moderate dementia and normal aging. Revista Brasileria Psiquiatria, 29(4), 350-353.
Hindmarch, I., Lehfeld, H., de Jongh, P., Erzigkeit, H. (1998). The Bayer Activities of Daily Living Scale (B-ADL). Dementia and Geriatric Cognitive Disorders, 9(suppl 2), 20-26.