Understanding the relative importance of preserving functional abilities in Alzheimer's disease in the United States and Germany

Qual Life Res. 2014 Aug;23(6):1813-21. doi: 10.1007/s11136-013-0620-5. Epub 2014 Jan 22.


Purpose: To estimate the relative importance that Alzheimer's disease (AD) caregivers in the United States and Germany place on preserving patients' ability to perform activities of daily living.

Methods: US and German residents providing care for a person with AD completed an online preference survey. Each respondent completed five best-worst scaling questions. Each question related to five of 10 activities from the Disability Assessment for Dementia scale. Preference weights, indicating the relative importance of preserving the ability to perform these 10 activities for 36 months, were estimated using maximum-difference scaling. A separate model was estimated for each country.

Results: Four hundred and three US and 400 German caregivers completed the survey. In both countries, preserving a patients' ability to use the toilet without accidents was the most important activity and handling money was the least important activity. There were few differences between US and German caregivers in the relative importance across activities.

Conclusions: Caregivers generally placed greater importance on preserving basic activities of daily living than on preserving instrumental activities of daily living. Understanding differences in the relative importance of functional items in the DAD may contribute to a better understanding of the benefits of different AD treatment and support measures.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Activities of Daily Living / psychology*
  • Alzheimer Disease / therapy*
  • Caregivers / psychology*
  • Caregivers / statistics & numerical data
  • Cross-Sectional Studies
  • Disability Evaluation
  • Educational Status
  • Female
  • Germany
  • Humans
  • Interviews as Topic
  • Male
  • Middle Aged
  • Quality of Life*
  • Social Class
  • Surveys and Questionnaires*
  • United States