The Bristol Activities of Daily Living Scale BADLS-CZ for the Evaluation of Patients with Dementia

Introduction: Deterioration in the activities of daily living (ADL) in patients with dementia may be evaluated by a questionnaire designed to be filled in by a person close to the patient. Our aim is to present a Czech version of the internationally used and recommended Bristol Activities of Daily Living Scale, BADLS-CZ. Methods: We created a BADLS-CZ questionnaire as an English translation of the original Bristol Activities of Daily Living Scale. The questionnaire is to be completed by a carer, who rates 20 activities in the patient's life. The carer selects one of four alternative statements that correspond to various levels of performance (0-3 points). Overall functional capacity can thus be summed up as a total score (min 0 - max 60 points). Compared to the original version, our Czech adaptation includes the conversion of points to a percentage rate of self-sufficiency. The BADLS-CZ questionnaire was completed by 73 persons, of whom 23 normal elderly evaluated their own capabilities and caregivers used it to assess the ADL of 50 patients with probable Alzheimer's disease. At the same time, cognitive performance was assessed by means of the Mini-Mental State Examination. Results: The carers of the 50 patients with AD (MMSE 17 +/- 5 points) evaluated ADL with the following results (mean +/- standard deviation): BADLS-CZ score 17 +/- 9 points, median 16 points, min max 2-39 points; 71% +/- 14% self-sufficiency, median 73%, min max 35%-96%. ADL results according to BADLS-CZ were significantly associated with MMSE (Spearman r = 0.5; p = 0.0002), but not influenced by age, education or gender of the patients. Completing the questionnaire was easy and usually took 6-12 minutes. Conclusion: The BADLS-CZ questionnaire, designed to be completed by a close carer, extends the options for structured evaluation of basic and instrumental ADL in patients with dementia, including AD, in the Czech Republic, and is freely available at vwvvv.pcp.lf3.cuni.cz/adcentrum.