In-Home Assessments of Alzheimer's Patients

Purpose: The objective of this study was to determine the validity and reliability of instruments used with Alzheimer's patients when administered in the home of participants. Methods: Twenty patients diagnosed with Alzheimer's disease were administered standardized tests to measure cognition (Mini-Mental State Examination and Alzheimer's Disease Assessment Scale) and mood (Geriatric Depression Scale and Short Happiness and Research Protocol). Patients were re-assessed after two weeks. All assessments were conducted in the patients' homes. Criterion and divergent validity were determined with correlations, and reliability was assessed with intra-class correlations. Ethics approval and consent were obtained prior to recruitment. Results: The correlation between instruments measuring cognition was 0.87, between instruments measuring mood it was 0.72. Intra-class correlations between test and re-test ranged from 0.75 to 0.93. With the low within-patient variability observed, small sample sizes would be required for studies using the instruments evaluated using in-home assessments. Recruitment goals were achieved more easily with in-home assessments than when patients were required to visit the clinic. Discussion: Assessments conducted in the home of patients are valid and reliable. Sample size requirements are small and recruitment goals are easier to achieve. The results suggest that in-home assessments are feasible, adequate, may be more convenient for patients and caregivers, and may facilitate research while increasing generalizability of the findings.