The iADRS as an integrated measure of cognition and function: Psychometric evidence from recent clinical trials in early symptomatic Alzheimer's disease

IF 11.1 1区医学 Q1 CLINICAL NEUROLOGY

Alzheimer's & Dementia Pub Date : 2025-09-14 DOI:10.1002/alz.70656

Alexandra S. Atkins, Sarah Marquis, Kristin Creel, Juliette Meunier, Stefan Cano, Laure Delbecque, Mingyang Shan, Alette M. Wessels

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Abstract

INTRODUCTION

Psychometric evaluation of the integrated Alzheimer's Disease Rating Scale (iADRS) was performed using data from three randomized clinical trials (RCTs).

METHODS

Traditional measurement properties of the iADRS were assessed using classical test theory (CTT). Rasch Measurement Theory (RMT) analyses evaluated response properties of cognitive and functional items across the disease severity continuum. Crosswalks between iADRS, Clinical Dementia Rating – Sum of Boxes (CDR-SB), and Mini-Mental State Examination (MMSE) were developed to provide estimates of score equivalence.

RESULTS

CTT results confirm good psychometric properties of the iADRS, including reliability (Cronbach's alpha 0.79–0.84), concurrent validity with CDR-SB (range: −0.64–0.70), and sensitivity to change. RMT findings demonstrate improved reliability of the integrated scale (person-separation index [PSI] = 0.92) compared to components and highlight concurrent and overlapping progression of cognitive and functional decline.

DISCUSSION

The findings confirm the psychometric strength of the iADRS as a fit-for-purpose integrated endpoint for RCTs in early symptomatic Alzheimer's disease (AD). Crosswalk tables facilitate interpretation of clinical trial findings in clinical practice.

Highlights

Findings confirm integrated Alzheimer's Disease Rating Scale (iADRS) total score reliability, validity, and sensitivity.
Using the Rasch Measurement Theory (RMT), iADRS item set shows improved reliability relative to its component subscales.
iADRS item thresholds are well distributed along the disease severity continuum.
iADRS shows sensitivity to concurrent progression of cognitive and functional impairment.
Crosswalk tables provide direct translation between iADRS, Clinical Dementia Rating – Sum of Boxes (CDR-SB), and Mini-Mental State Examination (MMSE).

Abstract Image

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iADRS作为认知和功能的综合测量：早期症状性阿尔茨海默病近期临床试验的心理测量证据

采用3个随机临床试验（rct）的数据对综合阿尔茨海默病评定量表（iADRS）进行心理测量学评估。方法采用经典测试理论（CTT）评价iADRS的传统测量特性。Rasch测量理论（RMT）分析了疾病严重程度连续体中认知和功能项目的反应特性。在iADRS、临床痴呆评分-方框总和（CDR-SB）和简易精神状态检查（MMSE）之间进行交叉评估，以提供评分等效性的估计。结果CTT结果证实了iADRS良好的心理测量特性，包括信度（Cronbach's alpha = 0.79-0.84）、与CDR-SB的并发效度（范围：−0.64-0.70）和对变化的敏感性。RMT结果表明，与组成部分相比，综合量表（人-分离指数[PSI] = 0.92）的可靠性有所提高，并突出了认知和功能衰退的并发和重叠进展。研究结果证实，在早期症状性阿尔茨海默病（AD）的随机对照试验中，iADRS的心理测量强度是一个合适的综合终点。人行横道表有助于临床实践中临床试验结果的解释。研究结果证实了综合阿尔茨海默病评定量表（iADRS）总分的信度、效度和灵敏度。利用Rasch测量理论（RMT）， iADRS项目集相对于其组成分量表显示出更高的可靠性。iADRS项目阈值沿疾病严重程度连续体分布良好。iADRS对认知和功能障碍的并发进展表现出敏感性。人行横道表提供了iADRS、临床痴呆评分-方框总和（CDR-SB）和简易精神状态检查（MMSE）之间的直接转换。

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来源期刊

Alzheimer's & Dementia 医学-临床神经学

CiteScore

14.50

自引率

5.00%

发文量

299

审稿时长

3 months

期刊介绍： Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.