Type: Informant-rated functional outcome measure
Purpose: Assess ability to perform daily activities in mild cognitive impairment and early Alzheimer's disease
Developer: Galasko et al., Alzheimer's Disease Cooperative Study (ADCS)[1]
Current use: Co-primary endpoint in LY-3372689 MAGNOLIA trial, and most early AD therapeutic trials
The ADCS-MCI-ADL is a 24-item informant-rated scale developed by the Alzheimer's Disease Cooperative Study to assess functional abilities in patients with mild cognitive impairment[1:1]. Unlike performance-based cognitive tests, this scale relies on an informant (caregiver, family member) who observes the patient's daily functioning over time.
The scale was specifically designed for MCI populations where functional impairment is subtle but clinically meaningful. It captures the early loss of instrumental activities of daily living (IADLs) that distinguishes MCI from normal aging[2]. The ADCS-MCI-ADL has become the standard functional co-primary endpoint in early AD trials, typically paired with ADAS-Cog as the cognitive co-primary.
The 24 items are organized into three categories:
Basic Activities of Daily Living (6 items)
Instrumental Activities of Daily Living (18 items)
The MAGNOLIA trial used ADCS-MCI-ADL as a co-primary endpoint alongside ADAS-Cog[4]:
| Scale | Type | Max Score | Population | Notes |
|---|---|---|---|---|
| ADCS-MCI-ADL | Informant | 60 | MCI, early AD | 24 items, MCI-optimized |
| ADCS-ADL | Informant | 78 | Mild-severe AD | 23 items, broader AD range |
| FAQ | Informant | 30 | MCI, dementia | 10 items, more general |
| UPSIT | Performance | N/A | Research use | Smell identification |
Galasko, D., Bennett, D. A., Sano, M., Ernesto, C., Thomas, R., Fenn, C. E., ... & Thal, L. J. An inventory to assess activities of daily living for clinical trials in patients with dementia. Alzheimer Disease and Associated Disorders. 1997. ↩︎ ↩︎
Petersen, R. C., et al. Effects of donepezil on cognitive function in mild cognitive impairment. New England Journal of Medicine. 2004. ↩︎
Zhu, C. W., et al. Sensitivity and informativeness of ADAS-Cog and ADCS-MCI-ADL in AD clinical trials. Alzheimer's and Dementia. 2006. ↩︎
Cummings, J. L., et al. Adding the functional component: ADCS-MCI-ADL in trial design. Alzheimer's Research and Therapy. 2020. ↩︎