The Alzheimer's Disease Activities of Daily Living International Scale (ADL-ISY)This article has its origin in a paper written for partial fulfillment of a LL.M. in Real Property Law taken at Osgoode Professional Development (York University), Advanced Property Law. Thanks are due to Professor B. Ziff

Activities of daily living (ADL) deficits are integral components of dementia disorders, and ADL measures are among the most robust markers of the course of Alzheimer's disease (AD). Despite this acknowledged importance, no clearly useful ADL instrument for cross-cultural application in pharmacologic trials in the early stages of AD had been available. An international effort was launched to develop an ADL scale for pharmacologic trials in early AD. Steps taken from 1990 to the present included: (1) international scientific working group meetings and reviews, (2) reviews of existing measures, (3) collating of existent, nonredundant items, (4) querying experts for new items, (5) interviews with informants and subjects in the USA, France, and Germany, toward the identification of potential new items, (6) identification of an item pool based upon these procedures, (7) creation of a trial instrument, (8) piloting of this instrument, and (9) refinement of the scale based upon statistical analysis of the pilot data. Final item selection was based upon: (1) relevance for 2 80% of subjects in severity stratified USA and German samples; (2) absence of gender and national biases; (3) significant (p