Assessment and Programming Considerations for Clients with Alzheimer's Disease
Baseline assessment priorities
Assessment for this population emphasizes function and safety over maximal performance. Screen for fall risk (balance, gait speed, sit-to-stand), current activity level, and medical clearance for comorbid cardiac or musculoskeletal conditions. Also assess communication ability, hearing and vision, and the client's capacity to follow multi-step instructions-these shape how you coach.
Cognitive and functional screening
You are not diagnosing; you are gathering information. Use simple, observable measures (e.g., ability to sequence a task, recall of a two-step instruction) and obtain caregiver report of function at home. A common trap is over-interpreting a screening score as a diagnosis, or ignoring caregiver input because the client "seems fine" in a structured gym setting.
Consent and capacity
Understand that informed consent may require involvement of a legally authorized representative as capacity changes. Document who provides consent and what the client can still decide for themselves.
Individualization
Programs should reflect the person's interests, routines, and prior activity history-familiar movements are easier to learn and more motivating. Assess pain, since clients may not report it reliably; watch for grimacing, guarding, or behavior change.
Rule of thumb
Assess what the client can do safely today, not what they could do a year ago; re-screen function every few months or after any health event.
Worked example
A client scores poorly on a recall task but performs a familiar cycling routine well. Use the functional performance, not the score alone, to set initial intensity-and document both.