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The Activities of Daily Living part of the Friedreich Ataxia Rating Scale (FARS\u2010ADL) captures functional impairment and longitudinal change but is only validated in Friedreich Ataxia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Validation of FARS\u2010ADL regarding disease severity and patient\u2010meaningful impairment, and its sensitivity to change across genetic ataxias.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Real\u2010world registry data of FARS\u2010ADL in 298 ataxia patients across genotypes were analyzed, including (1) cross\u2010correlation with FARS\u2010stage, Scale for the Assessment and Rating of Ataxia (SARA), Patient\u2010Reported Outcome Measure (PROM)\u2010ataxia, and European Quality of Life 5 Dimensions visual analogue scale (EQ5D\u2010VAS); (2) sensitivity to change within a trial\u2010relevant 1\u2010year median follow\u2010up, anchored in Patient Global Impression of Change (PGI\u2010C); and (3) general linear modeling of factors age, sex, and depression (nine\u2010item Patient Health Questionnaire [PHQ\u20109]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>FARS\u2010ADL correlated with overall disability (rho<jats:sub>FARS\u2010stage<\/jats:sub>\u2009=\u20090.79), clinical disease severity (rho<jats:sub>SARA<\/jats:sub> = 0.80), and patient\u2010reported impairment (rho<jats:sub>PROM\u2010ataxia<\/jats:sub>\u2009=\u20090.69, rho<jats:sub>EQ5D\u2010VAS<\/jats:sub>\u2009=\u2009\u20130.37), indicating comprehensive construct validity. Also at item level, and validated within genotype (SCA3, RFC1), FARS\u2010ADL correlated with the corresponding SARA effector domains; and all items correlated to EQ5D\u2010VAS quality of life. FARS\u2010ADL was sensitive to change at a 1\u2010year interval, progressing only in patients with worsening PGI\u2010C. Minimal important change was 1.1. points based on intraindividual variability in patients with stable PGI\u2010C. Depression was captured using FARS\u2010ADL (+0.3 points\/PHQ\u20109 count) and EQ5D\u2010VAS, but not FARS\u2010stage or SARA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>FARS\u2010ADL reflects both disease severity and patient\u2010meaningful impairment across genetic ataxias, with sensitivity to change in trial\u2010relevant timescales in patients perceiving change. It thus presents a promising patient\u2010focused outcome for upcoming ataxia trials. \u00a9 2024 The Authors. <jats:italic>Movement Disorders<\/jats:italic> published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mds.29788","type":"journal-article","created":{"date-parts":[[2024,3,21]],"date-time":"2024-03-21T00:28:47Z","timestamp":1710980927000},"page":"965-974","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["<scp>FARS\u2010ADL<\/scp> across Ataxias: Construct Validity, Sensitivity to Change, and Minimal Important Change"],"prefix":"10.1002","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8165-5898","authenticated-orcid":false,"given":"Andreas","family":"Trasch\u00fctz","sequence":"first","affiliation":[{"name":"Research Division \u201cTranslational Genomics of Neurodegenerative Diseases,\u201d 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