Activities of Daily Living, Cognitive Impairment and Social Function in Community Residents with Alzheimer Disease

Abstract

One hundred and one patients with Alzheimer disease who were residing in the community were surveyed twice, in a six-month longitudinal study. A strong linear relationship was found between function, as measured by activities of daily living and cognitive impairment and between activities of daily living and social function. At the first interview the proportion of variance in activities of daily living explained by cognitive impairment and social function, controlling for age, estimated duration of the disease and marital status was 65%. After six months the proportion had increased to 67%. The proportion of social function accounted for by activities of daily living was 30% at the initial interview; the proportion increased to 43% after six months. Patients lose the ability to perform instrumental activities of daily living before they lose the ability to perform self-care activities. The pattern of deterioration in activities of daily living is hierarchical. The results of the study have implications for assessment and for intervention programmes. For those patients who have a diagnosis of Alzheimer disease, measures of activities of daily living are more useful for helping caregivers and for planning intervention programmes than measures of cognitive impairment.

Functional Disabilities Profile of Chinese Elderly People with Alzheimer’s Disease – A Validation Study on the Chinese Version of the Disability Assessment for Dementia

“…The strength of the correlation was consistent with expectations, as impairment in cognition should have some degree of association with functional disability [31][32][33] . There have been some reports of an even stronger relationship between cognitive ability and functional status, with cognition explaining 69% of the variance in functional status [34] .…”

Functional and Cognitive Differences between Cognitively-Well People and People with Dementia

“…Unfortunately, because assessments of daily functioning have sometimes not been seen as easy or as economical to administer as short tests of mental state (Warren et aI1989), undue emphasis has often been placed on the mental state examination in the resultant management of dementia. This is despite the fact that intervention strategies are more helpful to the patient and (more usually) the caregiver if they are focused towards everyday activities (Carswell and Eastwood 1993). Furthermore, it is functional capacity that often determines whether or not a person with dementia can remain in his or her own home.…”

Occupational Engagement and Adaptation in Adults with Dementia: A Preliminary Investigation

“…Carswell and Eastwood (1993) found those with memory losses have progressive difficulty with both instrumental and personal activities of daily living, but the instrumental activities generally are affected before the personal activities. The participants reported stopping activities for a variety of reasons, including not needing to complete; not remembering; having difficulty concentrating; not wanting to bother others; no longer being able to complete; and experiencing frustration.…”