Age-Related Changes in Instrumental and Basic Activities of Daily Living Impairment in Older Adults with Very Mild Alzheimer’s Disease

Abstract

Background/Aims: Age-related changes in impairments in activities of daily living (ADL) in older adults with very mild Alzheimer's disease (vmAD) have been scarcely explored. We clarified the characteristics of ADL impairment and examined how ADL impairments differed by age in such patients compared with community-dwelling cognitively normal older adults. Methods: The participants were 107 older adults with vmAD (Mini-Mental State Examination [MMSE] score ≥24), all of whom were first-visit outpatients at the Dementia Clinic of the Department of Neuropsychiatry, Kumamoto University Hospital. The controls were 682 community-dwelling older adults who participated in the 3rd Nakayama Study with MMSE score ≥24. We examined the association of instrumental and basic ADL (IADL and BADL, respectively) independence with the odds of vmAD using multiple logistic regression analysis and determined differences in ADL impairment by age using age-and sex-matched analysis. Results: Impairments in handling finances (OR 57.08), managing medication (OR 5.13), and dressing (OR 3.35; BADL) were associated with greater odds of vmAD. Among those aged 65 years and above, there were fewer patients with vmAD than healthy controls who could independently handle finances and medication. Among patients with vmAD, the percentages of those who could independently manage shopping, food preparation, and housekeeping only decreased after age 74. Age-related decreases in independence were observed in few BADL items; these, however, were temporary. Conclusions: Patients with vmAD show significantly decreased IADL independence from early old age. and the AD and Related Disorders Association [10]. Comparative controls were 1,290 community-dwelling older adults who participated in the 3rd Nakayama Study (Ehime, Japan) [11]. Six hundred and eighty-two older people fulfilled the inclusion criteria of an MMSE score ≥24 and being aged 65 years or older; they were designated as the healthy control (HC) group. Exclusion criteria were (1) diagnosis of dementia and (2) physical diseases, such as stroke, that prominently affect ADL independence. The diagnosis of dementia was established according to DSMIII-R criteria. Both vmAD and HC were designated by senior neuropsychiatrists. This study was approved by the Human Ethics Review Committee of Kumamoto University. Written informed consent was obtained from all patients and their primary caregivers (all family members).

Reliability of P3 Event-Related Potential During Working Memory Across the Spectrum of Cognitive Aging

“…Deterioration in these iADL becomes more apparent with age-related neurodegeneration such as mild cognitive impairment (MCI) and Alzheimer's disease (AD) (Jekel et al, 2015). Executive functions in particular are paramount in carrying out numerous iADL, but are also vulnerable to the effects of normal and pathological cognitive aging (Overdorp et al, 2016;Tabira et al, 2020). Working memory is one core executive function that relates to the ability to temporarily store, process, and manipulate the information necessary for higher order cognitive tasks such as decision making, learning, and reasoning (Baddeley, 1992).…”

Functional status and its associated factors among community-dwelling older adults in rural Nepal: findings from a cross-sectional study

“…In line with previous studies that concluded that memory or attention deficiencies are significant predictors of ADL dependency among older adults [50,51], our participants with memory or concentration problem were at higher odds of poor functioning. Severe memory deficits is one of the earliest and most pronounced symptoms of cognitive impairment related to Alzheimer's disease, which often causes ADL limitations in older adults [52]. An earlier study also suggested that attentional impairments may be driving impairment in ADL among older people [53].…”

Development and Validation of the Yonsei Lifestyle Profile-Satisfaction (YLP-S) Using the Rasch Measurement Model

“…Based on the literature, there are highly significant age differences in food choice and consumption. 44 However, these items should be reexamined in future studies.…”

“…Second, the data of this study were gathered through personal interviews. As people tend to give more socially acceptable answers during face-to-face interaction than they might in other survey methods, 44 the results of the study should be interpreted carefully. As discussed above, the nutrition subscale required further scrutiny and revision to improve the PSIs and reliability.…”