Avaliação das atividades de vida diária de idosos com diferentes níveis de demência

Abstract

Objective: To compare the performance of elderly people with different levels of severity of dementia using questionnaires on basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs). Also, to verify whether there were any association between the IADL questionnaires applied. Method: Ninety elderly people, aged 75.46 ± 7.66 years with a clinical diagnosis of dementia (DSM-IV/APA) who were seen at the Minas Gerais Reference Center for the Elderly, were randomized selected and classified according to the level of severity of their dementia (Clinical Dementia Rating). Their BADLs were assessed using the Katz Index and their IADLs by the Lawton-Brody and Pfeffer indexes. The Kruskal-Wallis and Mann-Whitney tests were used in order to investigate the elderly people's performance regarding BADLs, while the Spearman correlation was used to investigate the relationships among the IADL (α< 0.05). Results: Statistically significant differences in performance were found between the elderly people with different levels of severity of dementia, as assessed by the BADL and IADL questionnaires (p< 0.001). The IADL questionnaires presented significant correlation for the total sample (p< 0.0001; r = -0.818) as well as for the groups with mild dementia (p= 0.007; r = -0.530) and severe dementia (p< 0.0001; r = -0.723). Conclusion: The severity of the dementia process interfered with the elderly people's performance of the elderly in BADLs and IADLs. The IADLs were more affected in the early stages of dementia whereas the BADLs were more affected in the more advanced stages. Despite structural particularities, the IADL questionnaires utilized seemed to be measuring a common construct. The variability in the clinical condition of the individuals with moderate dementia may be an explanation for the lack of correlation between the questionnaires in this specific group.

Equilíbrio, quedas e funcionalidade em idosos com alteração da função cognitiva

“…1,2 Currently, close to 44 million people live with this disease. 3 Alzheimer´s disease (AD) is the most common cause of this illness, causing between 60 and 70% of cases.…”

“…3 Alzheimer´s disease (AD) is the most common cause of this illness, causing between 60 and 70% of cases. 1,2 Between normal aging and dementia, there is a period known as mild cognitive impairment (MCI). This period is characterized by the maintenance of independence, from a functional perspective, and cognitive loss, when compared to normal people, without attaining the criteria of dementia.…”

Tradução, adaptação cultural e análise das propriedades psicométricas do Activities of Daily Living Questionnaire (ADLQ) para avaliação funcional de pacientes com a doença de Alzheimer

“…Some studies have shown that changes in ADL performance can occur at the initial stages of the disease. It has been suggested that there is a relationship between the severity of cognitive impairments and the functional performance; initially the losses are observed in IADLs and basic ADLs are only damaged in more advanced stages of dementia 10 . Based on the statistical analysis observed in the results, the items of the new instrument (ADLQ-Brazilian version) were distributed into six domains, encompassing relevant basic and instrumental ADLs usually affected during the process of the disease, which are important to the functional assessment 7 .…”

“…Although the concept of functional capacity is quite complex and encompasses deficiency, incapacity, disadvantage, as well as autonomy and independence, in practice, we work with the concept of capacity/incapacity 10 . Functional incapacity is defined by difficulty while performing certain gestures and ADLs or even the impossibility of performing these activities 7 .…”

“…Two main types of abilities are measured by functional assessment scales: ADLs, which consist in activities carried out regularly such as getting dressed, bathing and eating. In contrast, the instrumental activities of daily living (IADLs) require organization and planning and include tasks such as shopping, using public transportation, preparing meals, managing finances, housekeeping and using the telephone 10,11 .…”