Measuring change in activities of daily living in nursing home residents with moderate to severe cognitive impairment

Carpenter, Guy; Hastie, Charlotte L.; Morris, John N.; Fries, Brant E.; Ankri, Joël

doi:10.1186/1471-2318-6-7

Cited by 184 publications

(207 citation statements)

References 37 publications

(39 reference statements)

Supporting

Mentioning

191

Contrasting

Unclassified

Order By: Relevance

“…The transition to severe AD represents a turning point in the loss of independence. Our study confirms that different ADL items decline at different rates [22] . Some functional abilities are lost early (personal hygiene, dressing), while others are preserved in the midterm (toileting, continence) or even in the late term (locomotion, feeding).…”

Section: Discussionsupporting

confidence: 78%

Spared and Impaired Abilities in Community-Dwelling Patients Entering the Severe Stage of Alzheimer’s Disease

Gillioz

Villars

Voisin

et al. 2009

Dement Geriatr Cogn Disord

View full text Add to dashboard Cite

Background: Comprehensive geriatric assessments of patients entering the severe stage of Alzheimer’s disease (AD) are scarce. Methods: Cross-sectional study of 126 patients entering the severe stage of AD in the longitudinal study of REAL.FR cohort. Patients who had a first MMSE score <10 during follow-up underwent cognitive, behavioral, nutritional and functional assessment. Support requirements were also evaluated. Results: The best-preserved cognitive abilities were social interaction and response to own name, while praxis, orientation, memory and language showed the largest declines. Regarding independence in daily living, locomotion was best preserved (71% of patients independent) while personal hygiene deteriorated most (15.5%). Behavioral disorders were frequent, and consisted principally of apathy, aberrant motor behavior, and agitation. The Mini Nutritional Assessment showed that 68.5% of patients were malnourished or at risk of malnutrition. Caregiver burden remained mild to moderate in 69.8% of cases. In addition, 80% of patients still lived at home and 71.6% used at least 2 support services, consisting mainly of physician visits and home help. Conclusion: Assessment of remaining cognitive, functional abilities and behavioral disorders at entry to severe AD should help to improve targeted management aimed at preserving these abilities and treating complications, thereby optimizing these patients’ quality of life.

show abstract

Section: Discussionsupporting

confidence: 78%

Spared and Impaired Abilities in Community-Dwelling Patients Entering the Severe Stage of Alzheimer’s Disease

Gillioz

Villars

Voisin

et al. 2009

Dement Geriatr Cogn Disord

View full text Add to dashboard Cite

show abstract

“…Although AD in our subjects was not considered to produce symptoms severe enough to affect motor functions, the influences of AD on eating (dysphagia), eating (feeding) [16,17], and toilet use [18] seemed to be associated with cognitive impairments due to AD. These findings are supported by epidemiological studies on the natural course of the progress of AD [19].…”

Section: Discussionmentioning

confidence: 88%

“…A fracture in a lower limb has a much greater influence on toilet use because this ability largely depends upon the functions of the lower limbs [18]. However, there are few studies demonstrating how the complication of lower limb fracture with AD affects dysphagia or eating activity, which is unaffected by the fracture alone [22].…”

Section: Discussionmentioning

confidence: 99%

“…It is well known that osteoporosis, which often accompanies AD, leads to motor dysfunctions [5]. Some studies have demonstrated that problems in abnormal behaviors in AD patients may produce muscular dystrophy, which further damages physical functions [18,25]. Taking these findings together, motor dysfunctions such as in bed mobility, and transfer and locomotion are considered to be accelerated by the complication of fracture with AD.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Decreased activity of daily living produced by the combination of Alzheimer’s disease and lower limb fracture in elderly requiring nursing care

Inagawa

Hamagishi

Takaso

et al. 2012

Environ Health Prev Med

View full text Add to dashboard Cite

Objectives Alzheimer's disease (AD) impairs cognitive functions, subsequently decreasing activity of daily living (ADL), and is frequently accompanied by lower limb fracture including hip fracture in the elderly. However, there have been few studies on what kinds of physical functions are affected or what degrees of dysfunction are produced by this combination. This study aims to clarify the relationship between decreased ADL and the combination of AD and lower limb fracture. Methods We examined present illness and ADL in 4340 elderly aged 82.8 ± 9.36 years [average ± standard deviation (SD)] requiring nursing care and compared ADL between elderly with and without AD or lower limb fracture treated with surgery or conservatively using analysis of covariance (ANCOVA), with age and sex as covariants. Results We recognized that activities of cognitive function (p \ 0.001), eating (dysphagia) (p \ 0.001), eating (feeding) (p \ 0.001), and toilet use (p \ 0.001) in the elderly with AD were significantly lower than in those without the disease, even after adjusting for sex and age. Activities of bed mobility (p \ 0.05), transfer and locomotion (p \ 0.001), and bathing (p \ 0.05) in the elderly with a fracture treated with surgery were significantly lower, which differed from the results of AD. Significant interactions of AD and fracture treated with surgery on the ADL scores for bed mobility (p \ 0.001), dysphagia (p \ 0.01), feeding (p \ 0.001), and toilet use (p \ 0.05) show that the combination had a much more profound influence on the ADL scores than AD or fracture alone. We obtained almost the same results for fractures treated conservatively as for fractures treated with surgery. Conclusions These results demonstrated that the combined effects of AD and lower limb fracture were significantly greater than expected additive effects of AD and fracture, suggesting that the combination of AD and lower limb fracture has synergistic effects on almost all types of ADL except cognitive functions.

show abstract

“…30 The MDS-ADL scale has been validated in the literature as an appropriate outcome measure for institutionalized populations. 32,33 It is a 28-point ordinal scale summing seven items (bed mobility, transfers, locomotion, dressing, eating, toilet use, and personal hygiene) scoring degree of assistance required and frequency of assistance required each day. It is scored through observation of daily activities and care, by a trained clinical professional; scores range from 0 to 28, higher scores indicating greater dependence.…”

Section: Lower-functioning Groupmentioning

confidence: 99%

Cessation of Exercise in the Institutionalized Elderly: Effects on Physical Function

Marshall

Berg²

2010

Physiotherapy Canada

View full text Add to dashboard Cite

Purpose: The objectives of this study were (1) to examine the effects of a 12-week exercise cessation period separating two 12-week exercise sessions on physical variables in an elderly institutionalized population and (2) to explore overall programme effectiveness. Methods: The functional mobility of 25 elderly institutionalized adults participating in an existing exercise programme was examined using a one-group, interrupted time-series design. Functional mobility was evaluated at four time points during two cycles of a 12-week exercise programme, alternating with a 12-week period of no formal exercise. Results: The primary outcome was the change in functional mobility scores, assessed at baseline, 12, 24 and 36 weeks. In both the higher-functioning (HF) group and the lower-functioning (LF) group, the cessation of exercise was associated with deterioration in physical function. The overall noncontinuous nature of the programming under study also seemed to be detrimental to the physical function of the LF group. Conclusions: Findings of this small-sample study support the need to modify common practices in exercise programming for older, institutionalized people.Key Words: exercise cessation, exercise class, exercise programming, institutionalized elderly, physical function. Ré sultats : Le premier ré sultat observé a é té un changement dans les mesures de la mobilité fonctionnelle au dé but de l'é tude, puis aprè s 12, 24 et 36 semaines. Dans le groupe à haut fonctionnement (HF) comme dans le groupe à faible fonctionnement (FF), l'arrê t des sé ances d'activité physique a é té associé à une dé té rioration de la fonction physique. La nature globale non continue du programme auquel s'est inté ressé e cette é tude a é galement semblé nuire à la fonction physique du groupe FF. Conclusions : Les conclusions de cette é tude ré alisé e sur un petit é chantillon appuient la né cessité de modifier les pratiques usuelles lié es aux programmes d'exercices pour les aîné s en institution.

show abstract

Measuring change in activities of daily living in nursing home residents with moderate to severe cognitive impairment

Cited by 184 publications

References 37 publications

Spared and Impaired Abilities in Community-Dwelling Patients Entering the Severe Stage of Alzheimer’s Disease

Spared and Impaired Abilities in Community-Dwelling Patients Entering the Severe Stage of Alzheimer’s Disease

Decreased activity of daily living produced by the combination of Alzheimer’s disease and lower limb fracture in elderly requiring nursing care

Cessation of Exercise in the Institutionalized Elderly: Effects on Physical Function

Contact Info

Product

Resources

About