The mediating and moderating effects of depressive symptoms on the prospective association between cognitive function and activities of daily living disability in older adults

Author(s):  
Chao Wu
2019 ◽  
Vol 15 (3) ◽  
pp. e1-e10 ◽  
Author(s):  
Seonho Kim ◽  
Dallong Han ◽  
Jongeun Lee

Background and ObjectiveSocietal aging and increasing average life expectancy have led to a significant increase in the population of individuals aged 75 years or above. Hence, it is becoming more meaningful and appropriate for researchers to divide those above the age of 65 years into various subgroups, such as young-old and old-old. Based on this division, we investigated the prevalence and correlates of impairments in activities of daily living (ADLs) among community-dwelling older adults (young-old vs. old-old) in South Korea. Material and MethodsThis was a cross-sectional study. We used the data of 4,368 older adults (≥65 years old) from the 2012 Korean Longitudinal Study of Aging. ADL impairment was assessed using a modified version of the Katz Index of Independence in Activities of Daily Living. ResultsThe prevalence of ADL impairment was greater in old-old participants (12.7%) than in young-old ones (3.0%). ADL impairment was significantly associated with gender, perceived health status, regular exercise, cognitive function, and depressive symptoms in young-old individuals. By contrast, in old-old individuals, the significant predictors were residential area, socioeconomic status, perceived health status, regular exercise, cognitive function, and depressive symptoms. Among both age subgroups, cognitive function was the strongest predictive factor of ADL impairment. Conclusion We found clear age differences in the prevalence and correlates of ADL impairment in older Koreans. Such age differences should be considered when studying and developing interventions for ADL impairment in older adults.


2016 ◽  
Vol 29 (7) ◽  
pp. 1144-1159 ◽  
Author(s):  
Elizabeth B. Fauth ◽  
Sydney Y. Schaefer ◽  
Steven H. Zarit ◽  
Marie Ernsth-Bravell ◽  
Boo Johansson

Objective: Fine motor ability (FMA) is essential in certain activities of daily living (ADL) and is considered mostly as a component of physical function. We hypothesize that cognitive ability explains significant variance in ADL-related FMA, above and beyond what is explained by physical ability (grip strength). Method: Origins of Variance in the Old Old Study (OCTO)-Twin participants ( n = 218), aged 80+ (dementia, stroke, Parkinson’s disease excluded) were assessed on depressive symptoms (Center for Epidemiologic Studies–Depression Scale [CES-D]), a cognitive battery, grip strength, and FMA. Results: In a series of ordinary least squares regression models, FMA was not associated with gender or depressive symptoms, but was associated with age (marginally; β = −.164, p = .051), grip strength (β = −.381, p < .01), and one cognitive measure, perceptual speed (β = −.249, p < .01). Discussion: In nondemented older adults, cognitive speed predicts ADL-related FMA after controlling for age and physical ability. Physical rehabilitation of FMA in ADL tasks should consider the importance of cognitive ability, even in nondemented older adults.


BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e040098
Author(s):  
Bingyan Gong ◽  
Shaomei Shang ◽  
Chao Wu

ObjectivesThis study aimed to investigate the relationship between disability and domain-specific cognitive function in older adults with chronic obstructive pulmonary disease (COPD).DesignCross-sectional analyses combined with retrospective longitudinal analyses.SettingWe included 450 communities in China.ParticipantsIn this study, 1022 (mean age: 68.6±6.3; 612 males) and 152 (mean age: 67.0±5.2; 83 males) older adults with COPD from the China Health and Retirement Longitudinal Study were included in a cross-sectional multivariate linear regression analysis and a longitudinal logistic regression analysis, respectively.Outcome measuresDisability was determined by the difficulty or inability to complete 1 of the 12 activity items in basic activities of daily living (ADL) and instrumental ADL. The cognitive dimensions of episodic memory, attention/numerical ability, orientation to time, and visuospatial ability were assessed via the immediate/delayed recall task, serial sevens task, naming the current date and pentagon-figure-drawing tasks, respectively.ResultsOf 1022 older respondents with COPD at wave-4, 48.5% had ADL disability. Declines in the global cognitive function (β (95% CI)=−0.627 (−1.214 to –0.040)), orientation to time (β (95% CI)=−0.207 (−0.364 to –0.050)) and visuospatial ability (β (95% CI)=−0.068 (−0.127 to –0.009)) were significantly associated with the presence of ADL disability, when demographic and health-related variables were adjusted. Of 152 older participants with COPD and without ADL disability in wave-2, 61 (40.1 %) developed disability over a 2-year follow-up. Relative to the participants without a decline in orientation to tine, those with the condition had greater odds of incidence of ADL disability increased by a factor of about 1.46 over a 2-year follow-up.ConclusionsIn older adults with COPD, orientation to time and visuospatial inability are vulnerable to the presence of a disability. Prevention of a decline in orientation to time might help prevent disability in older people with COPD.


2012 ◽  
Vol 43 (4) ◽  
pp. 801-811 ◽  
Author(s):  
A. G. Gildengers ◽  
D. Chisholm ◽  
M. A. Butters ◽  
S. J. Anderson ◽  
A. Begley ◽  
...  

BackgroundWhile bipolar disorder (BD) is a leading cause of disability, and an important contributor to disability in BD is cognitive impairment, there is little systematic research on the longitudinal course of cognitive function and instrumental activities of daily living (IADLs) in late-life. In this report, we characterize the 2-year course of cognitive function and IADLs in older adults with BD.MethodWe recruited non-demented individuals 50 years and older with BD I or BD II (n = 47) from out-patient clinics or treatment studies at the University of Pittsburgh. Comparator subjects (‘controls’) were 22 individuals of comparable age and education with no psychiatric or neurologic history, but similar levels of cardiovascular disease. We assessed cognitive function and IADLs at baseline, 1- and 2-year time-points. The neuropsychological evaluation comprised 21 well-established and validated tests assessing multiple cognitive domains. We assessed IADLs using a criterion-referenced, performance-based instrument. We employed repeated-measures mixed-effects linear models to examine trajectory of cognitive function. We employed non-parametric tests for analysis of IADLs.ResultsThe BD group displayed worse cognitive function in all domains and worse IADL performance than the comparator group at baseline and over follow-up. Global cognitive function and IADLs were correlated at all time-points. The BD group did not exhibit accelerated cognitive decline over 2 years.ConclusionsOver 2 years, cognitive impairment and associated functional disability of older adults with BD appear to be due to long-standing neuroprogressive processes compounded by normal cognitive aging rather than accelerated cognitive loss in old age.


2020 ◽  
Author(s):  
Qian Sun ◽  
Nan Jiang ◽  
Nan Lu ◽  
Vivian W. Q. Lou

Abstract Background The Chinese population is experiencing rapid aging, limitations in activities of daily living and decline in cognitive function among the oldest-old group causes tremendous economic, family and social burden. Examining their relationship is critically relevant for policymakers. The present study aimed to determine the bidirectional relationship between cognitive function and the loss hierarchy of activities of daily living among older adults in China. Methods Data were derived from a sample of 469 older adults who participated in both the 2010 and 2013 waves of a Longitudinal Study on Family Caregivers for Frail Older Adults. Cognitive function was assessed using the Chinese version of the Short Portable Mental Status Questionnaire and activities of daily living were measured by self-reports of having difficulty or needing help with basic daily activities. A cross-lagged analysis was adopted. Results In general, the results showed cognitive function in 2010 was a significant predictor of middle loss activities of daily living (dressing, moving, bathing and toileting) in 2013, and late loss activities of daily living (feeding and hygiene) in 2013. The loss hierarchy of activities of daily living among older adults was not shown to be significant as a risk factor of cognitive function in 2013. Conclusions The findings expanded understanding of the relationship between cognitive function and the loss hierarchy of activities of daily living as well as provided evidence for clinicians and service planners for anticipating the subsequent care and service needs of the elderly and their families.


Author(s):  
Hyung-Seop Sim ◽  
Sang-Gyu Lee ◽  
Tae-Hyun Kim

Previous studies have shown that the physical functioning of older adults directly affects their depressive symptoms, and suicide is also closely associated with depression. This study determined the effects of physical functioning on depressive symptoms and suicidal ideation among older Korean adults. This study used data from the 2017 National Survey of Older Persons. Among the 10,299 participants in the entire data set, 10,083 participants were analyzed, excluding 216 participants who did not respond to the dependent variables. Data analyses included frequency, chi-squared tests, and binary logistic regression. The results indicated that physical functioning among older adults was associated with reduced depressive symptoms and suicidal ideation. Compared to the group that had non-limited activities of daily living (ADL) function, the group with limitations was 1.66 times more likely to show depressive symptoms (OR: 1.66, 95% CI: 1.36–2.02). Similar trends were observed in instrumental activities of daily living (IADL) (OR: 1.85, 95% CI: 1.58–2.16). When suicidal ideation was set as a dependent variable, IADL had a statistically significant impact (OR: 1.41, 95% CI: 1.14–1.74); however, ADL did not seem to have an impact. Moreover, both ADL (OR: 1.62, 95% CI: 1.35–1.94) and IADL (OR: 1.72, 95% CI: 1.49–1.97) had statistically significant effects when combined with depressive symptoms and suicidal ideation. Better physical functioning was associated with a reduction in depressive symptoms and suicidal ideation. This study emphasizes the importance of physical functioning when examining older adults’ mental health.


Sign in / Sign up

Export Citation Format

Share Document