Discriminative power of the advanced activities of daily living (a-ADL) tool in the diagnosis of mild cognitive impairment in an older population

2015 ◽  
Vol 27 (9) ◽  
pp. 1419-1427 ◽  
Author(s):  
P. De Vriendt ◽  
T. Mets ◽  
M. Petrovic ◽  
E. Gorus
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Clinical Evaluation ◽  
Predictive Value ◽  
Cognitive Aging ◽  
Daily Living ◽  
Functional Decline ◽  
Community Dwelling ◽  
Discriminative Power

ABSTRACTBackground:Mild cognitive impairment (MCI) is characterized by subjective and objective memory impairments in the absence of manifest functional decline. Mild changes in activities of daily living (ADL) can be present and probably predict conversion to dementia. A new advanced (a)-ADL tool was developed, evaluating high-level activities and, taking each participant as their own reference, distinguishing a global Disability Index (a-ADL-DI), a Cognitive Disability Index (a-ADL-CDI), and a Physical Disability Index (a-ADL-PDI), based on the number of activities performed and the severity and causes of the functional problem. This study evaluates the discriminative validity of the a-ADL in MCI.Method:Based upon clinical evaluation and a set of global, cognitive, mood, and functional assessments, 150 community-dwelling participants (average age 80.3 years (SD 5; 66–91)) were included and diagnosed as (1) cognitively healthy participants (n = 50); (2) patients with a-MCI (n = 48), or (3) mild to moderate AD (n = 52). The a-ADL tool was not a part of the clinical evaluation.Results:The a-ADL-DI and the a-ADL-CDI showed a sensitivity and specificity ranging from 70% to 94.2%, Positive Predictive Value ranging from 70% till 93.8%, and Negative Predictive Value from 64.4% and 93.8%, an area under the curve (AUC) ranging from 0.791 to 0.960. Functional decline related to physical deficits, as assessed by the a-ADL-PDI, did not discriminate between the different groups.Conclusion:The a-ADL tool has a good ability to distinguish normal and pathological cognitive aging. Its discriminative power for underlying causes of limitations may be an advantage.

scholarly journals Neuropsychological and Functional Impact of COVID-19 on Mild Cognitive Impairment

2020 ◽  
Vol 35 ◽  
pp. 153331752096087
Author(s):  
Kalpana P. Padala ◽  
Christopher M. Parkes ◽  
Prasad R. Padala
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Case Report ◽  
Mild Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Older Adult ◽  
Daily Living ◽  
Functional Decline ◽  
Depression And Anxiety ◽  
Physically Active

We present a case report to showcase that behavioral, cognitive, and functional decline may be associated with COVID-19 stay-home guidance among older adults with pre-existent cognitive impairment. In a functionally independent and physically active older adult with Mild Cognitive Impairment, there was worsening in depression and anxiety symptoms associated with the restrictions of COVID-19. Functional decline was also noted as assessed by Instrumental Activities of Daily Living. We discuss solutions to mitigate the effects of COVID-19 restrictions in this vulnerable population.

scholarly journals The process of decline in advanced activities of daily living: a qualitative explorative study in mild cognitive impairment

2012 ◽  
Vol 24 (6) ◽  
pp. 974-986 ◽  
Author(s):  
Patricia De Vriendt ◽  
Ellen Gorus ◽  
Elise Cornelis ◽  
Anja Velghe ◽  
Mirko Petrovic ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Functional Decline ◽  
International Classification Of Functioning ◽  
Cognitive Changes ◽  
Wide Range ◽  
Day Hospitals ◽  
Constant Comparative Analysis

ABSTRACTBackground: The notion of “minimal impairment in instrumental activities of daily living (i-ADL)” is important in the diagnosis of mild cognitive impairment (MCI), but is presently not adequately operationalized. ADL is stratified according to difficulty, complexity, and also to vulnerability to early cognitive changes in a threefold hierarchy: basic activities of daily living (b-ADL), i-ADL, and advanced activities of daily living (a-ADL). This study aims to gain a deeper understanding of the functional decline in the process of MCI.Methods: In a qualitative design, 37 consecutive patients diagnosed with amnestic (a)-MCI and their proxies were interviewed at two geriatric day hospitals. Constant comparative analysis was used for the analysis.Results: The a-ADL-concept emerged as important in the diagnosis of MCI. All participants were engaged in a wide range of activities, which could be clustered according to the International Classification of Functioning, Disability and Health (ICF). Participants reported subtle difficulties in performance. A process of functional decline was identified in which adaptation and coping mechanisms interacted with the process of reduced skills, leading to an activity disruption and an insufficiency in functioning.Conclusion: This study asserts the inclusion of an evaluation of a-ADL in the assessment of older persons. When evaluating ADL at three levels (b-ADL, i-ADL, and a-ADL), all the activities one can perform in daily living are covered.

scholarly journals Complex activities of daily living vary by mild cognitive impairment subtype

2010 ◽  
Vol 16 (4) ◽  
pp. 630-639 ◽  
Author(s):  
KATHERINE J. BANGEN ◽  
AMY J. JAK ◽  
DAWN M. SCHIEHSER ◽  
LISA DELANO-WOOD ◽  
ELIZABETH TUMINELLO ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Financial Management ◽  
Daily Living ◽  
Functional Decline ◽  
Health And Safety ◽  
Functional Abilities ◽  
Cognitively Normal ◽  
Amnestic Mci

AbstractThere is increasing consensus regarding the importance of operationally defining and measuring functional decline in mild cognitive impairment (MCI). However, few studies have directly examined functional abilities in MCI or its presumed subtypes and, to date, reported findings have been discrepant. Nondemented older adults (n = 120) were administered a comprehensive cognitive battery measuring multiple domains as well as a performance-based functional ability measure. Participants were characterized as either cognitively normal, amnestic MCI, or non-amnestic MCI. MCI individuals demonstrated decrements in instrumental activities of daily living (IADL) relative to their cognitively normal counterparts. Specifically, participants with amnestic MCI demonstrated significant decrements in financial management, whereas those with non-amnestic MCI showed poorer performance in abilities related to health and safety. Moreover, decreased functional abilities were associated with decrements in global cognitive functioning but not memory or executive functions in the MCI participants. Finally, logistic regression demonstrated that functional abilities accurately predicted MCI subtype. Results support the need for better delineation of functional decline in MCI. Given the implications of functional status for MCI diagnosis and treatment, the direct assessment of functional abilities is recommended. Results further suggest performance-based IADL assessment may have utility in distinguishing MCI subtypes. (JINS, 2010, 16, 630–639.)

scholarly journals Impacts of stroke and cognitive impairment on activities of daily living in the Taiwan longitudinal study on aging

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Pi-Hsia Lee ◽  
Ting-Ting Yeh ◽  
Hsin-Yen Yen ◽  
Wan-Ling Hsu ◽  
Valeria Jia-Yi Chiu ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Longitudinal Study ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Skill Training ◽  
Community Dwelling ◽  
Combined Effects ◽  
Stroke Group ◽  
The Individual ◽  
Community Dwelling Older Adults

AbstractStroke and cognitive impairment are common in older population. They often occur together and their combined effects significantly increase disability in both basic (BADLs) and instrumental (IADLs) activities of daily living. We investigated the individual and combined impacts of stroke and cognitive impairment on BADLs and IADLs. A total of 3331 community-dwelling older adults were enrolled from the Taiwan longitudinal study on aging in 2011. Both BADLs and IADLs were analyzed. Combination of stroke and cognitive impairment increased severity of ADL disabilities, but similar prevalence, similar numbers of summed BADL and IADL tasks with disability, and similar levels of difficulty for each BADL and IADL task were found between the stroke group and cognitive impairment group. The former had more difficult in dressing while the latter had more difficult in using the telephone, transport, and managing finances. A hierarchy of ADLs was also observed in all groups. ADL skill training supplemented with cognitive and physical interventions should focus on secondary prevention of dementia and improve motor functional capacity to reduce loss of ADLs.

scholarly journals Mild cognitive impairment in the elderly Relationship between communication and functional capacity

2018 ◽  
Vol 12 (2) ◽  
pp. 165-172 ◽  
Author(s):  
Ana Iza Gomes da Penha Sobral ◽  
Cláudia Marina Tavares de Araújo ◽  
Marcos Felipe Falcão Sobral
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Activities Of Daily Living ◽  
Elderly People ◽  
Communication Skills ◽  
Social Communication ◽  
Daily Living ◽  
The Elderly ◽  
Intermediate Form ◽  
Instrumental Activities

Abstract Mild Cognitive Impairment is characterized as an intermediate form between age-related change and dementia. For the elderly, autonomy and independence are related to the ability to remain active in conducting their social activities and, for this to occur, communication is fundamental in this process. Objective: To assess the association between communication and the abilities of elderly people with mild cognitive impairment to perform instrumental activities of daily living. Methods: A cross-sectional, quantitative, analytical, correlational study was conducted at the Open University of the Third Age (UnATI), a program of the Federal University of Pernambuco. This study included 92 people, comprising 46 elderly with mild cognitive impairment and a caregiver or family member who met the inclusion criteria. The elderly were asked to complete a sociodemographic questionnaire and Lawton-Brody’s Instrumental Activities of Daily Living Scale. The caregivers were asked to complete the Functional Assessment of Communication Skills. The following variables were studied: social communication skills and instrumental activities of daily living. Data were stored in an Excel® 2007 spreadsheet, and the Pearson correlation test was used for the statistical analysis. Results: There were statistically significant correlations in four domains of social communication: referring to family members by name (p=0.0033); requesting information about people or events (p=0.0355); understanding conversations in a noisy environment (p=0.0448); and understanding what they watch on television or listen to on the radio (p=0.0127). Conclusion: Changes in the communication of elderly people with mild cognitive impairment interfere with their ability to perform instrumental activities autonomously and independently.

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