Sociodemographic Determinants, Health Conditions, and Mental Status as Predictors of the Functional Status of Older Saudi People

The increasing population of Saudi elderly demands adequate assessment of their functional health status and mental status to improve their health and quality of life. This study aimed to determine the functional status of older Saudi people in performing basic activities of daily living (ADLs) and instrumental activities of daily living (IADLs) and its influencing factors. This quantitative, descriptive-correlational study surveyed a total of 203 participants using the Mini-Mental State Examination, Katz Index of ADL, and Lawton IADL. Overall, the participants had moderate cognitive impairment and were able to perform basic ADLs and IADLs independently, but they needed assistance in doing housework. Functional status was sensitive to their sociodemographic characteristics, presence of health problems, and mental status. Mental status, education, employment, marital status, and source of support were significantly associated with their ability to perform basic ADLs and IADLs. This study suggests that more efforts are needed to understand the sociodemographic characteristics, presence of health problems, and mental status that support the development of evidence-based public health policy on the functional status among older Saudi people. The findings can be utilized by hospital and nursing administrators to initiate educational and training programs for healthcare professionals including nurses and to create healthcare policies so that the health concerns and functional difficulties of older patients are adequately addressed.

Caregiver burden among family caregivers of incurable cancer patients in two eastern Mediterranean countries

Background Although family caregivers (FCs) play an important role in the care provided to incurable cancer patients in our region, little is known about the burden they experience. This study was conducted to determine the prevalence of caregiver burden (CB) among FCs of incurable cancer patients in two Eastern Mediterranean countries and to identify factors that may be associated with significant CB. Methods The study included 218 FCs, 165 from Egypt and 53 from Saudi Arabia. The 22-item Zarit Burden Interview (ZBI-22) was used to assess caregiver burden CB. Significant CB was defined as a ZBI-22 score ≥ 21. The assistance with basic ADLs was classified into 3 levels according to FCs’ assistance with early/middle/late-loss basic ADLs. The relationship between CB and the assistance with ADLs and other factors was studied. Results The mean (SD) ZBI-22 score among FCs was 23.4 (9.3) and the majority (128/218, 59%) had significant CB. Eighty-nine percent of FCs assisted with at least one basic ADL. Assistance with late-loss basic ADLs, best supportive care treatment plan and poorer performance status were associated with higher CB (p < 0.0001, =0.018 and = 0.005). However, in logistic regression analysis, only assistance with late-loss ADLs was independently associated with significant CB (OR = 3.4 [95%CI:1.2–9.7], p = 0.024). Conclusion A substantial proportion of FCs of incurable cancer patients in our region experience significant CB. Family caregivers assisting with late-loss basic ADLs are at risk of significant CB and should be routinely screened for CB.

Neuropsychiatric symptoms and activities of daily living in Alzheimer’s disease: ALSOVA 5-year follow-up study

ABSTRACTBackground:Neuropsychiatric symptoms (NPSs) in Alzheimer’s disease (AD) are related to activities of daily living (ADLs), but longitudinal studies are sparse.Objectives:We investigated which NPSs were related to decline in instrumental ADLs (IADLs) and basic ADLs (BADLs) in a 5-year follow-up of individuals with AD.Methods:ALSOVA 5-year follow-up study data of 236 individuals with very mild or mild AD at baseline and their caregiver were analyzed. IADLs and BADLs were assessed with Alzheimer’s Disease Cooperative Study ADL inventory, and NPSs with Neuropsychiatric Inventory at annual follow-up visits. Generalized estimating equations (GEEs) were used for longitudinal data analysis, and NPS–ADL networks were estimated to demonstrate symptom interactions.Results:Apathy [rate ratio (RR) 1.23, 95% CI 1.06–1.44, p = 0.007], aberrant motor behavior (RR 1.24, 95% CI 1.07–1.44, p = 0.005), and appetite disturbances (RR 1.22, 95% CI 1.06–1.41, p = 0.005) were related to impairment in BADLs, and the same symptoms (RR 1.13, 95% CI 1.07–1.21, p < 0.001; RR 1.13, 95% CI 1.07–1.20, p < 0.001; RR 1.14; 95% CI 1.08–1.21, p < 0.001, for apathy, aberrant motor behavior, and appetite disturbances, respectively), in addition to delusions (RR 1.09, 95% CI 1.03–1.15, p = 0.004), were related to IADL impairment. Symptom networks varied at different time points.Conclusion:As AD progresses, common (apathy) and uncommon NPSs (aberrant motor behavior, appetite disturbances, delusions) seem to be related to ADLs through various symptom interactions. Previous literature suggests that frontal pathology could underlie these relationships.

Burden and Anxiety in Family Caregivers in the Hospital That Debut in Caregiving

This cross-sectional study aims to determine the level of subjective burden and anxiety of caregivers of dependent older relatives that start providing care in the hospital and to analyse the relationship between objective burden, subjective burden and anxiety in these caregivers. Seventy-two caregivers of dependent older relatives were recruited in a medium–long stay hospital. Sociodemographic variables, number of basic activities of daily living (ADLs) attended, hours of surveillance, burden, and anxiety were collected from caregivers. A trajectory analysis was used to analyse the relationship between variables. Of the caregivers, 36.1% had subjective burden and 14.9% had anxiety. Subjective burden was positively associated with the number of basic ADLs attended, the hours of surveillance, and the cognitive impairment of the care recipient. Anxiety was also positively associated with subjective burden. Subjective burden mediated the effects of the number of basic ADLs attended, hours of surveillance and the cognitive impairment of the care recipient on anxiety. The levels of subjective burden and anxiety in caregivers debuting in hospital care are elevated, showing the need for these caregivers to be cared for. Subjective burden is a possible risk factor for anxiety, independent of the objective burden; it may buffer the effects of objective burden on anxiety.

The Link between Cognitive Measures and ADLs and IADL Functioning in Mild Alzheimer's: What Has Gender Got to Do with It?

Objectives. To investigate the link between neurocognitive measures and various aspects of daily living (ADL and IADL) in women and men with mild Alzheimer's disease (AD).Methods. Participants were 202 AD patients (91 male, 111 female) with CDR global scores of ≤1. ADLs and IADLs ratings were obtained from caregivers. Cognitive domains were assessed with neuropsychological testing.Results. Memory and executive functioning were related to IADL scores. Executive functioning was linked to total ADL. Comparisons stratified on gender found attention predicted total ADL score in both men and women. Attention predicted bathing and eating ability in women only. Language predicted IADL functions in men (food preparation) and women (driving).Conclusions. Associations between ADLs/IADLs and memory, learning, executive functioning, and language suggest that even in patients with mild AD, basic ADLs require complex cognitive processes. Gender differences in the domains of learning and memory area were found.