Abstract
Cognitive dysfunction affects the performance of Activities of Daily Living (ADL) and the quality of life of people with these deficits and their caregivers. To the knowledge of the authors, to date, there are few studies that focus on knowing the relationship between personal autonomy and deductive reasoning and/or categorization skills, which are necessary for the performance of the ADL. The aim of this study was to explore the relationships between ADL and categorization skills in older people. The study included 51 participants: 31 patients with cognitive impairment and 20 without cognitive impairment. Two tests were administered to assess cognitive functions: (1) the Montreal Cognitive Assessment (MoCA); and (2) the digital version of Riska Object Classification test (ROC-d). In addition, the Routine Tasks Inventory-2 (RTI-2) was applied to determine the level of independence in activities of daily living. People with cognitive impairment performed poorly in categorization tasks with unstructured information (p = 0.006). Also, the results found a high correlation between cognitive functioning and the performance of ADLs (Physical ADL: r = 0.798; p < 0.001; Instrumental ADL: r = 0.740; p < 0.001), a moderate correlation between Physical ADLs and categorization skills (unstructured ROC-d: r = 0.547; p < 0.001; structured ROC-d: r = 0.586; p < 0.001) and Instrumental ADLs and categorization skills in older people (unstructured ROC-d: r = 0.510; p < 0.001; structured ROC-d: r = 0.463; p < 0.001). The ROC-d allows the assessment of categorization skills to be quick and easy, facilitating the assessment process by OT, as well as the accuracy of the data obtained.
Highlights
The main risk factor for the development of cognitive decline is aging [1]
Cognitive impairment leads to greater difficulty in performing activities of daily living (ADLs), such as that seen in people with dementia [3], and affects the health-related quality of life of both the patient and the primary caregiver [4]
To the knowledge of the authors, this is the first study on Activities of Daily Living (ADL) and categorization skills in older people
Summary
The main risk factor for the development of cognitive decline is aging [1]. According to the WHO, the prevalence of dementia in the population over 60 years is 5–8% [2]. Deficits in executive functioning (cognitive flexibility, organization, initiation, and maintenance of actions or plans), processing speed, and delayed recall of memory tasks have been associated with poorer performance in ADLs [7,8]. This has been related to the frontal aging hypothesis, which suggests that the first cognitive functions to deteriorate are those associated with the functioning of the prefrontal cortex, such as executive functions [6]. The relationship between categorization, reasoning, and functioning in daily life has been less studied in elderly people with cognitive impairment [12] In part, this could be because few of the executive functioning assessment tools in the clinical setting include a detailed assessment of categorization skills [13,14]. The categorization is a fundamental cognitive process that is used in one way or another in almost all ADLs [10] and it has been related to cognitive flexibility, which allows adaptation to new situations [12]
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