An Evaluation of Change Over Time in Everyday Cognitive Competence Among Alzheimer’s Patients

Abstract

This short-term longitudinal study was designed to examine the pattern of change in everyday cognitive competence as assessed by an objective measure (i.e. the Test of Everyday Problem Solving for Cognitively Challenged Elderly; EPCCE; Willis, 1993) and by self- and caregiver reports (i.e. Instrumental Activities of Daily Living; IADL; Lawton & Brody, 1969). Patient and caregiver characteristics and clinical assessments were explored as predictors. Participants included 100 Alzheimer’s disease (AD) patients and their caregivers who were part of the Stanford Longitudinal Study. Four waves of data were examined via hierarchical linear modeling. Major findings revealed that the EPCCE and the patient IADL formed a linear pattern of decline while the caregiver IADL demonstrated a curvilinear form. Second, different sets of predictors explained the variance in the competence measures at initial status. Finally, the predictors did not account for a significant amount of variance in the instantaneous rate of change on any of the measures; however, a portion of the variance in the acceleration in the caregiver IADL was explained.