Dementia associated disorders, cognitive impairment and impact on social roles activities and participation: Patient centric impact

Abstract

AbstractBackgroundDementia associated diseases (DAD) refers to several clinical conditions that are characterized by progressive cognitive impairment that interferes with an individual’s ability to function independently. Cognitive impairments (CI) can vary in degree and combination across multiple cognitive domains (CD) that routine care or tests (MMSE, MOCA) might not adequately identify. Therefore, a clinician may not recognize these varied types of CI or change in CD scores effectively. Enhanced recognition of patient centric CI in routine care can be accomplished improved analytics by incorporating a validated, examiner independent computerized cognitive assessment battery (CAB‐NT). Patient self‐reported outcome measures (PRO) are concurrently incorporated with CAB‐NT to gauge associated disability progression. Ability and participation in social roles and activities and communication ability can adversely affect quality of life (QoL) for people with Dementia associated diseases (PwDAD) and are likely related to CI and other factors.MethodRetrospective review of consecutive PwDAD who completed both CAB‐NT and PRO (SSRA, APSRA, and C‐SF) on the same day in the course of routine care. CAB‐NT included 7 cognitive domains: memory (Mem), executive function (Exe), attention (Att), information processing speed (Inf), visual spatial (Vis), verbal function (Ver), motor skills (Mot) as well as a global cognitive summary score (GCS).Results312 PwDaD, 64.74% female, average age 66 +/‐ 17 years. Simple linear regression analyses were performed with significant correlations (p = <0.05): CAB‐NT vs SSRA: GCS r = 0.2, Exe r = 0.3, Mot r = 0.2, and Att r = 0.3. CAB‐NT vs APSRA: Exe r = 0.3, Att r = 0.2. CAB‐NT vs C‐SF: Exe r = 0.2.ConclusionSocial roles and communication in PwDAD are most impacted by CI associated with executive functioning and attention. Impairment in these domains are associated with increased difficulty for PwDaD to effectively interact with others and may lead to reduced QoL for these patients. Identifying the degree and combination of such CI precisely might allow for early and effective targeted proactive behavioral and/or medicinal intervention to improve QOL of these patients.