Differences in the pattern of influencing factors on instrumental activities of daily living in persons at different stages of mildly impaired cognition

Abstract

AbstractBackgroundInstrumental Activities of Daily Living (IADL) are crucial for a person’s autonomy. A better understanding of potentially influencing factors at different levels of cognitive impairment is relevant for diagnostic and therapeutic purposes. Therefore, we aimed to explore whether the pattern of influencing factors varies between persons with mild cognitive impairment (MCI) and mild dementia.MethodWe exploratively extended the secondary analysis of a cohort, including persons with amnestic (a‐)MCI and mild Alzheimer’s dementia (MD). We fitted linear regression models to the data within the two subgroups, with IADL as the response variable measured using the Brussels Integrated Activities of Daily Living Inventory (BIA) [1]. Selection of the predictors followed a multi‐step approach, including criterion‐based model selection and model fit. We used multivariate imputation by chained equations to estimate the coefficients of the final models and standardized coefficient estimates to relate and compare the effects of the predictors.ResultPersons with a‐MCI (n = 64, mean age 81.7 years, 69% females) and with MD (n = 41, mean age 82.3 years, 73% females) differed in their mean BIA scores (p<0.001). In persons with MCI, the final model (R2 = 0.46) included memory, attention, executive function, mobility, balance, vision, hearing, education, and living situation. Mobility was the only significant predictor and the predictor with the most considerable effect, followed by memory and attention. The final model (R2 = 0.21) in persons with MD included the same predictors; however, executive function and attention were derived from other assessments. The predictors with the most considerable effect were the living situation, mobility, and executive function, yet none was significant.ConclusionThe pattern of potentially influencing factors on IADL functioning differs between persons with aMCI and MD. Our results suggest that physical function plays an essential role in IADL functioning in persons with aMCI, whereas in MD, no significant predictor was detected. Furthermore, our results indicate that IADL functioning may be used to differentiate between diagnostic groups.[1] De Vriendt P, Cornelis E, Cools W, Gorus E. The Usefulness of Evaluating Performance of Activities in Daily Living in the Diagnosis of Mild Cognitive Disorders. International Journal of Environmental Research and Public Health. 2021;18(21):11623.