Abstract
BackgroundAlthough cognitive functions affect the health related quality of life (QoL), the relationship between perceived QoL and cognition including executive functions has not been studied adequately. Available studies show moderate to weak correlations. We evaluated the association of cognition and executive functions, namely working memory (WM) and inhibitory control (IC) with the perceived QoL of a sample of elderly people dwelling in residential aged care facilities (RACFs) in Southern Province of Sri Lanka.MethodsCognition was assessed using Mini-Mental State Examination (MMSE), while verbal WM (VWM), visuo-spatial WM (VSWM) and IC (interference control, inhibition of pre potent and ongoing responses) were assessed using VWM, VSWM tasks, colour word Stroop (CWS), go/no-go (GNG) and stop signal (SS) tasks respectively. WHOQoL-Bref (Total score and domain scores) were used to assess QoL. The relationship was analysed using Pearson correlation and hierarchical multiple regression analysis.ResultsStudy included 237 elderly people with a mean age of 71.11 ± 6.44 years. Participants scored the highest in the domain of environment (63.48 ± 10.63) and lowest in the domain of social relationships (55.43 ± 21.84) of QoL. Psychological health domain positively correlated with MMSE, VSWM and VWM scores and negatively correlated with CWS, SS and GNG task errors. Both physical health domain and total QoL demonstrated positive correlations with MMSE, VSWM and VWM scores, while negative correlations were observed with CWS task errors. Social relationships domain demonstrated a significant positive correlation with VSWM score. Environment domain positively correlated with MMSE, VSWM and VWM scores and negatively correlated with CWS and SS task errors. All were significant but weak correlations. When controlled for covariates, such as educational status, physical activity and marital status, cognition was a predictor of the domain of environment of QoL, while executive functions were not predictors of total QoL and domains of QoL.ConclusionCognition and executive functions weakly but significantly correlated with different domains of QoL. Only the level of cognition measured by MMSE was a predictor of the domain of environment of QoL and executive functions were not predictors of total QoL and domains of QoL in elderly people with normal cognitive functions dwelling in RACFs.
Highlights
Cognitive functions affect the health related quality of life (QoL), the relationship between perceived QoL and cognition including executive functions has not been studied adequately
Male participants performed a higher number of errors in response inhibition tasks and obtained lower scores in verbal working memory (WM) (VWM) and visuo-spatial WM (VSWM) tasks than female participants
Psychological health domain positively correlated with Mini-Mental State Examination (MMSE) (r = 0.18,p = 0.006), VSWM (r = 0.17, p = 0.007) and VWM (r = 0.15, p = 0.021) scores and negatively correlated with colour word Stroop (CWS) (r = − 0.14, p = 0.03), stop signal (SS) (r = − 0.13, p = 0.037) and GNG (r = − 0.13, p = 0.048) task errors
Summary
Cognitive functions affect the health related quality of life (QoL), the relationship between perceived QoL and cognition including executive functions has not been studied adequately. The number of elderly people moving to residential aged care facilities (RACFs) is increasing [2]. These facilities are available in the country for several decades [2]. Out of 447 elderly care facilities available in Sri Lanka, only 300 (67.1%) are RACFs, while others provide day care [3]. In Sri Lanka, the reason for the provision of residential care is not due to health problems, such as dementia or disability, but due to the lack of infrastructure and availability of personnel to provide care in the community. The demands of formal sector employment of their children and changing values are the main reasons for their admissions to care facilities [4]
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