Abstract
The assessment of daily living activities could provide information about daily functions and participation restrictions to develop intervention strategies. The purposes of this study were to assess the scores of the Barthel Index (BI) and Lawton Instrumental Activities of Daily Living (IADL) scale in older adults with cognitive impairment and to explore the different effects that levels of cognitive functions have on changes in IADL functions. We recruited 31 participants with dementia, 36 with mild cognitive impairment (MCI), and 35 normal controls (NCs) from the neurology outpatient department of a regional hospital. The results of the demographic and clinical characteristics through the Lawton IADL scale, BI, Quick Mild Cognitive Impairment (Qmci) screen, Montreal Cognitive Assessment (MoCA), and Mini-Mental State Examination (MMSE), were collected on the same day and compared with the Kruskal–Wallis test, Wilcoxon rank-sum test, Fisher’s exact test, and a multiple linear regression analysis, as appropriate. In the BI, bathing was the most discriminating activity to differentiate patients with MCI and dementia; in the Lawton IADL scale, medication responsibility and shopping were the most discriminating activities to differentiate NCs and patients with MCI, and patients with MCI and dementia, respectively. In addition, the predictors of changes in Lawton IADL scale scores were the problem-solving score of the Clinical Dementia Rating scale, a Qmci score of > 20.4 and an age of ≤ 81.2 years, a MoCA score of < 9.4 and an age of > 81.2 years, and the MMSE score and an age of > 81.2 years. This study adds to the evidence that the description of basic and instrumental daily activities is integrated in older adults with cognitive impairment. Notably, the Qmci is the most significant predictor of changes in IADL function for “young” older adults, as are the MoCA and MMSE for “old” older adults.
Highlights
The number of people older than 65 years has been increasing worldwide [1]
People with mild cognitive impairment (MCI) are completely capable of conducting self-care activities; they exhibit a slight impairment in the instrumental activities of daily living (IADL), whereas people with dementia need assistance or at least supervision for the basic activities of daily living (BADL) [4,5,6]
Following our previous study [12], we examined the differences in each item of the Barthel Index (BI) and Lawton IADL scale among the subjects of normal controls (NCs), MCI, and dementia from the same 102 participants in Tables 3 and 4
Summary
The number of people older than 65 years has been increasing worldwide [1]. The global prevalence of dementia is 1.2%–7.2% [2], and the population of older adults with dementia is expected to increase concurrently with global aging. The reported proportion of individuals with mild cognitive impairment (MCI)—at 5.0%–36.7% [3]—is higher than that of people with dementia; most cases of MCI and dementia in older adults remain underdiagnosed and unidentified. People with MCI are completely capable of conducting self-care activities; they exhibit a slight impairment in the instrumental activities of daily living (IADL), whereas people with dementia need assistance or at least supervision for the basic activities of daily living (BADL) [4,5,6]. Cognitive tests are routinely administered and are useful for detecting MCI and dementia under clinical settings, activities reflecting daily living functions are more observed by carers in real-life circumstances.
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