Peripheral Vascular Disease is Associated with Impaired Activities of Daily Living in the Elderly with Dementia: A Prospective Study.

Abstract

Although distinct disorders, peripheral vascular disease (PVD) and dementia are both associated with a progressive decline in activities of daily living in elderly patients. This study aimed to compare the functional performance scores between elderly patients with and without dementia and with or without PVD. Patients with Alzheimer's disease, vascular dementia, and mixed type dementia and controls were prospectively enrolled. Functional performance scores for basic activities of daily living (BADL) and instrumental activities of daily living (IADL) were evaluated using the Barthel scale and Lawton scale, respectively. PVD was diagnosed using the ankle brachial index (ABI). Controls without PVD were age- and sex-matched with 57 patients with both dementia and PVD and with 69 patients without dementia. The patients with PVD in both groups had lower mean BALD scores. Adjusting for age, clinical dementia rating, and depression, PVD was associated with a higher likelihood of being in the quartiles of lower BADL scores in those with dementia (p=0.020). Adjusting for age, sex, Mini-Mental State Examination (MMSE) score, depression, and comorbidity and drug counts among the patients without dementia, a significant association was observed with PVD and a higher likelihood of being in the quartiles of lower BADL scores (p=0.044). PVD was related to a higher likelihood of being in the quartiles of lower IADL scores in the non-dementia subjects (p=0.001) after adjusting for age, depression, MMSE, education, and comorbidity count. PVD presence determined the poorer status of BADL in demented individuals but not of the level of IADL. It is still unclear whether modifying PVD health risks and undergoing ABI screening may help demented people become more independent.