Abstract
Ability to predict and prevent incipient functional decline in older adults may help prolong independence. Cognition is related to everyday function and easily administered, sensitive cognitive tests may help identify at-risk individuals. Factors like depressive symptoms and self-rated health are also associated with functional ability and may be as important as cognition. The purpose of this study was to investigate the relationship between concurrent longitudinal changes in cognition, depression, self-rated health and everyday function in a well-defined cohort of healthy 85 year olds that were followed-up at the age of 90 in the Elderly in Linköping Screening Assessment 85 study. Regression analyses were used to determine if cognitive decline as assessed by global (the Mini-Mental State Examination) and domain specific (the Cognitive Assessment Battery, CAB) cognitive tests predicted functional decline in the context of changes in depressive symptoms and self-rated health. Results showed deterioration in most variables and as many as 83% of these community-dwelling elders experienced functional difficulties at the age of 90. Slowing-down of processing speed as assessed by the Symbol Digits Modality Test (included in the CAB) accounted for 14% of the variance in functional decline. Worsening self-rated health accounted for an additional 6%, but no other variables reached significance. These results are discussed with an eye to possible preventive interventions that may prolong independence for the steadily growing number of normally aging old-old citizens.
Highlights
Aging is the result of a lifetime of accumulated changes that eventually affect the capacity to live an autonomous life
The primary aim of the present study is to examine if cognitive decline, global or domain-specific, predicts functional decline in a subgroup of well-defined and intellectually healthy 85 year olds that were followed during 5 years as part of the Elderly in Linköping Screening Assessment 85 (ELSA 85, [6]) study
The MMSE and self-report questionnaires concerning functional status were administered during the home visit
Summary
Aging is the result of a lifetime of accumulated changes that eventually affect the capacity to live an autonomous life. Nutritional status and lifestyle habits, and age-related or pathological cognitive changes [1, 2] are known to affect instrumental abilities of daily living (IADLs). With the steady aging of the world’s population there has been a PLOS ONE | DOI:10.1371/journal.pone.0160742. Changes in Cognition, Health and Everyday Function in Normally Aging Octogenarians study design, data collection and analysis, decision to publish, or preparation of the manuscript
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