Performance-Based vs Informant-Reported Instrumental Activities of Daily Living in Predicting Dementia |
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| Institution: | 1. Centre for Healthy Brain Ageing, School of Psychiatry, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia;2. Department of Developmental Disability Neuropsychiatry, School of Psychiatry, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia;1. Department of Preventive Medicine and Population Health, University of Texas Medical Branch, Galveston, TX, USA;2. Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA;3. Department of Economics, Farmer School of Business, Miami University, Oxford, OH, USA;4. Scripps Gerontology Center, Miami University, Oxford, OH, USA;5. Department of Public Health Sciences, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA;6. Division of Geriatrics, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA;7. Geriatrics & Extended Care Data Analysis Center (GECDAC), Canandaigua VA Medical Center, Canandaigua, NY, USA;1. Division of Community Internal Medicine, Mayo Clinic, Rochester, MN, USA;2. Division of Geriatric Medicine and Gerontology, Mayo Clinic, Rochester, MN, USA;3. Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA;4. Department of Artificial Intelligence and Informatics, Mayo Clinic, Rochester, MN, USA;5. Division of Clinical Trials and Biostatistics, Mayo Clinic, Rochester, MN, USA;1. Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA;2. Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA;3. MGH Institute of Health Professions, Boston, MA, USA;4. Meyers Primary Care Institute, Worcester, MA, USA;5. Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA;1. African Health and Aging Research Center (AHaARC), Winneba, Ghana;2. School of Health Sciences, University of Tasmania, Hobart, Australia;3. Center for Women’s Health Research, Hunter Medical Research Institutes, The University of Newcastle, Callaghan, Australia;4. Department of Health Policy, Planning and Management, School of Public Health, University of Ghana, Accra, Ghana;5. Programa Centro Salud Pública, Facultad de Ciencias Médicas, Universidad de Santiago, Santago, Chile;6. Millennium Institute for Caregiving Research (MICARE), Santiago, Chile;1. Centre for Family Medicine Family Health Team, Kitchener, Ontario, Canada;2. Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada;3. Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario, Canada;4. GERAS Centre for Aging Research, Hamilton, Ontario, Canada;5. Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada |
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| Abstract: | ObjectivesIdentifying individuals at risk of developing dementia may be aided by early detection of functional impairments. The aims of the present study were to examine differences in informant-reported and performance-based measures of instrumental activities of daily living (IADL) and to assess whether a performance-based IADL measure contributes additional unique variance over informant reports in predicting incident dementia over 4 years.DesignProspective cohort study (Sydney Memory and Ageing Study).SettingEastern Suburbs, Sydney, Australia.Participants307 community-dwelling individuals (60.6% female) aged between 76 and 96 years with normal cognition (NC; n = 190) or mild cognitive impairment (MCI; n = 117).MethodsIADL ability was assessed with the performance-based Sydney Test of Activities of Daily Living in Memory Disorders (STAM) and the Bayer-Activities of Daily Living (B-ADL) informant report, at baseline and 4-year follow-up. Covariates included age, sex, education, Mini-Mental State Examination and Geriatric Depression Scale scores, arthritis, vision impairment, cardiovascular risk, and number of medications. Logistic regressions were conducted to examine the longitudinal association between the 2 types of IADL measures and incident dementia.ResultsLogistic regressions showed that performance-based IADL impairment at baseline odds ratio (OR) = 0.83, 95% confidence interval (CI) 0.77, 0.90; P < .001] and decline in performance-based IADL function (OR = 0.82, 95% CI 0.73, 0.91; P < .001) were associated with incident dementia over 4 years, with the association provided by the STAM being statistically significant over and above the B-ADL.Conclusions and ImplicationsPerformance-based measures of IADL can predict progression to dementia over 4 years beyond that provided by an informant report of IADL. Performance-based IADL measures are promising tools for clinical practice to identify individuals at greater risk of developing dementia. |
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| Keywords: | Activities of daily living performance test dementia mild cognitive impairment functional impairment IADL |
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