Volume 5, Issue 2 (10-2017)                   Jorjani Biomed J 2017, 5(2): 63-77 | Back to browse issues page

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Nourbakhsh S F, Fadayevatan R, Alizadeh-Khoei M, Sharifi F. Determining the status of activity of daily living (ADL) and instrumental activity of daily living (IADL) in healthy and cognitive impaired elderlies. Jorjani Biomed J 2017; 5 (2) :63-77
URL: http://goums.ac.ir/jorjanijournal/article-1-561-en.html
1- Gerontology department, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran
2- Elderly Health Research Center, Tehran University of Medical sciences, Tehran, Iran
3- Iranian Research Center of Aging, Gerontology department, University of Social Welfare and Rehabilitation Sciences (USWR), Tehran, Iran , mahtabalizadeh@yahoo.com
4- Elderly health research center, Tehran University of Medical sciences, Tehran, Iran.
Abstract:   (32158 Views)
Background & Objective: Dementia is associated with serious effects on memory, cognition and ability to carry out daily activities. There is evidence that impairment in activity of daily living (ADL) is even reported among elder patients who suffer from mild cognitive disorders. Therefore, we aimed to determine the status of ADL and instrumental activity of daily living (IADL) in healthy and cognitive impaired elderlies (MCI, Mild, and Moderate dementia).
Methods: In this cross-sectional study which was conducted in 2016, 300 elderlies (60 years and above) were selected using a classified cluster sampling in four groups (each group of 75 individuals). These groups comprised of healthy old people and elderlies with mild cognitive impairment (MCI) and mild to moderate dementia that were residing in rural areas of Isfahan and Tehran and were classified between stages of 1 to 5 according to the Global Deterioration Scale (GDS). All individuals in four groups were assessed by ADL and IADL evaluation tools. The geriatric depression scale (GDS-15) and DSM-IV scale were performed on healthy elderlies by a physician to confirm the lack of mild dementia or depression. Data were analyzed by SPSS 20 software and using descriptive statistics, analysis of variance and independent samples T-test.
Results: According to the cognitive impairment screening results by GDS, 76 elderlies were healthy, 75 were in MCI group, 72 individuals were diagnosed with mild dementia and 77 were suffering from moderate dementia. The mean scores of ADL tool on the basis of different cognitive stages of elderlies were statistically significant (p<0.001). The ADL scores among elderlies were lowered by increasing the severity of cognitive impairment. Moreover, the average scores of IADL among elderlies with different cognitive status were significantly different (p<0.001). The IADL scores in cases with moderate dementia were markedly declined in comparison to healthy subjects and elderlies with MCI and mild dementia.
Conclusion: Although applying the ADL and IADL tools are not considered as gold standards in rapid assessment of cognitive impairments among elderlies, they could be considered as useful and user friendly tools to detect performance alterations in elderlies with dementia to provide healthcare by geriatric teams.
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  • Dementia is associated with serious effects on memory, cognition and ability to carry out daily activities.
  • We aimed to determine the status of ADL and instrumental activity of daily living (IADL) in healthy and cognitive impaired elderlies (MCI, Mild, and Moderate dementia).
  • The ADL scores among elderlies were lowered by increasing the severity of cognitive impairment. Moreover, the average scores of IADL among elderlies with different cognitive status were significantly different (p<0.001).
  • The IADL scores in cases with moderate dementia were markedly declined in comparison to healthy subjects and elderlies with MCI and mild dementia.
  • Although applying the ADL and IADL tools are not considered as gold standards in rapid assessment of cognitive impairments among elderlies, they could be considered as useful and user friendly tools to detect performance alterations in elderlies with dementia to provide healthcare by geriatric teams.

Type of Article: Original article | Subject: General medicine
Received: 2018/02/4 | Accepted: 2018/02/4 | Published: 2018/02/4

References
1. United Nations Population Division | Department of Economic and Social Affairs [Internet]. [cited 2016 Sep 20]. Available from: http://www.un.org/en/development/desa/po pulation/publications/ageing/populationageing-development-2012.shtml
2. 2. Tak E, Kuiper R, Chorus A, Hopman-Rock M. Prevention of onset and progression of basic ADL disability by physical activity in community dwelling older adults: a metaanalysis. Ageing Res Rev. 2013;12(1):329- 38. [DOI:10.1016/j.arr.2012.10.001]
3. 3. Tagharrobi Z, Sharifi K, Sooky Z. Psychometric evaluation of Shah version of modified Barthel index in elderly people residing in Kashan Golabchi nursing home. KAUMS J FEYZ. 2011:15;15(3):213-24.
4. 4. Comer R. Diagnostic and Statistical Manual of Mental Disorders IV-TR. Washington DC: Worth Publishers; 2002.
5. 5. World Alzheimer Report 2015: The Global Impact of Dementia | Alzheimer's Disease International [Internet]. [cited 2016 Sep 20]. Available from: https://www.alz.co.uk/research/worldreport-2015
6. 6. Sharifi F, Fakhrzadeh H, Varmaghani M, Arzaghi S.M, Alizadeh Khoei M, Farzadfar F, Taheri Tanjani P. Prevalence of Dementia and Associated Factors among Older Adults in Iran: National Elderly Health Survey (NEHS). Arch Iran Med. 2016; 19(12): 838 - 844.
7. 7. Albert MS, DeKosky ST, Dickson D, Dubois B, Feldman HH, Fox NC, et al. The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the National Institute on AgingAlzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimers Dement J Alzheimers Assoc. 2011;7(3):270-9. [DOI:10.1016/j.jalz.2011.03.008]
8. 8. Petersen RC, Knopman DS, Boeve BF, Geda YE, Ivnik RJ, Smith GE, et al. MildCognitive Impairment: Ten Years Later. Arch Neurol. 2009 ;66(12):1447-55. [DOI:10.1001/archneurol.2009.266]
9. 9. Pereira FS, Yassuda MS, Oliveira AM, Diniz BS, Radanovic M, Talib LL, et al. Profiles of functional deficits in mild cognitive impairment and dementia: benefits from objective measurement. J Int Neuropsychol Soc JINS. 2010;16(2):297- 305. [DOI:10.1017/S1355617709991330]
10. 10. Emery VOB, Oxman TE. Dementia: Presentations, Differential Diagnosis, and Nosology. JHU Press; 2003. 576 p.
11. 11. Eichler T, Thyrian JR, Hertel J, Köhler L, Wucherer D, Dreier A, et al. Rates of formal diagnosis in people screened positive for dementia in primary care: results of the DelpHi-Trial. J Alzheimers Dis JAD. 2014;42(2):451-8. [DOI:10.3233/JAD-140354]
12. 12. Borson S, Scanlan J, Hummel J, Gibbs K, Lessig M, Zuhr E. Implementing routine cognitive screening of older adults in primary care: process and impact on physician behavior. J Gen Intern Med. 2007;22(6):811-7. [DOI:10.1007/s11606-007-0202-8]
13. 13. Snyder PJ. Introducing Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, an open access journal of the Alzheimer's Association. Alzheimers Dement Diagn Assess Dis Monit. 2015; 29;1(1):1-4. [DOI:10.1016/j.dadm.2015.01.001]
14. 14. Puente AN, Terry DP, Faraco CC, Brown CL, Miller LS. Functional impairment in mild cognitive impairment evidenced using performance-based measurement. J Geriatr Psychiatry Neurol. 2014;27(4):253-8. [DOI:10.1177/0891988714532016]
15. 15. Marshall GA, Amariglio RE, Sperling RA, Rentz DM. Activities of daily living: where do they fit in the diagnosis of Alzheimer's disease? Neurodegener Dis Manag. 2012; 1;2(5):483-91. [DOI:10.2217/nmt.12.55]
16. 16. Malakouti SK, Fatollahi P, Mirabzadeh A, Salavati M, Zandi T. Reliability, validity and factor structure of the GDS-15 in Iranian elderly. Int J Geriatr Psychiatry. 2006 ;21(6):588-93. [DOI:10.1002/gps.1533]
17. 17. Bakhtiyari F, Foroughan M, Fakhrzadeh H, Nazari N, Najafi B, Alizadeh M, et al. Validation Of The Persian Version Of Abbreviated Mental Test (Amt) In Elderly Residents Of Kahrizak Charity Foundation. Iran J Diabetes Metab. 2014; 15;13(6):487- 94.
18. 18. Munro BH. Statistical Methods for Health Care Research 5th (fifth) edition. 5 Pap/Cdr edition. Lippincott Williams & Wilkins; 2003.
19. 19. Collin C, Wade DT, Davies S, Horne V. The Barthel ADL Index: A reliability study. Int Disabil Stud. 1988;1;10(2):61-3. [DOI:10.3109/09638288809164103]
20. 20. Hassani Mehraban A, Soltanmohamadi Y, Akbarfahimi M, Taghizadeh G. Validity and reliability of the persian version of lawton instrumental activities of daily living scale in patients with dementia. Med J Islam Repub Iran. 2014;28:25.
21. 21. McDowell I. Measuring Health: A Guide to Rating Scales and Questionnaires. Oxford University Press; 2006. 765 p.
22. 22. Taheri Tanjani1 P, Azadbakht M. Psychometric Properties of the Persian Version of the Activities of Daily Living Scale and Instrumental Activities of Daily Living Scale in elderly. J Mazandaran Univ Med Sci. 2016; 15;25(132):103-12.
23. 23. Soltanmohamadi Y, Hassani Mehraban A, Taghizade Gh, Akbarfahimi M., Alahyari F. Validity and Reliability of the Persian Version of Lawton Instrumental Activites of Daily Living Scale among Patients with Dementia. Salmand. 2014:Vol 9, NO 2: 160-167
24. 24. Jekel K, Damian M, Wattmo C, Hausner L, Bullock R, Connelly PJ, et al. Mild cognitive impairment and deficits in instrumental activities of daily living: a systematic review. Alzheimers Res Ther [Internet]. 2015 Mar 18 [cited 2016 Sep 20];7(1). Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/ PMC4374414/ [DOI:10.1186/s13195-015-0099-0]
25. 25. Gold DA .An examination of instrumental activities of daily living assessment in olderadults and mild cognitive impairment. J Clin Exp Neuropsychol. 2012;34(1):11-34. doi: 10.1080/13803395.2011.614598. Epub 2011 Nov 4. [DOI:10.1080/13803395.2011.614598]
26. 26. Masoumi N, Sh J, A G, S.m E, E K, F S, et al. Assessment Of Cognitive Status And Related Factors In Elder People In Rasht. 2013; 1;8(29):80-6.
27. 27. Lin LP, Hsu SW, Hsia YC, Wu CL, Chu C, Lin JD. Association of early-onset dementia with activities of daily living (ADL) in middle-aged adults with intellectual disabilities: the caregiver's perspective. Res Dev Disabil. 2014 Mar;35(3):626-31. doi: 10.1016/j.ridd.2013.12.015. Epub 2014 Jan 24. [DOI:10.1016/j.ridd.2013.12.015]
28. 28. Mori A, Sugimura K. Characteristics of assessment of motor and process skills and Rivermead Behavioral Memory Test in elderly women with dementia and community-dwelling women. Nagoya J Med Sci. 2007 Jan;69(1-2):45-53.
29. 29. Sohrabi M., Zolfaghari P, Mahdizadeh F, Aghayan M, Ghasemian m, Shariati Z, et al. Evaluation and Comparison of Cognitive State and Depression in Elderly Admitted in Sanitarium with Elderly Sited in Personal Home. 2008;3(2):27-31.
30. 30. Sharifi F, Najafi B, Fakhrzadeh H, Noroozian M, Naderimagham S, Philp I, et al. National and sub-national trend of prevalence and burden of dementia in Iran, from 1990 to 2013; study protocol. Arch Iran Med. 2014;17(12):816-20.
31. 31. Sugimoto H, Demura S, Nagasawa Y. Age and Gender-Related Differences in Physical Functions of the Elderly Following OneYear Regular Exercise Therapy. Health (N Y). 2014;06(08):792-801. [DOI:10.4236/health.2014.68101]
32. 32. Ohri P, Gupta S, Upadhyai N. A Study of Daily Living Dependency Status among Elderly in an Urban Slum area of Dehradun. Ind J Comm Health. 2014;26(4):417-422.
33. 33. Moeini B, Barati M, Jalilian F. Factors associated with the functionalindependence level in older adults. Bimon J Hormozgan Univ Med Sci. 2012; 15;15(4):318-26.
34. 34. Alizadeh M, Rahimi A, Arshinji M, Sharifi F, Arzaghi M, Fakhrzadeh H. Physical health status and socio-economic outcomes on elderly in Tehran metropolitan area. ijdld. 2013; 13 (1) :29-37
35. 35. Nakazawa A, Nakamura K, Kitamura K, Yoshizawa Y. Association Between Activities of Daily Living and Mortality Among Institutionalized Elderly Adults in Japan. Journal of Epidemiology. 2012;22(6):501-507. doi:10.2188/jea.JE20110153. [DOI:10.2188/jea.JE20110153]
36. 36. Khadr Z, Yount K. Differences in selfreported physical limitation among older women and men in Ismailia, Egypt. Journals of Gerontology Series B. 2012;67(5):605-617. [DOI:10.1093/geronb/gbs066]
37. 37. Jabbour S, Giacaman R, Khawaja M, Nuwayhid I. Public Health in the Arab World. 1 edition. Cambridge: Cambridge University Press; 2012. 517 p.
38. 38. Simonsick EM, Kasper JD, Guralnik JM, Bandeen-Roche K, Ferrucci L, Hirsch R, et al. Severity of upper and lower extremity functional limitation: scale development and validation with self-report and performance-based measures of physical function. WHAS Research Group. Women's Health and Aging Study. J Gerontol B Psychol Sci Soc Sci. 2001;56(1):S10-19. [DOI:10.1093/geronb/56.1.S10]
39. 39. Egüez-Guevara P, Andrade FCD. Gender differences in life expectancy with and without disability among older adults in Ecuador. Arch Gerontol Geriatr. 2015 ;61(3):472-9. [DOI:10.1016/j.archger.2015.08.012]
40. 40. Whitson HE, Landerman LR, Newman AB, Fried LP, Pieper CF, Cohen HJ. Chronic medical conditions and the sex-based disparity in disability: the Cardiovascular Health Study. J Gerontol A Biol Sci Med Sci. 2010;65(12):1325-31. [DOI:10.1093/gerona/glq139]
41. 41. Zunzunegui M-V, Alvarado B-E, Béland F, Vissandjee B. Explaining health differencesbetween men and women in later life: a cross-city comparison in Latin America and the Caribbean. Soc Sci Med 1982. 2009;68(2):235-42. [DOI:10.1016/j.socscimed.2008.10.031]
42. 42. Millán-Calenti JC, Tubío J, Pita-Fernández S, Rochette S, Lorenzo T, Maseda A. Cognitive impairment as predictor of functional dependence in an elderly sample. Arch Gerontol Geriatr. 2012;54(1):197- 201. [DOI:10.1016/j.archger.2011.02.010]
43. 43. Oros I, Popescu C, Iova C., Mihancea P. The impact of cognitive impairment after stroke on activities of daily living. Human & Veterinary Medicine. 2016;8(1):P 41-44.
44. 44. Goldberg TE, Koppel J, Keehlisen L, Christen E, Dreses-Werringloer U, Conejero-Goldberg C, et al. PerformanceBased Measures of Everyday Function in Mild Cognitive Impairment. Am J Psychiatry. 2010;167(7):845-53. [DOI:10.1176/appi.ajp.2010.09050692]
45. 45. Mograbi DC, Faria C de A, Fichman HC, Paradela EMP, Lourenço RA. Relationship between activities of daily living and cognitive ability in a sample of older adults with heterogeneous educational level. Ann Indian Acad Neurol. 2014;17(1):71-6. [DOI:10.4103/0972-2327.128558]
46. 46. Regala P, Carter A. Instrumental Activities of Daily Living Questionnaires for Dementia and Mild Cognitive Impairment. J Neurol Res. 2015;5(1-2):153-9. [DOI:10.14740/jnr316w]
47. 47. Zidan M, Arcoverde C, Bom de Araújo N, Vasques P, Rios A, Laks J, et al. Motor and functional changes in different stages of Alzheimer's disease. Rev Psiq Clín. 2012;39(5):161-5 [DOI:10.1590/S0101-60832012000500003]
48. 48. Whitson HE, Landerman LR, Newman AB, Fried LP, Pieper CF, Cohen HJ. Chronic medical conditions and the sex-based disparity in disability: the Cardiovascular Health Study. J Gerontol A Biol Sci Med Sci. 2010;65(12):1325-31. [DOI:10.1093/gerona/glq139]
49. 49. Hall J.R., Vo H.T, Johnson L.A, Barber R.C, O'Bryant S. E, "The Link between Cognitive Measures and ADLs and IADL Functioning in Mild Alzheimer's: What Has Gender Got to Do with It?," International Journal of Alzheimer's Disease, vol. 2011, Article ID 276734, 6 pages, 2011. doi:10.4061/2011/276734 [DOI:10.4061/2011/276734]
50. 50. Millán-Calenti JC, Tubío J, Pita-Fernández S, González-Abraldes I, Lorenzo T, Fernández-Arruty T, Maseda A.. Prevalence of functional disability in activities of daily living (ADL), instrumental activities of daily living (IADL) and associated factors, as predictors of morbidity and mortality. Arch Gerontol Geriatr. 2010 May-Jun;50(3):306- 10. doi: 10.1016. [DOI:10.1016/j.archger.2009.04.017]
51. 51. Helvik A.S, Høgseth L.D, Bergh S, ŠaltytėBenth J, Kirkevold Q. A 36-month followup of decline in activities of daily living in individuals receiving domiciliary care. BMC Geriatrics. 2015:15(47);1-13. [DOI:10.1186/s12877-015-0047-7]

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