Patterns of instrumental activities of daily living between community-dwelling older adults

Abstract

The ability to perform instrumental activities of daily living (IADLs) is an important marker within the aging process, as it reflects the level of independence to perform in the real world. However, there is a scarcity of studies that investigate the different performance profiles among older adults. Objective: To investigate the heterogeneity present in the community of elderly people, grouping them based on characteristics and patterns observed through an objective performance-based assessment. Methods: Participants were selected according to the following inclusion criteria: fluency in Portuguese, 360 years, regular participation in a social program offered by the government of Rio de Janeiro, and absence of a caregiver. The evaluation of IADLs was determined by the total and brief version of the University of California, San Diego Performance-Based Skills Assessment (UPSA) and the Lawton and Brody IADL scale. The Brief Cognitive Screening Battery and the Mini-Mental State Examination were used to characterize the sample, in addition to the Geriatric Depression Scale. A total of 61 elderly people with an average age of 72.5 years, predominantly females (85.2%), and average education of 11.2 were evaluated and grouped according to their performance at UPSA through clustering analysis. Results: The analysis revealed three grouping patterns, subdividing the sample into subgroups that differed significantly in terms of age, education, global cognition, and all instrumental activities assessed by UPSA — planning, finance, communication, transportation, and household chores. Conclusions: This study was able to identify the heterogeneity present between the elderly people in the different factors that compose the IADLs through a performance-based assessment.

Prediction and mediation analysis for treatment responses to combined cognitive and physical training for older adults

“…Since age-related deterioration in cognition that may impede functional independence is a primary concern, combined cognitive and physical training is intended to enhance cognition in older adults based on the guided plasticity facilitation framework 37 . Previous studies have demonstrated that combined training improves the global cognition of older adults 38 – 42 , and that global cognition and IADL performance show a strong association 30 – 32 . However, given global cognition as a collection of cognitive capacities, it remains unclear how global cognition may improve IADL performance following combined training.…”

“…Existing evidence has shown that multi-dimensional cognitive abilities are associated with IADL in older adults 15 – 23 ; these abilities include processing speed (the ability to process information rapidly) 24 , sustained attention (the ability to maintain vigilance on a particular task over an extended period) 25 , 26 , verbal memory (the ability to store and recall phonological information) 27 , and executive functions (a collection of top-down mental control processes, including inhibition, working memory, and cognitive flexibility) 28 . Similarly, global cognition, referring to a family of cognitive capacities, including orientation, attention, memory, language, and executive function 29 is related to functional independence 30 – 32 . On the other hand, previous studies show that functional mobility, referring to the ability to independently and safely move across environments to engage in functional activities 33 , 34 , is related to IADL performance in older adults 13 , 35 , 36 .…”