Associations Between Psychotic Symptoms and Dependence in Activities of Daily Living Among Older Adults With Alzheimer's Disease

Tran, Mun; Bédard, Michel; Molloy, D. William; Dubois, Sacha; Lever, Judith A.

doi:10.1017/s1041610203008858

Cited by 21 publications

(15 citation statements)

References 23 publications

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“…Our AD patients were in a mild stage, but a previous study found a relationship between motor disability and everyday functioning in severely affected AD patients [40]. Consistent with several previous studies [3, 4, 9], behavioral disturbance was the best predictor of physical ADL for patients with AD. This may reflect a lack of motivation (i.e., apathy) or focus (i.e., disinhibition) necessary to carry out a task.…”

Section: Discussionsupporting

confidence: 84%

“…Cognitive decline in AD is often accompanied by behavioral changes such as depression, apathy, agitation or disinhibition [1], and in some combination these factors lead to profound functional decline with a gradual loss of independence in performing usual activities of daily living (ADL)[2]. Although cognitive impairment is usually viewed as the primary determinant of functional decline in AD, several studies have linked behavioral deficits to disability in physical self-maintenance (bathing, toileting, eating) and instrumental (e.g., financial management, shopping) ADL [3, 4] and particularly rapid loss of functional independence [3–9]. In some cases, the relationship between behavioral deficits and ADL decline is independent of cognitive dysfunction [6, 9, 10].…”

Section: Introductionmentioning

confidence: 99%

“…Although cognitive impairment is usually viewed as the primary determinant of functional decline in AD, several studies have linked behavioral deficits to disability in physical self-maintenance (bathing, toileting, eating) and instrumental (e.g., financial management, shopping) ADL [3, 4] and particularly rapid loss of functional independence [3–9]. In some cases, the relationship between behavioral deficits and ADL decline is independent of cognitive dysfunction [6, 9, 10]. …”

Section: Introductionmentioning

confidence: 99%

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Accounting for functional loss in Alzheimer's disease and dementia with Lewy bodies: Beyond cognition

Hamilton

Salmon

Raman

et al. 2013

Alzheimer's & Dementia

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Background The relative contributions of cognitive, motor and behavioral deficits to the impairment of physical or instrumental activities of daily living (ADL) may differ in patients with Dementia with Lewy Bodies (DLB) and Alzheimer’s Disease (AD). Methods Multiple linear regression analyses were used to identify the amount of variability in physical self-maintenance and instrumental ADL ratings predicted by cognitive, motor, and behavioral indices separately for patients with autopsy-diagnosed DLB (n=39) or AD (n=39). Results Motor dysfunction accounted for significant variance in physical ADL in DLB (R2 change=0.17), whereas behavioral (R2 change=0.23) and motor dysfunction (R2 change=0.13) accounted for significant variance in AD. Motor (R2 change=0.32) and cognitive (R2 change=0.10) dysfunction accounted for significant variance in instrumental ADL in DLB, whereas cognitive (R2 change=0.36) and behavioral (R2 change=0.12) dysfunction accounted for significant variance in AD. Conclusion Cognitive, motor, and behavioral deficits contribute differently to ADL changes in DLB and AD. Thus, treatments designed to ameliorate a certain aspect of AD or DLB (e.g., cognitive dysfunction) may have a larger impact on everyday function in one disorder than the other.

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Section: Discussionsupporting

confidence: 84%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Accounting for functional loss in Alzheimer's disease and dementia with Lewy bodies: Beyond cognition

Hamilton

Salmon

Raman

et al. 2013

Alzheimer's & Dementia

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“…Deterioration in these activities is a common complaint of both patients and their families and is usually associated with their distress. As decreases in functional performance may contribute to the patient's overall disability (Tran et al, 2003) and impair personal autonomy, it is important to identify the factors that compromise functional competency.…”

Section: Introductionmentioning

confidence: 99%

Functional competency and cognitive ability in mild Alzheimer's Disease: relationship between ADL assessed by a relative/carer-rated scale and neuropsychological performance

Matsuda

Saito

2005

Int. Psychogeriatr.

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Functional competency and cognitive ability in mild Alzheimer's Disease: relationship between ADL assessed by a relative/ carer-rated scale and neuropsychological performance . ABSTRACTBackground: Alzheimer's disease (AD) is characterized by multiple cognitive deficits and affects functional competency to perform daily activities (ADL). As this may contribute to the patient's overall disability, it is important to identify factors that compromise competency. Objective:The relationship between different cognitive domains and functional activities in AD was studied. Methods:The functional competency of 73 Japanese AD patients, most with mild dementia, was assessed using a 27-item relative/carer-rating scale covering 7 ADL: managing finances, using transportation, taking precautions, self-care, housekeeping, communication and taking medicine. Cognitive assessment used 16 neuropsychological tests from the Japanese version of the WAIS-R and COGNISTAT, covering 9 cognitive domains: orientation, attention, episodic memory, semantic memory, language, visuoperceptual and construction abilities, computational ability, abstract thinking, and psychomotor speed.Results: Multiple regression analysis by the stepwise method indicated that functional competency could, for the most part, be predicted from test scores for orientation, abstract thinking and psychomotor speed. Discussion:The results of this study suggest that impairment of these three cognitive domains plays an important role in the functional deterioration of AD.

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“…However, the relation of the PFDs as assessed by the NPI to the hallmarks of psychogeriatric patients -the cognitive function disorders and the related handicaps in activities of daily living (ADL) -is not obvious [Aalten et al, 2004;Tran et al, 2003]. The same implies to relevant general details such as gender, age, marital status, domicile and type of primary caregiver.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Psychiatric Function Disorders in Psychogeriatric Patients at Referral to Nursing Home Care – the Relation to Cognition, Activities of Daily Living and General Details

Bakker¹,

Duivenvoorden

Lee³

et al. 2005

Dement Geriatr Cogn Disord

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Objectives: This prospective, observation study (from June 2001 to October 2002) estimated the prevalence and co-occurrence of psychiatric function disorders (PFDs) in psychogeriatric patients suffering from cognitive function disorders at referral to clinical as well as non-clinical (transmural) psychogeriatric programmes. It is expected that PFDs, both total and individual, are positively related to the cognitive function disorders as well as the activities of daily living (ADL) handicaps. This expectation will be adjusted for general details particularly gender, age, marital status, domicile and type of primary caregiver. Exploratively, the structure of the interrelationship of PFDs, cognitive function disorders and ADL handicaps will be analysed. In addition, the general details and the structure to be identified will be described. Methods: We studied patients aged ≧ 65 years (n = 487), who were suspected to suffer from cognitive function disorders (MMSE ≤ 29) and were referred to trans-/intramural nursing home care in the Nieuwe Waterweg Noord region. General details, i.e. gender, age, marital status, domicile, primary caregiver, as well as PFDs (the Neuropsychiatric Inventory, NPI), cognition (MMSE) and ADL (Barthel Index, BI) were assessed. Results: Mean score NPI was 3.6 (SD = 2.3). Of the patients, 91.7% scored one or more NPI symptom; 81.6% two or more. Depression (43.9%), apathy (43.1%), anxiety (41.6%) and agitation/agression (31.2%) had a high prevalence. With respect to the NPI symptoms, i.e. delusion, hallucination, anxiety (more in women), agitation/aggression and irritability (more in men), there were significant gender differences on the same MMSE level. Compared with women, men were significantly younger, ADL independent, lived together with their spouse, who was often the primary caregiver. The performance of the logistic regression models for total NPI score with MMSE, BI separately as well as combined with general details was minor. The results of the regression analyses for the individual NPI symptoms showed comparable low R² values; they explained a small proportion of the variance. However, in the PRINCALS analysis the MMSE and BI highly correlated with the cognitive dimension, and the NPI with the psychiatric dimension. The model fit was good; 82.6% of the variance was explained. Conclusion: At the moment of referral to nursing home care, the prevalence and co-occurence of PFDs was high. The four main NPI symptoms were depression, apathy, anxiety and agitation/aggression. On the same level of MMSE score, gender difference was important for 3 NPI symptoms: delusion, hallucination and anxiety. NPI scores (total and per symptom) were relatively independent from MMSE, BI and general details. The PFDs – measured by the NPI – were a dimension on their own. Therefore, in psychogeriatrics it is of clinical relevance to think and act in terms of dimensions. Irrespective of a more rational psychopharmaceutical regime, this opens the door to the regular psychiatric domain for (psycho)the...

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Associations Between Psychotic Symptoms and Dependence in Activities of Daily Living Among Older Adults With Alzheimer's Disease

Cited by 21 publications

References 23 publications

Accounting for functional loss in Alzheimer's disease and dementia with Lewy bodies: Beyond cognition

Accounting for functional loss in Alzheimer's disease and dementia with Lewy bodies: Beyond cognition

Functional competency and cognitive ability in mild Alzheimer's Disease: relationship between ADL assessed by a relative/carer-rated scale and neuropsychological performance

Prevalence of Psychiatric Function Disorders in Psychogeriatric Patients at Referral to Nursing Home Care – the Relation to Cognition, Activities of Daily Living and General Details

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