Neuropsychological screening performance and the association with activities of daily living and instrumental activities of daily living in dementia: baseline and 18‐ to 24‐month follow‐up

Abstract

Objective: The use of neuropsychological assessment beyond diagnosis is related partly to the extent to which it can indicate everyday function. This study investigates whether the associations between neuropsychological functioning, activities of daily living (ADL) and instrumental activities of daily living (IADL) change over an 18-to 24-month follow-up, exploring whether these change with dementia progression.Method: Thirty-four patients with probable Alzheimer's disease were assessed at baseline and again after between 18 and 24 months. Neuropsychological function was assessed using the revised Cambridge Cognitive Examination, which includes in it the Mini mental state examination and an executive functions scale. ADL and IADL were also measured, together with background neuropsychiatric features by using the Neuropsychiatric Inventory.Results: Pearson correlations between the measures of daily functioning and cognitive abilities and neuropsychiatric symptoms showed that initially neuropsychological test results tended to correlate with IADL rather than ADL measures. Neuropsychiatric symptoms were not correlated whether IADL or ADL. At follow-up, none of the neuropsychological function measures correlated with IADL or ADL, but neuropsychiatric symptoms were correlated with IADL.Conclusions: At baseline, neuropsychological function is associated with IADL but not ADL. At followup, the association between neuropsychological function and IADL diminishes, and associations between neuropsychiatric disturbances and IADL emerge.

Alterações motoras e funcionais em diferentes estágios da doença de Alzheimer

“…Another study with a sample of 34 AD patients who were evaluated at baseline, 18 months, and 24 months later has found a strong relationship between cognition and IADL in the initial stages of AD. Such association becomes weaker as the disease progresses, increasing the association with psychiatric symptoms 27 .…”

Correlation and adaptation among functional and cognitive instruments for staging and monitoring Alzheimer?s disease in advanced stages

“…Another study, using a refined and elegant prospective design, compared cognitive, behavioral and functional findings in the initial evaluation and after 24 months 20 . In this case, after compared correlations and linear regressions, authors concluded that during follow-up a positive association between cognitive abilities and instrumental activities tended to decrease, while direct relationship between instrumental impact and neuropsychiatric disorders increases.…”

Alzheimer’s Patient Activity Assessment Using Different Sensors

“…IADLs are preferred to ADLs, as IADLs have been recently addressed as better indicators of emerging neuropsychiatric symptoms 5 . ADLs generally refer to basic activities of personal self-care (e.g., eating, dressing, washing), while IADLs are associated with more complex tasks, e.g., using the telephone, shopping groceries, organizing medications, and managing personal finances.…”

“…IADLs seem to be affected earlier than ADLs for early stage Alzheimer patients. We postulate that comparing data from several sensors could provide new (or at least complementary) quantitative evidence about changes in a patient's activities profile 5 . The clinical protocol' activities were specifically chosen according to their possibility of being realistically achieved into the observation room of the hospital and at the same time provide objective information about dementia symptoms.…”