Predictors of Functional Impairment in Residents of Assisted-Living Facilities: The Maryland Assisted Living Study

Abstract

Executive dysfunction, apraxia, memory impairment, depression, and general medical health are all significant predictors of functional impairment in assisted living residents, with executive dysfunction being the strongest. These results may be instrumental in developing a more efficient model of care for residents of assisted living facilities, one based on having accurate predictive models of degree of impairment.

Executive Function and Activities of Daily Living in Alzheimer’s Disease: A Correlational Meta-Analysis

“…One article, although it indicated possible significant associations between an ADL measure and both Category Fluency and the Stroop [29], was excluded as it did not present data and details of correlations could not be obtained. Four studies were excluded as the data presented included data from people without dementia [30,31,32,33]. One study utilised a composite executive function score and individual test scores could not be obtained [34]; however, this article was included in secondary analysis that investigated different methods of assessing ADL.…”

Perceptions and Performance of Function and Physical Activity in Assisted Living Communities

“…5,6,8 AL residents generally have less functional impairment (2 versus 4 impairments) than NH residents, although residents in AL decline over time at a rate that is similar to NH residents. [9][10][11][12] There is also evidence to suggest that most AL residents are inactive and have limited opportunities to engage in physical activity (PA).…”

“…Providing care for (eg, bathing or dressing an individual) as opposed to with (ie, helping the individual to complete as much of his or her own care as possible) older adults in AL may actually facilitate functional decline and a decrease in PA and cause further deconditioning and disability. [14][15][16][17][18][19] Other factors contributing to functional decline and decreased PA in AL residents include impaired cognitive function, depressed mood, poor perceived health status, 5 lack of motivation, 20,21 cultural expectations, 22,23 environmental barriers, [23][24][25] coexisting disease states, 5,26 pain, 27,28 and fear of falling. 29,30 The functional decline that occurs increases the cost of care and need for relocation to a NH setting.…”

Cognitive Predictors of Everyday Functioning in Older Adults: Results From the ACTIVE Cognitive Intervention Trial

“…other health characteristics (Burdick et al, 2005;Christensen et al, 1999;Galanos et al, 1994). Thus, the ability to predict changes in everyday functioning using cognitive tests is an active area of research (Burton, Strauss, Hultsch, & Hunter, 2006;Cahn-Weiner, Boyle, & Malloy, 2002;Jefferson, Paul, Ozonoff, & Cohen, 2006;Royall et al, 2007;Willis, 1996).…”

“…Global mental status is a strong predictor of everyday functioning (Burdick et al, 2005;Burton et al, 2006). In a critical review of existing research, Royall and colleagues (2007) reported that global measures of cognitive status explain on average 11.8% of the variance in measures of everyday functioning.…”