The relationship between basic, instrumental, and advanced activities of daily living and executive functioning in geriatric patients with neurocognitive disorders

Abstract

Objective: Although many studies explored the relationship between executive functions (EF) and activities of daily living (ADLs) in cognitive disorders, previous studies used measurements without well-defined levels of ADLs. This study explored the relationship between EF and the threefold classification of everyday functioning (basic or b-, instrumental or i-, and advanced or a-ADLs) and examined how EF account for the variance in this triad of everyday functioning. Methods:A sample of 44 cognitively healthy persons, 41 persons with mild cognitive impairment, and 35 persons with Alzheimer disease were assessed with comprehensive measures of EF and the b-, i-, and a-ADL tools. Results: Correlations demonstrated that subjects with higher executive dysfunctions have more limitations in b-, i-, and a-ADLs. The highest significant correlations with measures of EF were seen in i-and a-ADLs (ranging from r = −0.193 to r = −0.559, P < 0.05). However, correlations with a-ADLs were not stronger than with i-ADLs. The multivariate analyses revealed Trail Making Test A (TMT-A) as a significant contributor of everyday functioning in b-ADLs, as well as i-and a-ADLs, and Clock Drawing Test (CDT) and Animal Fluency Test (AFT) seemed to contribute significantly to variance in i-and a-ADLs. Conclusions: EF are less related to b-ADLs than i-and a-ADLs and contribute to the same amount of variance to limitations in both i-and a-ADLs. This study recommends using the TMT-A, CDT, and AFT as screening tools to indicate the need for profound evaluation of ADLs in older persons with neurocognitive disorders.

Identification of a Cascade of Changes in Activities of Daily Living Preceding Short-Term Clinical Deterioration in Mild Alzheimer’s Disease Dementia via Lead-Lag Analysis

“…Previous stepwise logistic models with mild AD patients showed that the TMT-A was able to best discriminate faster from slower progressors, with an overall accuracy of 68% [21]. Furthermore, multivariate analyses with cognitively healthy, MCI, and AD individuals revealed the TMT-A to be a significant predictor of daily functioning [38]. In the present study, the MMSE score was observed to change early in short-term, marked disease progression.…”

The role of physical and cognitive function in performance of activities of daily living in patients with mild-to-moderate Alzheimer’s disease – a cross-sectional study

“…As peviously stated, the findings may indicate that those complex activities comprising IADL are most reliant on cognition. Supporting this finding, IADL has been found to be more strongly associated with executive function than BADL in patients with mild-to-moderate AD [21,62]. Moreover, in older adults without dementia deterioration in executive function is independently correlated with the rate of change in IADL, and may be more deleterious, even in the presence of memory deficits [41].…”

How Well Does the Brief Interview for Mental Status Identify Risk for Cognition Mediated Functional Impairment in a Community Sample?

“…The Mini-Cog is the most similar to the BIMS in that it uses 3-word registration and recall, but it differs from the BIMS in using clock drawing, a measure considered sensitive to executive functioning, instead of an assessment of orientation. 47 , 48 As previously noted, the BIMS assesses memory and orientation, but does not include items sensitive to impaired executive functions 13 , 14 that are considered critical to IADL and community independence. 1 The Menu Task was designed to be a performance-based measure of functional cognition in which an individual has to complete a simulated menu while following rules.…”