gms | German Medical Science

51. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V. (gmds)

10. - 14.09.2006, Leipzig

Activities of daily living and cognitive function in the elderly

Meeting Abstract

  • Desiree Debling - Department of Psychology, University of Heidelberg, Germany
  • Manfred Amelang - Department of Psychology, University of Heidelberg, Germany
  • Petra Hasselbach - Department of Psychology, University of Heidelberg, Germany
  • Til Stürmer - Division of Preventive Medicine, Brigham and Women´s Hospital, Harvard Medical School, Boston, USA

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e.V. (gmds). 51. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie. Leipzig, 10.-14.09.2006. Düsseldorf, Köln: German Medical Science; 2006. Doc06gmds116

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/gmds2006/06gmds029.shtml

Veröffentlicht: 1. September 2006

© 2006 Debling et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background

Limitations in activities of daily living (ADL) have been associated with impaired cognitive function [1], [2], [3], but it is unknown which ADLs are most predictive or whether different ADLs can be ordered or grouped according to their association with cognitive function.

Material and Methods

In 2003, 740 participants of an ongoing population-based cohort study, aged 70 years or older were eligible for a telephone interview on cognitive function using the Telephone Interview of Cognitive Status (TICS). Health related ADLs were assessed separately by self-administered questionnaire using the ten questions from the SF36 with decreasing level of performance (e.g. from vigorous activities (such as running, lifting heavy objects, participating in strenuous sports) to bathing or dressing) with the categories “not limited at all”, “limited a little”, to “limited a lot”. We used multivariable logistic regression to estimate adjusted odds ratios (ORs) and their 95% confidence intervals (CI) for any limitation in each ADL compared with not limited and impaired cognitive function (TICS below 25th percentile) controlling for age, sex, education, smoking, alcohol consumption, BMI, depressive symptoms, and comorbidity.

Results

Out of 473 participants interviewed (64.9%), 407 reported any limitation in at least one of the 10 ADLs. There was an association between 4 of the 10 ADLs and impaired cognitive function (adjusted OR for impairment in climbing one flight of stairs: 2.2 (CI: 1.2-4.0), walking more than one km: 1.8 (1.1-3.1), some blocks: 2.6 (1.5-4.5), and one block: 2.7 (1.4-5.2). There was a trend towards an increased prevalence of cognitive impairment with limitations in climbing several flights of stairs: 1.6 (0.9-2.8), and a trend towards an increased prevalence of cognitive impairment with limitations in bending or kneeing: 1.4 (0.8-2.4). There was no association in limitations in vigorous activities: 1.0 (0.5-2.1), or moderate activities: 1.2 (0.7 – 2.0), lifting or carrying groceries: 1.1 (0.7-2.0), or dressing up/taking a bath: 1.3 (0.7-2.6) and impaired cognitive function.

Conclusion

Limitations in health related ADLs requiring a moderate level of physical intensity are associated with a lower cognitive performance in the elderly whereas limitations in ADLs of very high and very low level of physical intensity are not. The cross-sectional nature of the study does not allow assessment of temporal sequence and unmeasured confounding by severity of comorbidity cannot be excluded. The observed ∩-shaped pattern according to intensity of ADL, however, is difficult to explain by reversed causality or unmeasured comorbidity.


References

1.
Dodge HH, Kadowaki T, Hayakawa T, Yamakawa M, Sekikawa A, Ueshima H. Cognitive impairment as a strong predictor of incident disability in specific ADL-IADL tasks among community-dwelling elders: the Azuchi Study. Gerontologist 2005; 45: 222-30.
2.
Steen G, Sonn U, Hanson AB, Steen B. Cognitive function and functional ability. A cross-sectional and longitudinal study at ages 85 and 95 in a non-demented population. Aging Clin Exp Res 2001; 13: 68-77.
3.
Ishizaki J, Meguro K, Ohe K, Kimura E, Tsuchiya E, Ishii H, Sekita Y, Yamadori A. Therapeutic psychosocial intervention for elderly subjects with very mild Alzheimer disease in a community: the tajiri project. Alzheimer Dis Assoc Disord 2002; 16: 261-269.