gms | German Medical Science

Background and current state of (inter)national research: It is well known that people with dementia experience severe problems in their daily lives. Less is known about how self-perceived problems decline throughout the course of dementia together with their decline in memory, language, and executive functions.

Research questions and objectives: Hence, we wanted to assess self-perceived problems when performing daily activities as well as possible developed strategies that help to prevent mentioned difficulties at different cognitive stages for older people.

Methods or hypothesis: To attain our goal, we analyzed qualitative semi-structured interviews conducted with 25 people (age (mean: 67.64; SD: 23.625), sex (f: 14 (56%); m: 17 (68%)), cognitive status (healthy: 6; mild demented: 7; severe demented: 12)) based on the Grounded Theory approach from Glaser and Strauss. The interviews further comprised a cognitive and a functioning assessment, including Montreal Cognitive Assessment (MoCa), Subjective Cognitive Decline and the Lawton Instrumental Activities of Daily Living Scale (IADL), that were used as a base for the qualitative questions concerning self-perceived problems and thereupon developed strategies in daily activities.

Results: Three main categories where identified, (i) disturbing factors when performing daily activities, (ii) variations in the autonomy level and (iii) self-established daily life strategies to circumvent mentioned problems. Findings suggest that orderliness, making notes for appointments, and the usage of a shopping list help with daily activities whereas conversations, noise, and stress disturb the performance of daily activities. People who were aware of problems, reported developing strategies, while people who did not have awareness of any problems did not. Only people without and with mild dementia recognize problems and therefore develop strategies.

Discussion: This study aimed at understanding how self-perceived problems change and get affected with increasing cognitive impairment. It turns out that a certain cognitive status is needed to develop strategies and be aware of problems.

Practical implications: Further research is needed to establish more useful strategies that help dementia sufferers as well as older people to delay the progress or onset of the disease and make their lives longer, more independent and especially more worth living.