Age-Related Changes in Instrumental and Basic Activities of Daily Living Impairment in Older Adults with Very Mild Alzheimer's Disease

Takayuki Tabira; Maki Hotta; Miki Murata; Kazuhiro Yoshiura; Gwanghee Han; Tomohisa Ishikawa; Asuka Koyama; Noriyuki Ogawa; Michio Maruta; Yuriko Ikeda; Takaaki Mori; Taku Yoshida; Mamoru Hashimoto; Manabu Ikeda

doi:10.1159/000506281

Age-Related Changes in Instrumental and Basic Activities of Daily Living Impairment in Older Adults with Very Mild Alzheimer's Disease

Dement Geriatr Cogn Dis Extra. 2020 Mar 24;10(1):27-37. doi: 10.1159/000506281. eCollection 2020 Jan-Apr.

Authors

Affiliations

¹ Department of Clinical Neuropsychiatry, Graduate School of Health Sciences, Kagoshima University, Kagoshima, Japan.
² Department of Psychiatry, Graduate School of Medicine, Osaka University, Osaka, Japan.
³ Department of Occupational Therapy, Kumamoto Seimei Hospital, Kumamoto Seimei, Japan.
⁴ Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
⁵ Department of Neuropsychiatry, Kumamoto University Hospital, Kumamoto, Japan.
⁶ Department of Occupational Therapy, Faculty of Health Sciences, Kyoto Tachibana University, Kyoto, Japan.
⁷ Department of Neuropsychiatry, Molecules and Function, Ehime University Graduate School of Medicine, Ehime, Japan.
⁸ Department of Behavioral Neurology and Neuropsychiatry, Osaka University, Osaka, Japan.

Abstract

Background/aims: Age-related changes in impairments in activities of daily living (ADL) in older adults with very mild Alzheimer's disease (vmAD) have been scarcely explored. We clarified the characteristics of ADL impairment and examined how ADL impairments differed by age in such patients compared with community-dwelling cognitively normal older adults.

Methods: The participants were 107 older adults with vmAD (Mini-Mental State Examination [MMSE] score ≥24), all of whom were first-visit outpatients at the Dementia Clinic of the Department of Neuropsychiatry, Kumamoto University Hospital. The controls were 682 community-dwelling older adults who participated in the 3rd Nakayama Study with MMSE score ≥24. We examined the association of instrumental and basic ADL (IADL and BADL, respectively) independence with the odds of vmAD using multiple logistic regression analysis and determined differences in ADL impairment by age using age- and sex-matched analysis.

Results: Impairments in handling finances (OR 57.08), managing medication (OR 5.13), and dressing (OR 3.35; BADL) were associated with greater odds of vmAD. Among those aged 65 years and above, there were fewer patients with vmAD than healthy controls who could independently handle finances and medication. Among patients with vmAD, the percentages of those who could independently manage shopping, food preparation, and housekeeping only decreased after age 74. Age-related decreases in independence were observed in few BADL items; these, however, were temporary.

Conclusions: Patients with vmAD show significantly decreased IADL independence from early old age.

Keywords: Activities of daily living; Aging; Very mild Alzheimer's disease.