Early cognitively based functional limitations predict loss of independence in instrumental activities of daily living in older adults

Karen M. Lau, Mili Parikh, Danielle J Harvey, Chun Jung Huang, Sarah E Tomaszewski Farias

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Older adults with early forms of neurodegenerative disease are at risk for functional disability, which is often defined by the loss of independence in instrumental activities of daily living (IADLs). The current study investigated the influence of mild changes in everyday functional abilities (referred to as functional limitations) on risk for development of incident functional disability. A total of 407 participants, who were considered cognitively normal or diagnosed with mild cognitive impairment (MCI) at baseline, were followed longitudinally over an average 4.1 years (range=0.8-9.2 years). Informant-based ratings from the Everyday Cognition (ECog; Farias et al., 2008) and the Instrumental Activities of Daily Living (Lawton & Brody, 1969) scales assessed the degree of functional limitations and incident IADL disability, respectively. Cox proportional hazards models revealed that more severe functional limitations (as measured by the Total ECog score) at baseline were associated with approximately a four-fold increased risk of developing IADL disability a few years later. Among the ECog domains, functional limitations in Everyday Planning, Everyday Memory, and Everyday Visuospatial domains were associated with the greatest risk of incident functional disability. These results remained robust even after controlling for participants' neuropsychological functioning on tests of executive functions and episodic memory. Current findings indicate that early functional limitations have prognostic value in identifying older adults at risk for developing functional disability. Findings highlight the importance of developing interventions to support everyday abilities related to memory, executive function, and visuospatial skills in an effort to delay loss of independence in IADLs.

Original languageEnglish (US)
Pages (from-to)688-698
Number of pages11
JournalJournal of the International Neuropsychological Society
Volume21
Issue number9
DOIs
StatePublished - Sep 22 2015

Fingerprint

Activities of Daily Living
disability
Aptitude
Executive Function
incident
Episodic Memory
Proportional Hazards Models
Neurodegenerative Diseases
Cognition
ability
cognition
rating
Disease
planning
Values

Keywords

  • Alzheimer's disease
  • Cognition
  • Dementia
  • Disability
  • Everyday function
  • Instrumental activities of daily living

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Clinical Psychology
  • Neuroscience(all)
  • Language and Linguistics
  • Linguistics and Language

Cite this

@article{1faf38b204d0403eb87abafd24f3607d,
title = "Early cognitively based functional limitations predict loss of independence in instrumental activities of daily living in older adults",
abstract = "Older adults with early forms of neurodegenerative disease are at risk for functional disability, which is often defined by the loss of independence in instrumental activities of daily living (IADLs). The current study investigated the influence of mild changes in everyday functional abilities (referred to as functional limitations) on risk for development of incident functional disability. A total of 407 participants, who were considered cognitively normal or diagnosed with mild cognitive impairment (MCI) at baseline, were followed longitudinally over an average 4.1 years (range=0.8-9.2 years). Informant-based ratings from the Everyday Cognition (ECog; Farias et al., 2008) and the Instrumental Activities of Daily Living (Lawton & Brody, 1969) scales assessed the degree of functional limitations and incident IADL disability, respectively. Cox proportional hazards models revealed that more severe functional limitations (as measured by the Total ECog score) at baseline were associated with approximately a four-fold increased risk of developing IADL disability a few years later. Among the ECog domains, functional limitations in Everyday Planning, Everyday Memory, and Everyday Visuospatial domains were associated with the greatest risk of incident functional disability. These results remained robust even after controlling for participants' neuropsychological functioning on tests of executive functions and episodic memory. Current findings indicate that early functional limitations have prognostic value in identifying older adults at risk for developing functional disability. Findings highlight the importance of developing interventions to support everyday abilities related to memory, executive function, and visuospatial skills in an effort to delay loss of independence in IADLs.",
keywords = "Alzheimer's disease, Cognition, Dementia, Disability, Everyday function, Instrumental activities of daily living",
author = "Lau, {Karen M.} and Mili Parikh and Harvey, {Danielle J} and Huang, {Chun Jung} and {Tomaszewski Farias}, {Sarah E}",
year = "2015",
month = "9",
day = "22",
doi = "10.1017/S1355617715000818",
language = "English (US)",
volume = "21",
pages = "688--698",
journal = "Journal of the International Neuropsychological Society",
issn = "1355-6177",
publisher = "Cambridge University Press",
number = "9",

}

TY - JOUR

T1 - Early cognitively based functional limitations predict loss of independence in instrumental activities of daily living in older adults

AU - Lau, Karen M.

AU - Parikh, Mili

AU - Harvey, Danielle J

AU - Huang, Chun Jung

AU - Tomaszewski Farias, Sarah E

PY - 2015/9/22

Y1 - 2015/9/22

N2 - Older adults with early forms of neurodegenerative disease are at risk for functional disability, which is often defined by the loss of independence in instrumental activities of daily living (IADLs). The current study investigated the influence of mild changes in everyday functional abilities (referred to as functional limitations) on risk for development of incident functional disability. A total of 407 participants, who were considered cognitively normal or diagnosed with mild cognitive impairment (MCI) at baseline, were followed longitudinally over an average 4.1 years (range=0.8-9.2 years). Informant-based ratings from the Everyday Cognition (ECog; Farias et al., 2008) and the Instrumental Activities of Daily Living (Lawton & Brody, 1969) scales assessed the degree of functional limitations and incident IADL disability, respectively. Cox proportional hazards models revealed that more severe functional limitations (as measured by the Total ECog score) at baseline were associated with approximately a four-fold increased risk of developing IADL disability a few years later. Among the ECog domains, functional limitations in Everyday Planning, Everyday Memory, and Everyday Visuospatial domains were associated with the greatest risk of incident functional disability. These results remained robust even after controlling for participants' neuropsychological functioning on tests of executive functions and episodic memory. Current findings indicate that early functional limitations have prognostic value in identifying older adults at risk for developing functional disability. Findings highlight the importance of developing interventions to support everyday abilities related to memory, executive function, and visuospatial skills in an effort to delay loss of independence in IADLs.

AB - Older adults with early forms of neurodegenerative disease are at risk for functional disability, which is often defined by the loss of independence in instrumental activities of daily living (IADLs). The current study investigated the influence of mild changes in everyday functional abilities (referred to as functional limitations) on risk for development of incident functional disability. A total of 407 participants, who were considered cognitively normal or diagnosed with mild cognitive impairment (MCI) at baseline, were followed longitudinally over an average 4.1 years (range=0.8-9.2 years). Informant-based ratings from the Everyday Cognition (ECog; Farias et al., 2008) and the Instrumental Activities of Daily Living (Lawton & Brody, 1969) scales assessed the degree of functional limitations and incident IADL disability, respectively. Cox proportional hazards models revealed that more severe functional limitations (as measured by the Total ECog score) at baseline were associated with approximately a four-fold increased risk of developing IADL disability a few years later. Among the ECog domains, functional limitations in Everyday Planning, Everyday Memory, and Everyday Visuospatial domains were associated with the greatest risk of incident functional disability. These results remained robust even after controlling for participants' neuropsychological functioning on tests of executive functions and episodic memory. Current findings indicate that early functional limitations have prognostic value in identifying older adults at risk for developing functional disability. Findings highlight the importance of developing interventions to support everyday abilities related to memory, executive function, and visuospatial skills in an effort to delay loss of independence in IADLs.

KW - Alzheimer's disease

KW - Cognition

KW - Dementia

KW - Disability

KW - Everyday function

KW - Instrumental activities of daily living

UR - http://www.scopus.com/inward/record.url?scp=84945442198&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84945442198&partnerID=8YFLogxK

U2 - 10.1017/S1355617715000818

DO - 10.1017/S1355617715000818

M3 - Article

C2 - 26391766

AN - SCOPUS:84945442198

VL - 21

SP - 688

EP - 698

JO - Journal of the International Neuropsychological Society

JF - Journal of the International Neuropsychological Society

SN - 1355-6177

IS - 9

ER -