An explorative study of the relationship between functional and cognitive decline in older persons with mild cognitive impairment and Alzheimer’s disease

Abstract

Introduction This study explored the relationship between functional decline on three advanced activities of daily living and cognitive decline in elderly persons. The use of everyday technology, driving a vehicle, and performing complex economic activities are advanced activities of daily living domains presumed to be sensitive to early cognitive decline and therefore of interest for the profession of occupational therapy. Method We included 45 persons with mild cognitive impairment, 48 persons with Alzheimer’s disease, and 50 cognitively healthy controls. Functional impairment due to cognitive decline was evaluated by the advanced activities of daily living tool. Cognitive disability indices were computed for the investigated advanced activities of daily living domains and correlated with the Mini Mental State Examination and the Cambridge Examination for Mental Disorders of the Elderly, Cognitive Part. Results The cognitive disability index for performing complex economic activities and the cognitive disability index for the three advanced activities of daily living domains together differed significantly between the three groups. For the whole sample, the advanced activity of daily living cognitive disability indices correlated strongly with the cognitive measures. Within each separate group, few correlations were found. Conclusion This study contributes to the field of knowledge for occupational therapy by emphasizing the value of assessment of advanced activities of daily living in early cognitive decline. For the occupational therapy profession, further research is required in the interaction between functional decline and cognition in early cognitive decline.