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Assessing functional status using the IADL-extended scale: results from the HELIAD study

Published online by Cambridge University Press:  10 September 2019

F. Kalligerou
Affiliation:
1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, Greece
R. Fieo
Affiliation:
Center for Cognitive Aging and Memory, Department of Geriatric Research, College of Medicine, University of Florida, Gainesville, FL, USA
G. P. Paraskevas
Affiliation:
1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, Greece
I. Zalonis
Affiliation:
1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, Greece
M. H. Kosmidis
Affiliation:
Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
M. Yannakoulia
Affiliation:
Department of Nutrition and Diatetics, Harokopio University, Athens, Greece
E. Ntanasi
Affiliation:
Department of Nutrition and Diatetics, Harokopio University, Athens, Greece
E. Dardiotis
Affiliation:
School of Medicine, University of Thessaly, Larissa, Greece
G. Hadjigeorgiou
Affiliation:
Department of Neurology, Medical School, University of Cyprus, Cyprus
P. Sakka
Affiliation:
Athens Association of Alzheimer’s Disease and Related Disorders, Athens, Greece
N. Scarmeas
Affiliation:
1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, Greece
Corresponding
E-mail address:

Abstract

Objectives:

Instrumental activities of daily living (IADL) have been operationalized as exhibiting a greater level of complexity than basic ADL. In the same way, incorporating more advanced ADLs may increase the sensitivity of functional measures to identify cognitive changes that may precede IADL impairment. Towards this direction, the IADL-extended scale (IADL-x) consists of four IADL tasks and five advanced ADLs (leisure time activities).

Design:

Retrospective, cross-sectional study.

Setting:

Athens and Larissa, Greece.

Participants:

1,864 community-dwelling men and women aged over 64.

Measurements:

We employed both the IADL-x and IADL scales to assess functional status among all the participants. Diagnoses were assigned dividing the population of our study into three groups: cognitively normal (CN), mild cognitive impairment (MCI) and dementia patients. Neuropsychological evaluation was stratified in five cognitive domains: memory, language, attention-speed, executive functioning and visuospatial perception. Z scores for each cognitive domain as well as a composite z score were constructed. Models were controlled for age, sex, education and depression.

Results:

In both IADL-x and IADL scales dementia patients reported the most functional difficulties and CN participants the fewest, with MCI placed in between. When we restricted the analyses to the CN population, lower IADL-x score was associated with worse cognitive performance. This association was not observed when using the original IADL scale.

Conclusion:

There is strong evidence that the endorsement of more advanced IADLs in functional scales may be useful in detecting cognitive differences within the normal spectrum.

Type
Original Research Article
Copyright
© International Psychogeriatric Association 2019

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