Evaluation of the activities of daily living of elderly people with different levels of dementia (original) (raw)
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International Psychogeriatrics, 2012
ABSTRACTBackground: Studies on functional capacity in community-dwelling older people have shown associations between declines in instrumental activities of daily living (IADL) and several factors. Among these, age has been the most consistently related to functional capacity independent of other variables. We aimed at evaluating the performance of a sample of healthy and cognitively intact Brazilian older people on activities of daily living and to analyze its relation to social-demographic variables.Methods: We conducted a secondary analysis of data collected for previous epidemiological studies with community-dwelling subjects aged 60 years or more. We selected subjects who did not have dementia or depression, and with no history of neurological diseases, heart attack, HIV, hepatitis or arthritis (n = 1,111). Functional capacity was assessed using the Brazilian version of the Older American Resources and Services Questionnaire (BOMFAQ). ADL performance was analyzed according to a...
Avaliação das atividades de vida diária de idosos com diferentes níveis de demência
Revista Brasileira de …, 2007
Objective: To compare the performance of elderly people with different levels of severity of dementia using questionnaires on basic activities of daily living (BADLs) and instrumental activities of daily living (IADLs). Also, to verify whether there were any association between the IADL questionnaires applied. Method: Ninety elderly people, aged 75.46 ± 7.66 years with a clinical diagnosis of dementia (DSM-IV/APA) who were seen at the Minas Gerais Reference Center for the Elderly, were randomized selected and classified according to the level of severity of their dementia (Clinical Dementia Rating). Their BADLs were assessed using the Katz Index and their IADLs by the Lawton-Brody and Pfeffer indexes. The Kruskal-Wallis and Mann-Whitney tests were used in order to investigate the elderly people's performance regarding BADLs, while the Spearman correlation was used to investigate the relationships among the IADL (α< 0.05). Results: Statistically significant differences in performance were found between the elderly people with different levels of severity of dementia, as assessed by the BADL and IADL questionnaires (p< 0.001). The IADL questionnaires presented significant correlation for the total sample (p< 0.0001; r =-0.818) as well as for the groups with mild dementia (p= 0.007; r =-0.530) and severe dementia (p< 0.0001; r =-0.723). Conclusion: The severity of the dementia process interfered with the elderly people's performance of the elderly in BADLs and IADLs. The IADLs were more affected in the early stages of dementia whereas the BADLs were more affected in the more advanced stages. Despite structural particularities, the IADL questionnaires utilized seemed to be measuring a common construct. The variability in the clinical condition of the individuals with moderate dementia may be an explanation for the lack of correlation between the questionnaires in this specific group.
Revista Brasileira de Psiquiatria, 2014
Objective: To propose and evaluate the psychometric properties of a multidimensional measure of activities of daily living (ADLs) based on the Katz and Lawton indices for Alzheimer's disease (AD) and mild cognitive impairment (MCI). Methods: In this study, 85 patients with MCI and 93 with AD, stratified by age (f 74 years, . 74 years), completed the Mini Mental State Examination (MMSE) and the Geriatric Depression Scale, and their caregivers completed scales for ADLs. Construct validity (factor analysis), reliability (internal consistency), and criterion-related validity (receiver operating characteristic analysis and logistic regression) were assessed. Results: Three factors of ADL (self-care, domestic activities, and complex activities) were identified and used for item reorganization and for the creation of a new inventory, called the General Activities of Daily Living Scale (GADL). The components showed good internal consistency (. 0.800) and moderate (younger participants) or high (older participants) accuracy for the distinction between MCI and AD. An additive effect was found between the GADL complex ADLs and global ADLs with the MMSE for the correct classification of younger patients. Conclusion: The GADL showed evidence of validity and reliability for the Brazilian elderly population. It may also play an important role in the differential diagnosis of MCI and AD.
DOAJ (DOAJ: Directory of Open Access Journals), 2013
Objective: To evaluate the elderly persons' functionality, based on the International Classification of Functionality. Methods: a cross-sectional, descriptive study; a stratified random sample of 903 elderly persons; a confidence level of 95%; and a margin of error of 2.5%. Questionnaire based on the International Classification of Functionality; data was collected based on structured interviews undertaken by health professionals in the health centers in the Alentejo region of Portugal. Results: 30.7% of the elderly persons stated that they were illiterate, and 22.9% lived alone. Feeding/dietary (18.7%), housing (19.2%) and health needs (26.0%) were not met. Orientation functions were maintained in 83.4%; 58% of the elderly persons referred to pain so intense that it required care; 73.3% of the elderly persons did not have functional dentition. Levels of performance were superior to 80% in the participation activities: washing oneself (82.6%), toileting (92.2%), dressing, eating, and drinking (89%). Conclusion: although a progressive decline in functionality is observed as age advances, the majority of dimensions are preserved until around 75 years of age.
2011
A review of the evidence on cognitive, functional and behavioral assessment for the diagnosis of dementia due to Alzheimer's disease (AD) is presented with revision and broadening of the recommendations on the use of tests and batteries in Brazil for the diagnosis of dementia due to AD. A systematic review of the literature (MEDLINE, LILACS and SCIELO database) was carried out by a panel of experts. Studies on the validation and/or adaptation of tests, scales and batteries for the Brazilian population were analyzed and classified according to level of evidence. There were sufficient data to recommend the IQCODE, DAFS-R, DAD, ADL-Q and Bayer scale for the evaluation of instrumental activities of daily living, and the Katz scale for the assessment of basic activities of daily living. For the evaluation of neuropsychiatric symptoms, the Neuropsychiatric Inventory (NPI) and the CAMDEX were found to be useful, as was the Cornell scale for depression in dementia. The Mini-Mental State Examination has clinical utility as a screening test, as do the multifunctional batteries (CAMCOG-R, ADAS-COG, CERAD and MDRS) for brief evaluations of several cognitive domains. There was sufficient evidence to recommend the CDR scale for clinical and severity assessment of dementia. Tests for Brazilian Portuguese are recommended by cognitive domain based on available data.
Arquivos De Neuro-psiquiatria, 2010
Objective: To assess the functional capacity and to determine the difference between the means of functional capacity (basic and instrumental activities of daily living) and the age groups of elderly residents in an outlying area in the hinterland of Bahia/Northeast of Brazil. Method: Analytical study with cross-sectional design and a sample of 150 elderly individuals enrolled in four Health Units in the municipality of Jequié, Bahia, Brazil. The instrument consisted of sociodemographic and health data, the Barthel Index and the Lawton scale. Results: In all, 78.00% of the elderly were classified as dependent in the basic activities and 65.33% in the instrumental activities of daily living. Using the Kruskal-Wallis test, we found a statistically significant difference between the means of instrumental activities and the age groups (p=0.011). Conclusion: An elevated number of elderly were classified as dependent in terms of functional capacity and increased age is related to greater impairment in the execution of instrumental activities of daily living.
Acta Fisiátrica, 2022
To evaluate dementia staging, physical-functional performance, and their possible correlations of elderlies with Alzheimer's Disease, assisted by a referral center. Method: Quantitative cross-sectional study of elderlies of both sexes, aged 60 years or older, with a clinical diagnosis of Alzheimer's Disease. The participants were evaluated with the Timed Up and Go Test (TUG), Rikli & Jones Sit and stand Test, Berg Balance Scale, and the Clinical Dementia Rating Score (CDR). Statistical analysis classified and compared groups of frail and non-frail participants with unpaired tests. The significance level was 0.05. Results: 46 participants of both sexes with a mean age of 78.72±7.37 years. Subjects were divided into frail and non-frail elderly. Older people were classified into questionable to mild dementia and moderate to severe dementia and matched. There was a significant correlation between age and TUG (r= 0.532; p= 0.041), age and Berg (r=-0.343; p= 0.040), TUG and Berg (r=-0.562; p= 0.029), and sit-stand test and Berg (r= 0.706; p= 0.003). Conclusion: Lower performance compared to the specialized literature for the assessment instruments proposed in this research was found, indicating that AD progression was directly related to their performance in physical-functional tests.
Revista Brasileira de Psiquiatria, 2007
The Bayer -Activities of Daily Living Scale (B-ADL) in the differentiation between mild to moderate dementia and normal aging A escala da Bayer -Atividades da Vida Diária (B-AVD) na diferenciação entre demência leve e moderada e o envelhecimento normal A b s t r a c t Objectives: To investigate the applicability of the Bayer -Activities of Daily Living scale and its efficiency in differentiating individuals with mild to moderate dementia from normal elderly controls. Method: We selected 33 patients with diagnosis of mild to severe dementia, according to ICD-10 criteria, and 59 controls. All the subjects were evaluated with the Mini-Mental State Examination and the Clinical Dementia Rating Scale and the Bayer -Activities of Daily Living scale was applied to informants. Results: The internal consistency of the Bayer -Activities of Daily Living was high (Cronbach's alpha = 0.981). Mean Mini-Mental State Examination and Bayer -Activities of Daily Living scores of demented patients and controls were significantly different (p < 0.001). Mean Mini-Mental State Examination and Bayer -Activities of Daily Living scores were significantly different between Clinical Dementia Rating Scale 0 (controls; n = 59) versus Clinical Dementia Rating Scale 1 (mild dementia; n = 15), Clinical Dementia Rating Scale 0 versus Clinical Dementia Rating Scale 2 (moderate dementia; n = 13), and for Clinical Dementia Rating Scale 1 versus Clinical Dementia Rating Scale 2 (p < 0.003). Discussion: The Bayer -Activities of Daily Living scale and Mini-Mental State Examination differentiated elderly controls from patients with mild or moderate dementia, and patients with mild dementia from those with moderate dementia. Conclusions: The results suggest that the Bayer -Activities of Daily Living scale applied to an informant can help in the diagnosis and follow-up of Brazilian patients with mild to moderate dementia. Descriptors: Dementia; Diagnosis; Activities of daily living; MMSE; Ageing Resumo Objetivos: Investigar a aplicabilidade da escala Bayer -Atividades de Vida Diária e sua eficiência em diferenciar indivíduos com demência leve a moderada de indivíduos normais. Método: Foram selecionados 33 pacientes com diagnóstico de demência leve a grave, de acordo com os critérios da CID-10, e 59 controles. Todos os indivíduos foram avaliados pelo Mini-Exame do Estado Mental e pela Escala de Avaliação Clínica de Demência e os informantes responderam à Bayer -Atividades de Vida Diária. Resultados: A consistência interna da Bayer -Atividades de Vida Diária foi alta (Cronbach Alpha = 0,981). A pontuação média do Mini-Exame do Estado Mental e da Bayer -Atividades de Vida Diária foi significativamente diferente entre os pacientes com demência e o grupo controle (p < 0,001). Os valores do Mini-Exame do Estado Mental e da Bayer -Atividades de Vida Diária foram significativamente diferentes entre a Escala de Avaliação Clínica de Demência 0 (controles; n = 59) e a Escala de Avaliação Clínica de Demência 1 (demência leve; n = 15), a Escala de Avaliação Clínica de Demência 0 e a Escala de Avaliação Clínica de Demência 2 (demência moderada; n = 13) e entre a Escala de Avaliação Clínica de Demência 1 e a Escala de Avaliação Clínica de Demência 2 (p < 0,003). Discussão: A Bayer -Atividades de Vida Diária e o Mini-Exame do Estado Mental diferenciaram controles idosos de pacientes com demência leve ou moderada, e pacientes com demência leve daqueles com demência moderada. Conclusões: Os resultados sugerem que a Bayer -Atividades de Vida Diária, aplicada aos cuidadores, é um instrumento que pode ajudar no diagnóstico e seguimento de pacientes brasileiros com demência leve a moderada.