Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-27T07:16:45.005Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  10 September 2019

F. Kalligerou ,
R. Fieo ,
G. P. Paraskevas ,
I. Zalonis ,
M. H. Kosmidis ,
M. Yannakoulia ,
E. Ntanasi ,
E. Dardiotis ,
G. Hadjigeorgiou  and
P. Sakka
...Show all authors
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
*
Correspondence should be addressed to: Nikolaos Scarmeas, M.D., M.Sc., Ph.D., Associate Professor of Neurology, National and Kapodistrian University of Athens, Aiginition Hospital, Leof. Vasilissis Sofias 72, Athens, 115 28, Greece. Phone: +30 2107289310. Email: ns257@columbia.edu.
Get access

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.

Keywords

IADL-extendedcognitionfunction
Type
Original Research Article
Information
International Psychogeriatrics , Volume 32 , Issue 9: Issue Theme: Enhanced Assessment Instruments for Older Adults with Major Neurocognitive Disorders , September 2020 , pp. 1045 - 1053
Copyright
© International Psychogeriatric Association 2019

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Albert, M. S.et al. (2011). The diagnosis of mild cognitive impairment due to Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimer’s & Dementia, 7, 270–279.CrossRefGoogle Scholar
American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Washington, DC: APA.Google Scholar
Amieva, H.et al. (2008). Prodromal Alzheimer’s disease: successive emergence of the clinical symptoms. Annals of Neurology, 64, 492–498.CrossRefGoogle ScholarPubMed
Anastasiou, C. A.et al. (2017). Mediterranean diet and cognitive health: Initial results from the Hellenic Longitudinal Investigation of Ageing and Diet. PLoS One, 12, e0182048.CrossRefGoogle ScholarPubMed
BADL. (1959). MULTIDISCIPLINARY studies of illness in aged persons. II. A new classification of functional status in activities of daily living. Journal of Chronic Diseases, 9, 55–62.CrossRefGoogle Scholar
Benton, A. L. (1994). Neuropsychological assessment. Annual Review of Psychology, 45, 1–23.CrossRefGoogle ScholarPubMed
Blessed, G., Tomlinson, B. E. and Roth, M. (1968). The association between quantitative measures of dementia and of senile change in the cerebral grey matter of elderly subjects. British Journal of Psychiatry, 114, 797–811.CrossRefGoogle ScholarPubMed
Bozikas, V. P., Giazkoulidou, A., Hatzigeorgiadou, M., Karavatos, A. and Kosmidis, M. H. (2008). Do age and education contribute to performance on the clock drawing test? Normative data for the Greek population. Journal of Clinical and Experimental Neuropsychology, 30, 199–203.CrossRefGoogle ScholarPubMed
Buchman, A. S., Boyle, P. A., Wilson, R. S., Fleischman, D. A., Leurgans, S. and Bennett, D. A. (2009). Association between late-life social activity and motor decline in older adults. Archives of Internal Medicine, 169, 1139–1146.CrossRefGoogle ScholarPubMed
Crous-Bou, M., Minguillon, C., Gramunt, N. and Molinuevo, J. L. (2017). Alzheimer’s disease prevention: from risk factors to early intervention. Alzheimer’s Research & Therapy, 9, 71.CrossRefGoogle ScholarPubMed
Dardiotis, E., Kosmidis, M. H., Yannakoulia, M., Hadjigeorgiou, G. M. and Scarmeas, N. (2014). The Hellenic Longitudinal Investigation of Aging and Diet (HELIAD): rationale, study design, and cohort description. Neuroepidemiology, 43, 9–14.CrossRefGoogle ScholarPubMed
Farias, S. T.et al. (2013). Longitudinal trajectories of everyday function by diagnostic status. Psychology and Aging, 28, 1070–1075.CrossRefGoogle ScholarPubMed
Fieo, R. A., Austin, E. J., Starr, J. M. and Deary, I. J. (2011). Calibrating ADL-IADL scales to improve measurement accuracy and to extend the disability construct into the preclinical range: a systematic review. BMC Geriatrics, 11, 42.CrossRefGoogle ScholarPubMed
Fieo, R., Manly, J. J., Schupf, N. and Stern, Y. (2014). Functional status in the young-old: establishing a working prototype of an extended-instrumental activities of daily living scale. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 69, 766–772.CrossRefGoogle ScholarPubMed
Fieo, R. and Stern, Y. (2018). Increasing the sensitivity of functional status assessment in the preclinical range (normal to mild cognitive impairment): exploring the IADL-extended approach. Dementia and Geriatric Cognitive Disorders, 45, 282–289.CrossRefGoogle ScholarPubMed
Fieo, R., Zahodne, L., Tang, M. X., Manly, J. J., Cohen, R. and Stern, Y. (2017). The historical progression from ADL scrutiny to IADL to advanced ADL: assessing functional status in the earliest stages of dementia. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 73, 1695–1700.CrossRefGoogle Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle ScholarPubMed
Fortinsky, R. H., Garcia, R. I., Joseph Sheehan, T., Madigan, E. A. and Tullai-McGuinness, S. (2003). Measuring disability in Medicare home care patients: application of Rasch modeling to the outcome and assessment information set. Medical Care, 41, 601–615.CrossRefGoogle ScholarPubMed
Giaglis, G., Kyriazidou, S., Paraskevopoulou, E., Tascos, N. and Kosmidis, M. (2010). Evaluating premorbid level: preliminary findings regarding the vulnerability of scores on cognitive measures in patients with MS. Journal of the International Neuropsychological Society, 15.Google Scholar
Jack, C. R. Jret al. (2013). Tracking pathophysiological processes in Alzheimer’s disease: an updated hypothetical model of dynamic biomarkers. Lancet Neurology, 12, 207–216.CrossRefGoogle ScholarPubMed
Kosmidis, M. H.et al. (2018). Dementia Prevalence in Greece: The Hellenic Longitudinal Investigation of Aging and Diet (HELIAD). Alzheimer Disease & Associated Disorders, 32, 232–239.CrossRefGoogle Scholar
Kosmidis, M. H., Tsotsi, S., Karambela, O., Takou, E. and Vlahou, C. H. (2010). Cultural factors influencing performance on visuoperceptual neuropsychological tasks. Behavioural Neurology, 23, 245–247.CrossRefGoogle ScholarPubMed
Kosmidis, M. H., Vlahou, C. H., Panagiotaki, P. and Kiosseoglou, G. (2004). The verbal fluency task in the Greek population: normative data, and clustering and switching strategies. Journal of the International Neuropsychological Society, 10, 164–172.CrossRefGoogle ScholarPubMed
LaPlante, M. P. (2010). The classic measure of disability in activities of daily living is biased by age but an expanded IADL/ADL measure is not. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 65, 720–732.CrossRefGoogle ScholarPubMed
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist, 9, 179–186.CrossRefGoogle ScholarPubMed
Lezak, M. D., Howieson, D. B., Loring, D. W. and Fischer, J. S. (2004). Neuropsychological Assessment. New York: Oxford University Press.Google Scholar
Lindbergh, C. A., Dishman, R. K. and Miller, L. S. (2016). Functional disability in mild cognitive impairment: a systematic review and meta-analysis. Neuropsychology Review, 26, 129–159.CrossRefGoogle ScholarPubMed
Luck, T.et al. (2012). Prediction of incident dementia: impact of impairment in instrumental activities of daily living and mild cognitive impairment-results from the German study on ageing, cognition, and dementia in primary care patients. American Journal of Geriatric Psychiatry, 20, 943–954.CrossRefGoogle Scholar
Luck, T., Luppa, M., Angermeyer, M. C., Villringer, A., Konig, H. H. and Riedel-Heller, S. G. (2011). Impact of impairment in instrumental activities of daily living and mild cognitive impairment on time to incident dementia: results of the Leipzig Longitudinal Study of the Aged. Psychological Medicine, 41, 1087–1097.CrossRefGoogle ScholarPubMed
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer’s disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer’s Disease. Neurology, 34, 939–944.CrossRefGoogle ScholarPubMed
Ntanasi, E.et al. (2018). Adherence to Mediterranean Diet and Frailty. Journal of the American Medical Directors Association, 19, 315–322.e312.CrossRefGoogle ScholarPubMed
Peres, K.et al. (2008). Natural history of decline in instrumental activities of daily living performance over the 10 years preceding the clinical diagnosis of dementia: a prospective population-based study. Journal of the American Geriatrics Society, 56, 37–44.Google ScholarPubMed
Petersen, R. C.et al. (2001). Current concepts in mild cognitive impairment. Archives of Neurology, 58, 1985–1992.CrossRefGoogle ScholarPubMed
Prince, M., Bryce, R., Albanese, E., Wimo, A., Ribeiro, W. and Ferri, C. P. (2013). The global prevalence of dementia: a systematic review and metaanalysis. Alzheimer’s and Dementia, 9, 63–75.e62.CrossRefGoogle ScholarPubMed
Puente, A. N., Terry, D. P., Faraco, C. C., Brown, C. L. and Miller, L. S. (2014). Functional impairment in mild cognitive impairment evidenced using performance-based measurement. Journal of Geriatric Psychiatry and Neurology, 27, 253–258.CrossRefGoogle ScholarPubMed
Reppermund, S.et al. (2013). Impairment in instrumental activities of daily living with high cognitive demand is an early marker of mild cognitive impairment: the Sydney memory and ageing study. Psychological Medicine, 43, 2437–2445.CrossRefGoogle ScholarPubMed
Reuben, D. B., Laliberte, L., Hiris, J. and Mor, V. (1990). A hierarchical exercise scale to measure function at the Advanced Activities of Daily Living (AADL) level. Journal of the American Geriatrics Society, 38, 855–861.CrossRefGoogle ScholarPubMed
Scarmeas, N., Levy, G., Tang, M. X., Manly, J. and Stern, Y. (2001). Influence of leisure activity on the incidence of Alzheimer’s disease. Neurology, 57, 2236–2242.CrossRefGoogle ScholarPubMed
Scarmeas, N. and Stern, Y. (2003). Cognitive reserve and lifestyle. Journal of Clinical and Experimental Neuropsychology, 25, 625–633.CrossRefGoogle Scholar
Snyder, P. J.et al. (2014). Assessing cognition and function in Alzheimer’s disease clinical trials: do we have the right tools? Alzheimer’s & Dementia, 10, 853–860.CrossRefGoogle ScholarPubMed
Sperling, R. A.et al. (2011). Toward defining the preclinical stages of Alzheimer’s disease: recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimer’s & Dementia, 7, 280–292.CrossRefGoogle ScholarPubMed
Tsapanou, A.et al. (2017a). Sleep quality and duration in relation to memory in the elderly: initial results from the Hellenic Longitudinal Investigation of Aging and Diet. Neurobiology of Learning and Memory, 141, 217–225.CrossRefGoogle ScholarPubMed
Tsapanou, A.et al. (2017b). Dataset on the associations between sleep quality/duration and cognitive performance in cognitively healthy older adults. Data in Brief, 14, 720–723.CrossRefGoogle ScholarPubMed
Tsapkini, K., Vlahou, C. H. and Potagas, C. (2010). Adaptation and validation of standardized aphasia tests in different languages: lessons from the Boston Diagnostic Aphasia Examination – Short Form in Greek. Behavioural Neurology, 22, 111–119.CrossRefGoogle ScholarPubMed
Vellas, B.et al. (2015). Endpoints for Pre-Dementia AD trials: a report from the EU/US/CTAD Task Force. Journal of Prevention of Alzheimer’s Disease, 2, 128–135.Google ScholarPubMed
Verlinden, V. J. A., van der Geest, J. N., de Bruijn, R., Hofman, A., Koudstaal, P. J. and Ikram, M. A. (2016). Trajectories of decline in cognition and daily functioning in preclinical dementia. Alzheimer’s and Dementia, 12, 144–153.CrossRefGoogle ScholarPubMed
Vlahou, C. and Kosmidis, M. (2002). The Greek Trail Making Test: preliminary normative data for clinical and research use. Psychology: The Journal of the Hellenic Psychological Society, 9, 336–352.Google Scholar
Vlahou, C. H.et al. (2013). Development of the Greek Verbal Learning Test: reliability, construct validity, and normative standards. Archives of Clinical Neuropsychology, 28, 52–64.CrossRefGoogle ScholarPubMed
Wang, H. X.et al. (2013). Late life leisure activities and risk of cognitive decline. Journals of Gerontology Series A: Biomedical Sciences and Medical Sciences, 68, 205–213.CrossRefGoogle ScholarPubMed
Wilms, H. U., Riedel-Heller, S. G. and Angermeyer, M. C. (2007). Limitations in activities of daily living and instrumental activities of daily living capacity in a representative sample: disentangling dementia- and mobility-related effects. Comprehensive Psychiatry, 48, 95–101.CrossRefGoogle Scholar
Yesavage, J. A. (1988). Geriatric depression scale. Psychopharmacology Bulletin, 24, 709–711.Google ScholarPubMed
Supplementary material: File

Kalligerou et al. supplementary material

Kalligerou et al. supplementary material 1

Download Kalligerou et al. supplementary material(File)
File 14.8 KB
Supplementary material: Image

Kalligerou et al. supplementary material

Kalligerou et al. supplementary material 2

Download Kalligerou et al. supplementary material(Image)
Image 29.3 KB
Supplementary material: File

Kalligerou et al. supplementary material

Kalligerou et al. supplementary material 3

Download Kalligerou et al. supplementary material(File)
File 13 KB
Supplementary material: File

Kalligerou et al. supplementary material

Kalligerou et al. supplementary material 4

Download Kalligerou et al. supplementary material(File)
File 29.3 KB