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Deconstructing the performance of everyday activities: a case in dementia

Published online by Cambridge University Press:  08 February 2017

Clarissa M. Giebel*
Affiliation:
School of Health Sciences, University of East Anglia, Norwich, UK Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK
Daniela Montaldi
Affiliation:
Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK
*
Correspondence should be addressed to: Clarissa Giebel, Queen's Building, School of Health Sciences, University of East Anglia, NR4 7TJ, Norwich, UK. Phone: +44 1603 593259. Email: [email protected].
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Abstract

Background:

The assessment of everyday functioning in dementia is currently very global and in most cases fails to provide an in-depth overview of specific areas of deficits. Every activity comprises different sub-tasks which may be impaired to different degrees. Performance of some sub-tasks might be maintained and could thus be the foundation for remaining independent for longer. Thus, the objective of this study was to explore the benefits of breaking down everyday activities into sub-tasks.

Methods:

A total of 183 family carers of people with mild dementia completed the revised Interview for Deteriorations in Daily Living Activities in Dementia 2 (R-IDDD2) rating their relative's everyday functioning. Each of the 20 activities comprised three sub-tasks. Data were analyzed using ANOVA with Bonferroni corrections, and sub-tasks were clustered in relation to different forms of cognition.

Results:

The majority of activities showed at least one major area of impairment. Sub-tasks could be clustered based on different types of cognition. Several sub-tasks had a focus on memory (forgetting it is time to do the cleaning; forgetting previously known telephone numbers), whereby short-term, long-term, and prospective memory could be distinguished further. Other sub-tasks were clustered into attention (getting more distracted when driving) and executive function (sorting out bills).

Conclusions:

The R-IDDD2 and its analysis of sub-task performance offers a novel platform to examine impairments comprehensively. This can help both in aiding timelier diagnosis by recognizing subtle deficits, but also in care management planning, whereby family and paid carers should only care for those sub-tasks that are most impaired and thus encourage remaining independent for longer.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2017 

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References

Bahar-Fuchs, A., Clare, L. and Woods, B. (2013). Cognitive training and cognitive rehabilitation for persons with mild to moderate dementia of the Alzheimer's or vascular type: a review. Alzheimer's Research & Therapy, 5, 3548.CrossRefGoogle ScholarPubMed
Bier, N., Bottari, C., Hudon, C., Joubert, S., Paquette, G. and Macoir, J. (2013). The impact of semantic dementia on everyday actions: evidence from an ecological study. Journal of the International Neuropsychological Society, 19, 162172.Google Scholar
Chiong, W., Hsu, M., Wudka, D., Miller, B. L. and Rosen, H. J. (2014). Financial errors in dementia: testing a neuroeconomic conceptual framework. Neurocase, 20, 389396.CrossRefGoogle ScholarPubMed
Cipriani, G., Bianchetti, A. and Trabucchi, M. (2006). Outcomes of a computer-based cognitive rehabilitation program on Alzheimer's disease patients compared with those on patients affected by mild cognitive impairment. Archives of Gerontology and Geriatrics, 43, 327335.Google Scholar
Earnst, K.S. et al. (2001). Loss of financial capacity in Alzheimer's disease: the role of working memory. Aging, Neuropsychology, and Cognition, 8, 109119.Google Scholar
Folstein, M., Folstein, S., McHugh, P. (1975). “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189198.Google Scholar
Gelinas, I., Gauthier, L., McIntyre, M. and Gauthier, S. (1999). Development of a functional measure for persons with Alzheimer's disease: the disability assessment for dementia. American Journal of Occupational Therapy, 53, 471481.Google Scholar
Giebel, C. M., Callis, D. and Montaldi, D. (2015). Understanding the cognitive underpinnings of functional impairments in early dementia: a review. Aging & Mental Health, 19, 859875.Google Scholar
Giebel, C. M., Challis, D. and Montaldi, D. (2016a). A revised Interview for deterioration in daily living activities in dementia reveals the relationship between social activities and well-being. Dementia, 15, 10681081.Google Scholar
Giebel, C., Challis, D. and Montaldi, D. (2016b). The newly revised Interview for deteriorations in daily living activities in Dementia (R-IDDD2): distinguishing initiative from performance at assessment. International Psychogeriatrics, doi: 10.1017/S1041610216002003.Google Scholar
Giovannetti, T., Schmidt, K. S., Gallo, J. L., Sestito, N. and Libon, D. J. (2006). Everyday action in dementia: evidence for differential deficits in Alzheimer's disease versus subcortical vascular dementia. Journal of the Neuropsychological Society, 12, 4563.Google Scholar
Giovannetti, T., Seligman, S. C., Britnell, P., Brennan, L. and Libon, D. J. (2015). Differential effects of goal cues on everyday action errors in Alzheimer's disease versus Parkinson's disease dementia. Neuropsychology, 29, 592602.Google Scholar
Griffith, H. R. et al. (2003). Impaired financial abilities in mild cognitive impairment: a direct assessment approach. Neurology, 60, 449457.Google Scholar
Hsieh, S., Schubert, S., Hoon, C., Mioshi, E. and Hodges, J. R. (2013). Validation of the Addenbrooke's Cognitive Examination III in frontotemporal dementia and Alzheimer's disease. Dementia and Geriatric Cognitive Disorders, 36, 242250.CrossRefGoogle ScholarPubMed
Lawton, M. P. and Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist, 9, 179186.Google Scholar
Levine, B. et al. (2000). Rehabilitation of executive functioning: an experimental-clinical validation of goal management training. Journal of the International Neuropsychological Society, 6, 299312.Google Scholar
Marson, D. (2016). Conceptual models and guidelines for clinical assessment of financial capacity. Archives of Clinical Neuropsychology, doi: 10.1093/arclin/acw052.Google Scholar
Marson, D. C. et al. (2000). Assessing financial capacity in patients with Alzheimer's disease: a conceptual model and prototype instrument. Archives of Neurology, 57, 877884.CrossRefGoogle ScholarPubMed
Martyr, A. and Clare, L. (2012). Executive function and activities of daily living in Alzheimer's disease: a correlational meta-analysis. Dementia and Geriatric Cognitive Disorders, 33, 189203.Google Scholar
McAlister, C. and Schmitter-Edgecombe, M. (2016). Everyday functioning and cognitive correlates in healthy older adults with subjective cognitive concerns. The Clinical Neuropsychologist, doi: 10.1080/13854046.2016.1190404.Google Scholar
Mioshi, E., Kipps, C. M., Dawson, K., Mitchell, J., Graham, A. and Hodges, J. R. (2007). Activities of daily living in frontotemporal dementia and Alzheimer disease. Neurology, 68, 20772084.Google Scholar
Monaci, L. and Morris, R. G. (2012). Neuropsychological screening performance and the association with activities of daily living and instrumental activities of daily living in dementia: baseline and 18- to 24-month follow-up. International Journal of Geriatric Psychiatry, 27, 197204.Google Scholar
Munro, C. A. et al. (2010). Predictors of lane-change errors in older drivers. Journal of the American Geriatrics Society, 58, 457464.Google Scholar
Nagaratnam, N., Nagaratnam, K. and O'Mara, D. (2013). Bayer activities of daily living scale in mild and moderate dementia of the Alzheimer type. American Journal of Alzheimer's Disease and Other Dementias, 28, 784789.CrossRefGoogle ScholarPubMed
Nasreddine, Z. S. (2005). The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53, 695699.CrossRefGoogle Scholar
O'Connor, C. M. et al. (2016). Longitudinal change in everyday function and behavioral symptoms in frontotemporal dementia. Neurology Clinical Practice, doi: 10.1212/CPJ.0000000000000264.Google Scholar
Patterson, M. B., Mack, J. L., Neundorfer, M. M., Martin, R. J., Smyth, K. A. and Whitehouse, P. J. (1992). Assessment of functional ability in Alzheimer disease: a review and a preliminary report on the cleveland scale for activities of daily living. Alzheimer Disease and Associated Disorders, 6, 145–63.Google Scholar
Pocnet, C., Rossier, J., Antonietti, J.-P. and von Gunten, A. (2013). Personality features and cognitive level in patients at an early stage of Alzheimer's disease. Personality and Individual Differences, 54, 174179.CrossRefGoogle Scholar
Razani, J., Cassas, R., Wong, J. T., Lu, P., Alessi, C. and Josephson, K. (2007). Relationship between executive functioning and activities of daily living in patients with relatively mild Dementia. Applied Neuropsychology, 14, 208214.Google Scholar
Schmitter-Edgecombe, M. and Parsey, C. M. (2014). Cognitive correlates of functional abilities in individuals with mild cognitive impairment: comparison of questionnaire, direct observation, and performance-based measures. The Clinical Neuropsychologist, 28, 726746.Google Scholar
Schmitter-Edgecombe, M., Woo, E. and Greeley, D. R. (2009). Characterizing multiple memory deficits and their relation to everyday functioning in individuals with mild cognitive impairment. Neuropsychology, 23, 168177.Google Scholar
Schwartz, M. F., Buxbaum, L. J., Ferraro, M., Veramonti, T. and Segal, M. (2003). The Naturalistic Action Test. Bury St. Edmunds: Thames Valley Test Company.Google Scholar
Shankle, W. R. et al. (2013). Relating memory to functional performance in normal aging to Dementia using hierarchical bayesian cognitive processing models. Alzheimer Disease and Associated Disorders, 27, 1622.CrossRefGoogle ScholarPubMed
Sikkes, S. A. M. et al. (2011). Do instrumental activities of daily living predict dementia at 1- and 2-year follow-up? Findings from the development of screening guidelines and diagnostic criteria for predementia Alzheimer's disease study. Journal of the American Geriatrics Society, 59, 22732281.CrossRefGoogle ScholarPubMed
Teunisse, S., Derix, M. M. A. and van Crevel, H. (1991). Assessing the severity of dementia. Archives of Neurology, 48, 274277.Google Scholar
van Steenoven, I. et al. (2014). Conversion between mini-mental state examination, montreal cognitive assessment, and Dementia rating scale-2 scores in Parkinson's disease. Movement Disorders, 29, 18091815.Google Scholar
Vermeersch, S., Gorus, E., Cornelis, S. and De Vriendt, P. (2015). An explorative study of the relationship between functional and cognitive decline in older persons with mild cognitive impairment and Alzheimer's disease. British Journal of Occupational Therapy, 78, 166174.Google Scholar
Yamin, S., Stinchcombe, A. and Gagnon, S. (2016). Deficits in attention and visual processing but not global cognition predict simulated driving errors in drivers diagnosed with mild Alzheimer's disease. American Journal of Alzheimer's Disease & Other Dementias, 31, 351360.Google Scholar
Zanetti, O., Geroldi, C., Frisoni, G. B., Bianchetti, A. and Trabucchi, M. (1999). Contrasting results between caregiver's report and direct assessment of activities of daily living in patients affected by mild and very mild Dementia: the contribution of the caregiver's personal characteristics. Journal of the American Geriatrics Society, 47, 196202.Google Scholar