Cognitive predictors of functional impairment in patients with Alzheimer's disease

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Cognitive predictors of functional impairment in patients with Alzheimer's disease


Author: Leung, Sze-nok Frank
Title: Cognitive predictors of functional impairment in patients with Alzheimer's disease
Degree: M.Sc.
Year: 2007
Subject: Hong Kong Polytechnic University -- Dissertations.
Dementia -- Patients -- Health and hygiene.
Cognition in old age -- Testing.
Department: Dept. of Rehabilitation Sciences
Pages: x, 59 leaves ; 30 cm.
Language: English
InnoPac Record:
Abstract: Hong Kong, like many developed countries in the world, is facing the challenge of an ageing population. Coupled with the ageing population, age-related disease such as dementia has also increased substantially. Dementia incur considerable health and social costs for the society. Cognitive deficits are major features of dementia and a number of good cognitive assessment tools were available and widely adopted in different settings. While it is generally believed that cognition deficits are closely linked to functional independence, there are few studies which closely examine the link between the two constructs. The study aims to investigate the association between aspects of cognitive performance, which is measured by Chinese version Mini-mental State Examination(CMMSE) and Chinese version Dementia Rating Scale(CDRS), with functional level, which was measured by Modified Barthel Index(MBI) and Lawton Instrumental Activity of Daily Living (lADLs), in patients with Alzheimer's dementia. It also examined how far specific cognitive function could predict functional level. The study reviewed case files of 78 patients with Alzheimer's dementia who attended dementia day care center in Wong Chuk Hang Hospital from Sept 2003 to Jan 2007. Among the subjects, 24 (30.7%) of them were male and 54 (69.3%) of them were female and the mean age of the subjects was 77.62 years old, (SD = 7.98). In analysis of the relationship between demographic variables and functional abilities, years of education did not have significant correlations with both the MBI and lADLs. Age was negatively and weakly correlated with IADL scores but not with MBI (r = -.277, p= .014). The results also showed that CMMSE, CDRS-total and the CDRS-subscales had significantly correlation with MBI and lADLs. In predicting functional abilities from cognition function, the accuracy of the prediction was high (R2 = .52). The Initiation and Perseveration (I/P) subscale was found to be the most significant predictor of functional abilities among the five CDRS subscales. The results supported that cognitive abilities are important determinants of the functional ADL and IADL tasks and almost all of the cognitive sub-components are related to functional independence. The contribution of this study and dynamic between cognition and functional level would be further discussed. By establishing the relationship between cognitive deficits on functional ability, focus of treatment can be narrowed through systematic assessment. The results of this study could highlight areas for rehab program development (in cognition and functional abilities), resulting in more efficient use of limited health care resources.

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