Role of behavioural disturbance in the loss of autonomy for activities of daily living in Alzheimer patients

• Published in: International journal of geriatric psychiatry Vol. 18; no. 11; pp. 977 - 982
• Main Authors: Lechowski, L., Dieudonné, B., Tortrat, D., Teillet, L., Robert, P. H., Benoit, M., Forette, B., Vellas, B.
• Format: Journal Article
• Language: English
• Published: Chichester, UK John Wiley & Sons, Ltd 01.11.2003; Wiley
• Subjects: Activities of Daily Living; Age Factors; Aged; Aged, 80 and over; Alzheimer Disease - psychology; Alzheimer Disease - rehabilitation; Alzheimer's disease; behavioural disturbance; Biological and medical sciences; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Female; functional status; Humans; Linear Models; Male; Medical sciences; Middle Aged; Neurology; Neuropsychological Tests; Personal Autonomy; Prospective Studies; Psychiatric Status Rating Scales; Social Behavior Disorders - etiology; Human; Disability; Nervous system diseases; Alzheimer disease; Etiology; Daily living; Central nervous system disease; Degenerative disease; Elderly; Cerebral disorder; Behavioral disorder
• ISSN: 0885-6230; 1099-1166
• DOI: 10.1002/gps.999

Background Cognitive impairment is associated with functional impairment in patients with Alzheimer's disease (AD). Behavioural disturbance is very common in these patients. Nevertheless, there has been very little research into the relations between behavioural disturbance and functional status in AD. The purpose of this study is to investigate the relationship between behavioural disturbance and functional status after taking account of cognitive impairment. Material and methods 579 patients were prospectively evaluated at 16 French hospitals, all referents for AD, and were diagnosed with possible or probable AD. These patients were assessed with NeuroPsychiatric Inventory (NPI), cognitive subscales of the Alzheimer's Disease Assessment Scale (ADAS‐cog), Clinical Dementia Rating scale (CDR) and Instrumental Activities of Daily Living scale (IADL). Results The number of men with available data for IADL total score was too small to make any analysis. ‘Group A’ gathered 256 women for whom the relation between autonomy for Activities of Daily Living (ADL) and the other variables were determined. ‘Group B’, pooled 85 women for whom relations found were verified. Linear regression was used for the analysis. With age, cognitive impairment allows us to explain best (38%) the loss of autonomy for ADL. Conclusion The role of behavioural disturbances in the loss of autonomy for ADL was not determinant in our study, whereas cognitive impairment and age were better able to determine the loss of autonomy for ADL. Further study is needed to explain the decline of functional status in AD patients. Copyright © 2003 John Wiley & Sons, Ltd.