Racial and Sex Differences in Associations Between Activities of Daily Living and Cognition in Community-Dwelling Older Adults

• Published in: Journal of the American Geriatrics Society (JAGS) Vol. 61; no. 12; pp. 2174 - 2180
• Main Authors: Garrett, Stephanie L., Sawyer, Patricia, Kennedy, Richard E., McGuire, Dawn, Simon, Roger P., Strothers III, Harry S., Allman, Richard M.
• Format: Journal Article
• Language: English
• Published: Hoboken, NJ Blackwell Publishing Ltd 01.12.2013; Wiley-Blackwell; Wiley Subscription Services, Inc
• Subjects: Activities of Daily Living; Aged; Aged, 80 and over; Alabama - epidemiology; Biological and medical sciences; Cognition & reasoning; Cognition Disorders - epidemiology; Cognition Disorders - ethnology; cognitive screening; Cross-Sectional Studies; Epidemiology; ethnicity; Female; function; Gender differences; General aspects; Geriatric Assessment; Humans; Independent Living; instrumental activities of daily living; Male; Medical sciences; Mini-Mental State Examination; Mobility; Older people; Prevalence; Prevention and actions; Prospective Studies; Public health. Hygiene; Public health. Hygiene-occupational medicine; race; Racial differences; sex; sex differences; Sex Factors; Socioeconomic Factors; Alabama; Human; ethnicity; Daily living; Sex; Activity; Male; Cognition; Medical screening; Housing; Epidemiology; Ethnic group; Association; instrumental activities of daily living; cognitive screening; activities of daily living; At home; Race; function; Female; Elderly; Mini-Mental State Examination; Comparative study; sex differences
• ISSN: 0002-8614; 1532-5415
• DOI: 10.1111/jgs.12543

Objectives To examine the association between function measured according to activities of daily living (ADLs), instrumental activ1ities of daily living (IADLs), and cognition assessed according to Mini‐Mental State Examination (MMSE) scores of older African‐American and non‐Hispanic white community‐dwelling men and women. Design Cross‐sectional study assessing associations between self‐reported ADL and IADL difficulty and MMSE scores for race‐ and sex‐specific groups. Setting Homes of community‐dwelling older adults. Participants A random sample of 974 African‐American and non‐Hispanic white Medicare beneficiaries aged 65 and older living in west‐central Alabama and participating in the University of Alabama at Birmingham Study of Aging, excluding those with reported diagnoses of dementia or with missing data. Measurements Function, based on self‐reported difficulty in performing ADLs and IADLs, and cognition, using the MMSE. Multivariable linear regression models were used to test the association between function and cognition in race‐ and sex‐specific groups after adjusting for covariates. Results Mini‐Mental State Examination scores were modestly correlated with ADL and IADL difficulty in all four race‐ and sex‐specific groups, with Pearson correlation coefficients ranging from −0.189 for non‐Hispanic white women to −0.429 for African‐American men. Correlations between MMSE and ADL or IADL difficulty in any of the race‐ and sex‐specific groups were no longer significant after controlling for sociodemographic factors and comorbidities. Conclusion Mini‐Mental State Examination was not significantly associated with functional difficulty in older African‐American and non‐Hispanic white men and women after adjusting for sociodemographic factors and comorbidities, suggesting a mediating role in the relationship between cognition and function.