Journal List > Dement Neurocogn Disord > v.12(4) > 1120810

Dement Neurocogn Disord. 2013 Dec;12(4):100-106. Korean.
Published online Dec 31, 2013.  https://doi.org/10.12779/dnd.2013.12.4.100
© 2013 Korean Dementia Association
Predictive Factors for Decline in Activities of Daily Living in Alzheimer's Disease Dementia with More than 2 Follow-up
Sung-Hee Kim, M.D.,* Hyeran Yang, M.D., Ye Ji Choi, M.D.,* Hee Jin Kang, M.D.,* Kyoung-Gyu Choi, M.D.,* and Jee Hyang Jeong, M.D.*
*Department of Neurology, Ewha Womans University School of Medicine and Ewha Medical Research Institute, Seoul, Korea.
Department of Neurology, Dongshin Hospital, Seoul, Korea.

Address for correspondence: Jee Hyang Jeong, M.D. Department of Neurology, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 158-710, Korea. Tel. +82-2-2650-2776, Fax +82-2-2650-2652, Email: jjeong@ewha.ac.kr
Received Nov 11, 2013; Revised Dec 30, 2013; Accepted Dec 30, 2013.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Background

Impairment in activities of daily living (ADL) is a major problem in Alzheimer's disease (AD), and is related to increased caregiver burden.The present study evaluated whether there are any components of initial dementia evaluation that could predict ADL decline in years follow-up.

Methods

The 32 subjects underwent more than two consecutive neuropsychological evaluation and maintained anti-dementia medication from the Ewha Dementia Cohort. The first clinical, neuropsychological test results, medial temporal atrophy rating and white matter ratings were correlated with the final ADL scores. The subjects were further divided into ADL-preserved and declined groups for the comparison depending on final ADL scores.

Results

The annual decline of the Korean Mini-mental status examination (K-MMSE) score was 1.5±1.2 and of the Seoul-instrumental ADL score was 6.1±4.6. The Factors correlated with the ADL at baseline were the clinical dementia rating, K-MMSE, memory function score and the total neuropsychological test score, left medial temporal lobe atrophy rating, and the neuropsychiatric total score. Only the neuropsychological component including total test, frontal and visuospatial function scores were statistically different between the two groups in the baseline evaluation.

Conclusions

The result of our preliminary study emphasize the other study results that the initial cognitive and dementia status are the strong predictive factors not only for the initial ADL dysfunction but also for the ADL decline in years followed-up dementia cohort.

Keywords: Activities of daily living; Medial temporal lobe atrophy; Alzheimer's disease dementia

Tables


Table 1
The comparison between baseline and follow-up evaluation
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Table 2
Correlation coefficients between baseline evaluationfactors andS-IADL atbaseline and follow-up
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Table 3
Correlation coefficients between baseline evaluation factors and medial temporal lobe atrophyat baseline imaging
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Table 4
The comparison between ADL-preserved groupandADL-aggravated group
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