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The process of decline in advanced activities of daily living: a qualitative explorative study in mild cognitive impairment

(2012) INTERNATIONAL PSYCHOGERIATRICS. 24(6). p.974-986
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Abstract
Background: The notion of "minimal impairment in instrumental activities of daily living (i-ADL)" is important in the diagnosis of mild cognitive impairment (MCI), but is presently not adequately operationalized. ADL is stratified according to difficulty, complexity, and also to vulnerability to early cognitive changes in a threefold hierarchy: basic activities of daily living (b-ADL), i-ADL, and advanced activities of daily living (a-ADL). This study aims to gain a deeper understanding of the functional decline in the process of MCI. Methods: In a qualitative design, 37 consecutive patients diagnosed with amnestic (a)-MCI and their proxies were interviewed at two geriatric day hospitals. Constant comparative analysis was used for the analysis. Results: The a-ADL-concept emerged as important in the diagnosis of MCI. All participants were engaged in a wide range of activities, which could be clustered according to the International Classification of Functioning, Disability and Health (ICF). Participants reported subtle difficulties in performance. A process of functional decline was identified in which adaptation and coping mechanisms interacted with the process of reduced skills, leading to an activity disruption and an insufficiency in functioning. Conclusion: This study asserts the inclusion of an evaluation of a-ADL in the assessment of older persons. When evaluating ADL at three levels (b-ADL, i-ADL, and a-ADL), all the activities one can perform in daily living are covered.
Keywords
early cognitive disorders, functional impairment, Alzheimer's disease, activities of daily living evaluation, International Classification of Functioning, Disability and Health (ICF), COMPLEX ACTIVITIES, OLDER-ADULTS, SCALE, DEMENTIA, DISABILITY, VALIDATION, DIAGNOSIS, LANGUAGE, VALIDITY, MCI

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Chicago
DE VRIENDT, PATRICIA, Ellen Gorus, Elise Cornelis, Anja Velghe, Mirko Petrovic, and Tony Mets. 2012. “The Process of Decline in Advanced Activities of Daily Living: a Qualitative Explorative Study in Mild Cognitive Impairment.” International Psychogeriatrics 24 (6): 974–986.
APA
DE VRIENDT, P., Gorus, E., Cornelis, E., Velghe, A., Petrovic, M., & Mets, T. (2012). The process of decline in advanced activities of daily living: a qualitative explorative study in mild cognitive impairment. INTERNATIONAL PSYCHOGERIATRICS, 24(6), 974–986.
Vancouver
1.
DE VRIENDT P, Gorus E, Cornelis E, Velghe A, Petrovic M, Mets T. The process of decline in advanced activities of daily living: a qualitative explorative study in mild cognitive impairment. INTERNATIONAL PSYCHOGERIATRICS. 2012;24(6):974–86.
MLA
DE VRIENDT, PATRICIA, Ellen Gorus, Elise Cornelis, et al. “The Process of Decline in Advanced Activities of Daily Living: a Qualitative Explorative Study in Mild Cognitive Impairment.” INTERNATIONAL PSYCHOGERIATRICS 24.6 (2012): 974–986. Print.
@article{1965451,
  abstract     = {Background: The notion of {\textacutedbl}minimal impairment in instrumental activities of daily living (i-ADL){\textacutedbl} is important in the diagnosis of mild cognitive impairment (MCI), but is presently not adequately operationalized. ADL is stratified according to difficulty, complexity, and also to vulnerability to early cognitive changes in a threefold hierarchy: basic activities of daily living (b-ADL), i-ADL, and advanced activities of daily living (a-ADL). This study aims to gain a deeper understanding of the functional decline in the process of MCI. 
Methods: In a qualitative design, 37 consecutive patients diagnosed with amnestic (a)-MCI and their proxies were interviewed at two geriatric day hospitals. Constant comparative analysis was used for the analysis. 
Results: The a-ADL-concept emerged as important in the diagnosis of MCI. All participants were engaged in a wide range of activities, which could be clustered according to the International Classification of Functioning, Disability and Health (ICF). Participants reported subtle difficulties in performance. A process of functional decline was identified in which adaptation and coping mechanisms interacted with the process of reduced skills, leading to an activity disruption and an insufficiency in functioning. 
Conclusion: This study asserts the inclusion of an evaluation of a-ADL in the assessment of older persons. When evaluating ADL at three levels (b-ADL, i-ADL, and a-ADL), all the activities one can perform in daily living are covered.},
  author       = {DE VRIENDT, PATRICIA and Gorus, Ellen and Cornelis, Elise and Velghe, Anja and Petrovic, Mirko and Mets, Tony},
  issn         = {1041-6102},
  journal      = {INTERNATIONAL PSYCHOGERIATRICS},
  keyword      = {early cognitive disorders,functional impairment,Alzheimer's disease,activities of daily living evaluation,International Classification of Functioning,Disability and Health (ICF),COMPLEX ACTIVITIES,OLDER-ADULTS,SCALE,DEMENTIA,DISABILITY,VALIDATION,DIAGNOSIS,LANGUAGE,VALIDITY,MCI},
  language     = {eng},
  number       = {6},
  pages        = {974--986},
  title        = {The process of decline in advanced activities of daily living: a qualitative explorative study in mild cognitive impairment},
  url          = {http://dx.doi.org/10.1017/S1041610211002766},
  volume       = {24},
  year         = {2012},
}

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