Functionality on mild, moderate and severe Alzheimer's disease: a cros-sectional study
DOI:
https://doi.org/10.5935/0104-7795.20170016Keywords:
Alzheimer Disease, Dementia, Aged, Activities of Daily LivingAbstract
Objective: To evaluate the functionality of patients with Alzheimer's disease (AD) living in a community, in the city of Guarapuava PR, South of Brazil. Methods: A cross-sectional study was performed with patients with AD living in the community. Participants were classified according to Clinical Dementia Rating as CDR 1 (mild AD), CDR 2 (moderate AD) and CDR 3 (severe AD). The mental state was assessed by the Mini Mental State Examination; the basic activities of daily living (ADLs) was determined by the Barthel Index and instrumental activities of daily living (IADLs) via by Lowton and Brody Index. Results: 49 elderly patients with AD diagnosis were evaluated, 14 (24.1%) of which were classified as CDR 1, 21 (36.2%) as CDR 2, and 23 (39.7%) as CDR 3. There was a significant difference between the levels of dependence for the performance of the basic ADLs and IADLs among all phases of AD (p <0.001). The dependence was higher in both CDR 2 and CDR 3. Conclusion: Functional dependence for basic activities of daily living becomes more frequent in the most advanced stages of AD, whereas dependence for IADLs is onset since early stages of AD, even more noticeable than dependence for basic ADLs, what suggests a progressive loss of functionality.
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Alzheimer's Association. 2017 Alzheimer's disease facts and figures. Alzheimers Dement. 2017;13:325-73. DOI: http://dx.doi.org/10.1016/j.jalz.2017.02.001
Fujisawa C, Umegaki H, Okamoto K, Nakashima H, Kuzuya M, Toba K, et al. Physical function differences between the stages from normal cognition to moderate Alzheimer disease. J Am Med Dir Assoc. 2017;18(4):368.e9-368.e15. DOI: http://dx.doi.org/10.1016/j.jamda.2016.12.079
Talmelli LFS, Vale FAC, Gratão ACM, Kusumota L, Rodrigues RAP. Alzheimer's disease: functional decline and stage of dementia. Acta Paul Enferm. 2013; 26(3):219-25. DOI: http://dx.doi.org/10.1590/S0103-21002013000300003
Lenardt MH, Silva SC, Seima MD, Willig MH, Fuchs PAO. Desempenho das atividades de vida diária em idosos com Alzheimer. Cogitare Enferm. 2011; 16(1):13-21. DOI: http://dx.doi.org/10.5380/ce.v16i1.21106
Maciel MC. Atividade física e funcionalidade do idoso. Motriz. 2010;16 (4):1024-32.
Kumar A, Singh A, Ekavali. A review on Alzheimer's disease pathophysiology and its management: an update. Pharmacol Rep. 2015;67(2):195-203. DOI: http://dx.doi.org/10.1016/j.pharep.2014.09.004
Lilamand, M, Cesari, M, del Campo, N, Cantet, C, Soto, M, Ousset, PJ, et al. Brain amyloid deposition is associated with lower instrumental activities of daily living abilities in older adults. Results from the mapt study. J Gerontol A Biol Sci Med Sci. 2016;71(3):391-7.
Borges LL, Albuquerque CR, Garcia PA. O impacto do declínio cognitivo, da capacidade funcional e da mobilidade de idosos com doença de Alzheimer na sobrecarga dos cuidadores. Fisioter Pesq. 2009;16(3):246-51. DOI: http://dx.doi.org/10.1590/S1809-29502009000300010
Barbe C, Morrone I, Wolak-Thierry A, Dramé M, Jolly D, Novella, JL, et al. Impact of functional alterations on quality of life in patients with Alzheimer's disease. Aging Ment Health. 2017;21(5):571-6. DOI: http://dx.doi.org/10.1080/13607863.2015.1132674
Morris JC. The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology. 1993;43(11):2412-4. DOI: http://dx.doi.org/10.1212/WNL.43.11.2412-a
Folstein MF, Folstein SE, McHugh PR. "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12(3):189-98. DOI: http://dx.doi.org/10.1016/0022-3956(75)90026-6
Bertolucci BHF, Brucki SMD, Campacci SR, Juliano Y. O Mini Exame do Estado Mental em uma população geral - impacto da escolaridade. Arq. Neuro-Psiquiatr. 1994,52(1):1-7. DOI: http://dx.doi.org/10.1590/S0004-282X1994000100001
Apóstolo JLA. Instrumentos para avaliação em geriatria (Geriatric Instruments). Coimbra: Escola superior de Enfermagem de Coimbra; 2012.
Duque AS, Gruner H, Clara JG, Ermida JG, Veríssimo MT. Avaliação geriátrica. Lisboa: Núcleo de Estudos de Geriatria da Sociedade Portuguesa de Medicina Interna (GERMI); 2017.
Wajman JR, Oliveira FF, Marin SM, Schultz RR, Bertolucci PH. Is there correlation between cognition and functionality in severe dementia? The value of a performance-based ecological assessment for Alzheimer's disease. Arq Neuropsiquiatr. 2014;72(11):845-50. DOI: http://dx.doi.org/10.1590/0004-282X20140145
Potki SG, Anand R, Hartman R, Veach J, Grossberg G. Impact of Alzheimer's disease and rivastigmine treatment on activities of daily living over the course of mild to moderately severe disease. Prog Neuropsychopharmacol Biol Psychiatry. 2002;26(4):713-20. DOI: http://dx.doi.org/10.1016/S0278-5846(02)00212-9
Pini L, Pievani M, Bocchetta M, Altomare D, Bosco P, Cavedo E, et al. Brain atrophy in Alzheimer's Disease and aging. Ageing Res Rev. 2016;30:25-48. DOI: http://dx.doi.org/10.1016/j.arr.2016.01.002
Marshall GA, Rentz DM, Frey MT, Locascio JJ, Johnson KA, Sperling RA. Executive function and instrumental activities of daily living in mild cognitive impairment and Alzheimer's disease. Alzheimers Dement. 2011;7(3):300-8. DOI: http://dx.doi.org/10.1016/j.jalz.2010.04.005
Yildiz D, Büyükkoyuncu Pekel N, Kiliç AK, Tolgay EN, Tufan F. Malnutrition is associated with dementia severity and geriatric syndromes in patients with Alzheimer disease. Turk J Med Sci. 2015;45(5):1078-81.
Goes VF, Horst JAE, Almeida JC, Silva WCFN, Bonini JS. Nutritional status and food intake of Brazilian patients at various stages of Alzheimer's disease: A crosssectional study. Rev Ciênc Farm Básica Apl. 2014;35(2):211-5.
Spaccavento S, Del Prete M, Craca A, Fiore P. Influence of nutritional status on cognitive, functional and neuropsychiatric deficits in Alzheimer's disease. Arch Gerontol Geriatr. 2009;48(3):356-60. DOI: http://dx.doi.org/10.1016/j.archger.2008.03.002
Siddique N, O'Donoghue M, Casey MC, Walsh JB. Malnutrition in the elderly and its effects on bone health - A review. Clinical Nutrition ESPEN.2017;21:31-9. DOI: http://dx.doi.org/10.1016/j.clnesp.2017.06.001
Buffa R, Mereu E, Putzu P, Mereu RM, Marini E. Lower lean mass and higher percent fat mass in patients with Alzheimer's disease. Exp Gerontol. 2014;58:30-3. DOI: http://dx.doi.org/10.1016/j.exger.2014.07.005
Tekin S, Fairbanks LA, O'Connor S, Rosenberg S, Cummings JL. Activities of daily living in Alzheimer's disease: neuropsychiatric, cognitive, and medical illness influences. Am J Geriatr Psychiatry. 2001;9(1):81-6. DOI: http://dx.doi.org/10.1097/00019442-200102000-00013
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