Racial and sex differences in associations between activities of daily living and cognition in community-dwelling older adults.
OBJECTIVE
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.


METHODS
Cross-sectional study assessing associations between self-reported ADL and IADL difficulty and MMSE scores for race- and sex-specific groups.


METHODS
Homes of community-dwelling older adults.


METHODS
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.


METHODS
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.


CONCLUSIONS
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.
Department of Family Medicine, National Center for Primary Care, Morehouse School of Medicine, Atlanta, Georgia.
Stephanie L
SL
Garrett
Comprehensive Center for Healthy Aging, Gerontology Education Program, University of Alabama at Birmingham, Birmingham, Alabama.|Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama.
Patricia
P
Sawyer
Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama.
Richard E
RE
Kennedy
Neuroscience Institute, Morehouse School of Medicine, Atlanta, Georgia.
Dawn
D
McGuire
Translational Programs in Stroke, Morehouse School of Medicine, Atlanta, Georgia.|Department of Medicine (Neurology), Morehouse School of Medicine, Atlanta, Georgia.|Department of Neurobiology, Morehouse School of Medicine, Atlanta, Georgia.
Roger P
RP
Simon
Department of Family Medicine, Morehouse School of Medicine, Atlanta, Georgia.
Harry S
HS
Strothers
Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama.|Birmingham/Atlanta Veterans Affairs Geriatric Research, Education, and Clinical Center, Birmingham, Alabama.|Comprehensive Center for Healthy Aging, Deep South Resource Center for Minority Aging Research, University of Alabama at Birmingham, Birmingham, Alabama.|Southeast Center of Excellence in Geriatric Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
Richard M
RM
Allman
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000407:Alabama / Q000453:epidemiology; D003072:Cognition Disorders / Q000453:epidemiology / Q000208:ethnology*; D003430:Cross-Sectional Studies; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D057187:Independent Living; D008297:Male; D015995:Prevalence; D011446:Prospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors