Deterioration of basic activities of daily living and their impact on quality of life across different cognitive stages of dementia: a European study.
BACKGROUND
Performing basic activities of daily living (ADLs) is one of the major difficulties encountered in dementia, which can have considerable negative impacts on the quality of life (QoL) of people with dementia (PwD). However, the extent to which basic ADL performance deteriorates across mild, moderate, and severe dementia is little examined and its impact, together with depression and neuropsychiatric behavior, upon QoL, is of considerable relevance across European countries.


METHODS
Data were drawn from people living in the community who were participants in a large-scale European study on transition from community living to care homes of PwD. PwD completed measures on cognitive functioning and QoL, and informal carers reported upon QoL, depressive symptomatology, psychopathology, and functional ability of the PwD.


RESULTS
ADL performance deteriorated differently for each activity. In particular, toileting, transfer, and feeding remained relatively intact throughout, whereas performance on bathing and dressing deteriorated to a greater extent from mild to severe dementia. It appears that continence was not affected by the stage of dementia with similar levels of impairment. Basic ADL performance impacted to different degrees on QoL across dementia stages and countries.


CONCLUSIONS
Interventions aimed at maintaining independence or QoL need to target different ADLs across different dementia stages and perhaps also tailor interventions to the context of different countries. Findings contribute to the development of non-pharmaceutical interventions and governmental pledges to promote independence in dementia.
School of Psychological Sciences,University of Manchester,Manchester,UK.
Clarissa M
CM
Giebel
Personal Social Services Research Unit,University of Manchester,Manchester,UK.
Caroline
C
Sutcliffe
Department of Nursing Science,University of Turku,Turku,Finland.
Minna
M
Stolt
Department of Health Sciences,Lund University,Lund,Sweden.
Staffan
S
Karlsson
School of Nursing Science,Faculty of Health,University of Witten/Herdecke,Witten,Germany.
Anna
A
Renom-Guiteras
Department of Geriatric Medicine,Gerontopole,INSERM 1027,University Hospital de Toulouse,Toulouse,France.
Maria
M
Soto
Department of Health Services Research,Maastricht University,Maastricht,the Netherlands.
Hilde
H
Verbeek
Hospital Clinic de Barcelona,Barcelona,Spain.
Adelaida
A
Zabalegui
Personal Social Services Research Unit,University of Manchester,Manchester,UK.
David
D
Challis
D000203:Activities of Daily Living / Q000523:psychology*; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology; D003431:Cross-Cultural Comparison; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D003863:Depression / Q000175:diagnosis*; D018450:Disease Progression; D005008:Ethnopsychology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D057187:Independent Living / Q000523:psychology; D008297:Male; D016743:Mental Competency; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires