title: Specific cognitive functions and depressive symptoms as predictors of activities of daily living in older adults with heterogeneous cognitive backgrounds.
abstract: Cognitive functioning influences activities of daily living (ADL). However, studies reporting the association between ADL and neuropsychological performance show inconsistent results regarding what specific cognitive domains are related to each specific functional domains. Additionally, whether depressive symptoms are associated with a worse functional performance in older adults is still under explored. We investigated if specific cognitive domains and depressive symptoms would affect different aspects of ADL. Participants were 274 older adults (96 normal aging participants, 85 patients with mild cognitive impairment, and 93 patients probable with mild Alzheimer's disease dementia) with low formal education (∼4 years). Measures of ADL included three complexity levels: Self-care, Instrumental-Domestic, and Instrumental-Complex. The specific cognitive functions were evaluated through a factorial strategy resulting in four cognitive domains: Executive Functions, Language/Semantic Memory, Episodic Memory, and Visuospatial Abilities. The Geriatric Depression Scale measured depressive symptoms. Multiple linear regression analysis showed executive functions and episodic memory as significant predictors of Instrumental-Domestic ADL, and executive functions, episodic memory and language/semantic memory as predictors of Instrumental-Complex ADL (22 and 28% of explained variance, respectively). Ordinal regression analysis showed the influence of specific cognitive functions and depressive symptoms on each one of the instrumental ADL. We observed a heterogeneous pattern of association with explained variance ranging from 22 to 38%. Different instrumental ADL had specific cognitive predictors and depressive symptoms were predictive of ADL involving social contact. Our results suggest a specific pattern of influence depending on the specific instrumental daily living activity.
authors.affiliation: Faculdade de Medicina, Instituto Nacional de Ciências e Tecnologia e em Medicina Molecular, Universidade Federal de Minas Gerais Belo Horizonte, Brazil ; Department of Psychology, Faculdade de Ciências Médicas de Minas Gerais Belo Horizonte, Brazil.
authors.forename: Jonas J
authors.initials: JJ
authors.lastname: de Paula
authors.affiliation: Faculdade de Medicina, Instituto Nacional de Ciências e Tecnologia e em Medicina Molecular, Universidade Federal de Minas Gerais Belo Horizonte, Brazil ; Department of Mental Health, Faculdade de Medicina, Universidade Federal de Minas Gerais Belo Horizonte, Brazil.
authors.forename: Breno S
authors.initials: BS
authors.lastname: Diniz
authors.affiliation: Faculdade de Medicina, Instituto Nacional de Ciências e Tecnologia e em Medicina Molecular, Universidade Federal de Minas Gerais Belo Horizonte, Brazil ; Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais Belo Horizonte, Brazil.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Bicalho
authors.affiliation: Faculdade de Medicina, Instituto Nacional de Ciências e Tecnologia e em Medicina Molecular, Universidade Federal de Minas Gerais Belo Horizonte, Brazil ; Department of Physical Education, Universidade Federal de Viçosa Viçosa, Brazil.
authors.forename: Maicon Rodrigues
authors.initials: MR
authors.lastname: Albuquerque
authors.affiliation: Faculdade de Medicina, Instituto Nacional de Ciências e Tecnologia e em Medicina Molecular, Universidade Federal de Minas Gerais Belo Horizonte, Brazil ; Department of Mental Health, Faculdade de Medicina, Universidade Federal de Minas Gerais Belo Horizonte, Brazil.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Nicolato
authors.affiliation: Faculdade de Medicina, Instituto Nacional de Ciências e Tecnologia e em Medicina Molecular, Universidade Federal de Minas Gerais Belo Horizonte, Brazil ; Department of Internal Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais Belo Horizonte, Brazil.
authors.forename: Edgar N
authors.initials: EN
authors.lastname: de Moraes
authors.affiliation: Faculdade de Medicina, Instituto Nacional de Ciências e Tecnologia e em Medicina Molecular, Universidade Federal de Minas Gerais Belo Horizonte, Brazil ; Department of Mental Health, Faculdade de Medicina, Universidade Federal de Minas Gerais Belo Horizonte, Brazil.
authors.forename: Marco A
authors.initials: MA
authors.lastname: Romano-Silva
authors.affiliation: Faculdade de Medicina, Instituto Nacional de Ciências e Tecnologia e em Medicina Molecular, Universidade Federal de Minas Gerais Belo Horizonte, Brazil ; Department of Mental Health, Faculdade de Medicina, Universidade Federal de Minas Gerais Belo Horizonte, Brazil.
authors.forename: Leandro F
authors.initials: LF
authors.lastname: Malloy-Diniz
keywords: activities of daily living; dementia; depression; executive functions; functional performance; mild cognitive impairment; neuropsychological assessment