Cognitive domains and trajectories of functional independence in nondemented elderly persons

被引:87
作者
Dodge, Hiroko H.
Du, Yangchun
Saxton, Judith A.
Ganguli, Mary
机构
[1] Oregon State Univ, Dept Publ Hlth, Corvallis, OR 97331 USA
[2] Univ Pittsburgh, Grad Sch Publ Hlth, Dept Epidemiol, Pittsburgh, PA 15260 USA
[3] Boston Univ, Sch Publ Hlth, Dept Biostat, Boston, MA 02215 USA
[4] Univ Pittsburgh, Sch Med, Dept Neurol, Pittsburgh, PA 15261 USA
[5] Univ Pittsburgh, Sch Med, Dept Psychiat, Pittsburgh, PA 15261 USA
来源
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES | 2006年 / 61卷 / 12期
关键词
D O I
10.1093/gerona/61.12.1330
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Background. Cognitive impairment in general is known to predict functional disability, but it is not clear whether performance on specific cognitive domains predicts future disability trends among nondemented elderly persons. Methods. In a representative elderly community-based cohort over up to 10 years of follow-up, we examined predictors of longitudinal trajectories in ability to perform Instrumental Activities of Daily Living (IADL) among nondemented elderly persons. We used trajectory analyses to identify homogeneous groups with respect to trends over time in the numbers of IADL disabilities and their association with baseline demographics, social engagement, depression, physical well-being, and general and domain-specific cognitive functions. We excluded from these analyses those individuals found to have dementia at baseline or at any time during follow-up. Results. Trajectory analysis revealed three homogeneous latent groups which we characterized as No Decline (no decline in abilities to perform IADL tasks over the course of study), Moderate Decline (some functional decline), and Sharp Decline (steep functional decline followed by death). Compared to the Sharp Decline group, the No Decline group was associated with higher baseline functions in all cognitive domains, and the Moderate Decline group was associated with higher baseline functions in all cognitive domains except psychomotor speed and naming. The Moderate and No Decline groups did not differ on any cognitive measure. Conclusion. Among community dwelling elderly persons who remained free from dementia throughout the study, poorer scores in all cognitive domains predicted sharp functional decline followed by death.
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页码:1330 / 1337
页数:8
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