Engagement in instrumental activities of daily living, social activities, and use of everyday technology in older adults with and without cognitive impairment

Introduction: Little is known about how subtle activity limitations may be manifested and clinically detected in people with mild cognitive impairment, but these people have been found to experience greater challenges with everyday technology use. The aim of this study was to investigate levels and profiles of engagement in activities, and their associations with perceived difficulty in technology use, for people with mild cognitive impairment, and to compare this group to people with Alzheimer's disease and to controls. Method: Samples with mild cognitive impairment (n = 37), Alzheimer's disease (n = 37), and controls (n = 44) were included. Based on raw data from the Frenchay Activity Index, a Rasch model was used to generate linear measures. Analysis of variance and differential item functioning were used. Results: The analysis yielded a profile of decreased engagement in specific activities even in mild cognitive impairment. The association between activity engagement and difficulty with everyday technology use was stronger in people with mild cognitive impairment and Alzheimer's disease than in controls. Conclusion: Taken together, engagement in outdoor activities showed the greatest decrease of all activity types for the group with mild cognitive impairment, suggesting that participation in life outside the home is threatened. The results also suggest that challenges in managing technology are restricting people with cognitive impairment more than they restrict controls.