One hundred and one patients with Alzheimer disease who were residing in the community were surveyed twice, in a six-month longitudinal study. A strong linear relationship was found between function, as measured by activities of daily living and cognitive impairment and between activities of daily living and social function.
At the first interview the proportion of variance in activities of daily living explained by cognitive impairment and social function, controlling for age, estimated duration of the disease and marital status was 65%. After six months the proportion had increased to 67%. The proportion of social function accounted for by activities of daily living was 30% at the initial interview; the proportion increased to 43% after six months. Patients lose the ability to perform instrumental activities of daily living before they lose the ability to perform self-care activities. The pattern of deterioration in activities of daily living is hierarchical.
The results of the study have implications for assessment and for intervention programmes. For those patients who have a diagnosis of Alzheimer disease, measures of activities of daily living are more useful for helping caregivers and for planning intervention programmes than measures of cognitive impairment.
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