de Paula Jonas J, Diniz Breno S, Bicalho Maria A, Albuquerque Maicon Rodrigues, Nicolato Rodrigo, de Moraes Edgar N, Romano-Silva Marco A, Malloy-Diniz Leandro F
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.
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.
Front Aging Neurosci. 2015 Jul 20;7:139. doi: 10.3389/fnagi.2015.00139. eCollection 2015.
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.
认知功能会影响日常生活活动（ADL）。然而，关于ADL与神经心理学表现之间关联的研究在具体哪些认知领域与每个特定功能领域相关这一问题上，结果并不一致。此外，抑郁症状是否与老年人较差的功能表现相关仍在探索之中。我们调查了特定认知领域和抑郁症状是否会影响ADL的不同方面。研究参与者为274名受教育程度较低（约4年）的老年人（96名正常衰老参与者、85名轻度认知障碍患者和93名可能患有轻度阿尔茨海默病痴呆症的患者）。ADL的测量包括三个复杂程度级别：自我护理、工具性家庭活动和工具性复杂活动。通过一种析因策略评估特定的认知功能，得出四个认知领域：执行功能、语言/语义记忆、情景记忆和视觉空间能力。采用老年抑郁量表测量抑郁症状。多元线性回归分析表明，执行功能和情景记忆是工具性家庭活动ADL的显著预测因素，执行功能、情景记忆和语言/语义记忆是工具性复杂活动ADL的预测因素（分别解释了22%和28%的方差）。有序回归分析显示了特定认知功能和抑郁症状对每种工具性ADL的影响。我们观察到一种异质性的关联模式，解释的方差范围为22%至38%。不同的工具性ADL有特定的认知预测因素，抑郁症状可预测涉及社交接触的ADL。我们的结果表明，根据特定的工具性日常生活活动，存在一种特定的影响模式。
