通过主观和客观测量评估的日常生活工具性活动：抑郁和人格的影响
Instrumental Activities of Daily Living by Subjective and Objective Measures: The Impact of Depression and Personality.
作者信息
Numbers Katya, Jang Sujin, Brodaty Henry, Sachdev Perminder S, Draper Brian, Reppermund Simone
机构信息
Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia.
Department of Developmental Disability Neuropsychiatry, Faculty of Medicine and Health, School of Psychiatry, University of New South Wales, Sydney, NSW, Australia.
出版信息
Front Aging Neurosci. 2022 Jul 22;14:829544. doi: 10.3389/fnagi.2022.829544. eCollection 2022.
OBJECTIVE
Previous research shows that depression and personality are independently associated with self- and informant-reports of the ability to perform instrumental activities of daily living (IADLs). However, less is known about the association between depression and personality and performance-based measures of IADLs. We aimed to determine how depression and personality predict self-and informant-reports of IADL compared to performance-based measures of IADLs in a sample of older adults with normal cognition (NC) and Mild Cognitive Impairment (MCI).
METHODS
Participants consisted of 385 older adults with NC ( = 235), or a diagnosis of MCI ( = 150), aged between 76 and 99-years from the Sydney Memory and Ageing Study. Participants underwent comprehensive neuropsychological and clinical assessments to determine global cognition and clinical diagnoses. Personality traits were measured by the NEO Five-Factor Inventory (NEO-FFI) and depression by the Geriatric Depression Scale (GDS). Subjective IADLs were self- and informant-reported Bayer Activities of Daily Living (B-ADL) scales and objective IADL was the Sydney Test of Activities of Daily Living in Memory Disorders (STAM). Linear regressions examined the relationship between depression and personality and the three types of IADL measures, controlling for all covariates and global cognition.
RESULTS
Participant-reported IADL, although associated with global cognition, was more strongly associated with GDS and NEO-FFI scores (conscientiousness and neuroticism). Informant-reported IADL was strongly associated with both global cognition and participants' GDS scores. STAM scores were not associated with participants' GDS or NEO-FFI scores; instead, they were predicted by demographics and global cognition.
CONCLUSION
These results suggest that performance-based measures of IADL may provide more objective and reliable insight into an individual's underlying functional ability and are less impacted by the participants' mood and personality compared to subjectively reported IADL. We argue that performance-based IADL measures are preferable when trying to accurately assess everyday functional ability and its relationship to cognitive status. Where performance-based measures are not available (e.g., in some clinical settings), informant ratings should be sought as they are less influenced by the participant's personality and mood compared to self-reports.
目的
先前的研究表明，抑郁和人格分别与自我报告及他人报告的日常生活工具性活动（IADL）能力相关。然而，对于抑郁和人格与基于表现的IADL测量之间的关联，我们了解得较少。我们旨在确定在认知正常（NC）和轻度认知障碍（MCI）的老年人样本中，与基于表现的IADL测量相比，抑郁和人格如何预测IADL的自我报告及他人报告。
方法
参与者包括来自悉尼记忆与衰老研究的385名年龄在76至99岁之间的老年人，其中235名认知正常（NC），150名被诊断为MCI。参与者接受了全面的神经心理学和临床评估，以确定整体认知和临床诊断。人格特质通过NEO五因素问卷（NEO-FFI）进行测量，抑郁通过老年抑郁量表（GDS）进行测量。主观IADL是自我报告及他人报告的拜耳日常生活活动（B-ADL）量表，客观IADL是记忆障碍日常生活活动悉尼测试（STAM）。线性回归分析了抑郁和人格与三种IADL测量之间的关系，同时控制了所有协变量和整体认知。
结果
参与者报告的IADL，尽管与整体认知相关，但与GDS和NEO-FFI得分（尽责性和神经质）的关联更强。他人报告的IADL与整体认知和参与者的GDS得分均密切相关。STAM得分与参与者的GDS或NEO-FFI得分无关；相反，它们由人口统计学因素和整体认知所预测。
结论
这些结果表明，与主观报告的IADL相比，基于表现的IADL测量可能能更客观、可靠地洞察个体的潜在功能能力，且受参与者情绪和人格的影响较小。我们认为，在试图准确评估日常功能能力及其与认知状态的关系时，基于表现的IADL测量更可取。在无法获得基于表现的测量方法时（例如，在某些临床环境中），应寻求他人评分，因为与自我报告相比，他人评分受参与者人格和情绪的影响较小。
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