Tsiakiri Anna, Plakias Spyridon, Kokkotis Christos, Vlotinou Pinelopi, Kyriazidou Sotiria, Giarmatzis Georgios, Kallivoulos Stylianos, Terzoudi Aikaterini, Tsiptsios Dimitrios, Merai Souzana, Emmanouilidou Chrysoula, Kariotis Christos, Kanidou Anna, Aggelousis Nikolaos, Vadikolias Konstantinos, Christidi Foteini
Dementia Day Center, Department of Neurology, School of Medicine, Democritus University of Thrace, 68100 Alexandroupolis, Greece.
Department of Physical Education and Sport Science, University of Thessaly, 42100 Trikala, Greece.
Brain Sci. 2025 Apr 19;15(4):417. doi: 10.3390/brainsci15040417.
: Instrumental Activities of Daily Living (IADL) are the key indicators of the autonomy and functional ability in older adults with neurocognitive disorders (NCDs). However, the specific predictors of IADL performance across the NCD spectrum remains insufficiently characterized. This study aimed to identify the cognitive, motor, and caregiver-related determinants of the IADL in individuals with minor and major NCDs. : A cross-sectional study was conducted involving 117 participants referred from a university-based dementia clinic. Standardized tools were administered to evaluate their IADL performance (Lawton IADL Scale), cognition [Addenbrooke's Cognitive Examination III (ACE-III)], Functional Cognitive Assessment Scale (FUCAS)], motor functions, balance, and mobility [Tinetti Test, Timed Up and Go (TUG)], emotional status [Geriatric Depression Scale (GDS)], neuropsychiatric symptoms [Neuropsychiatric Inventory (NPI)], and caregiver burden [Zarit Burden Interview (ZBI)]. Multiple regression analyses were performed to identify the significant predictors of IADL performance. : In the total sample (n = 117), the IADL performance was significantly predicted via ACE-III, FUCAS, and Tinetti-balance (adjusted R = 0.729). In the minor NCD group (n = 41), the significant predictors included sex, FUCAS, GDS, Tinetti-balance, and TUG (adjusted R = 0.725). In the major NCD group (n = 76), ACE-III, FUCAS, and Tinetti-balance remained the significant predictors (adjusted R = 0.634). Female sex and a worse profile on the other variables were associated with lower IADL scores. : Global cognitive decline, executive dysfunction in everyday problem-solving situations, and balance impairment are the key determinants of IADL performance across both minor and major NCDs. Female sex and depressive symptoms further predicted the IADL performance in the minor NCD group. These findings highlight the need for multidisciplinary assessment and intervention strategies to promote health and autonomy and preserve the functional independence in older adults with NCDs.
日常生活工具性活动（IADL）是患有神经认知障碍（NCD）的老年人自主性和功能能力的关键指标。然而，在整个NCD范围内，IADL表现的具体预测因素仍未得到充分描述。本研究旨在确定轻度和重度NCD患者IADL的认知、运动和照顾者相关决定因素。：进行了一项横断面研究，纳入了117名从大学痴呆诊所转诊的参与者。使用标准化工具评估他们的IADL表现（Lawton IADL量表）、认知能力[Addenbrooke认知检查III（ACE-III）、功能性认知评估量表（FUCAS）]、运动功能、平衡和活动能力[Tinetti测试、定时起立行走测试（TUG）]、情绪状态[老年抑郁量表（GDS）]、神经精神症状[神经精神科问卷（NPI）]以及照顾者负担[Zarit负担访谈（ZBI）]。进行多元回归分析以确定IADL表现的显著预测因素。：在总样本（n = 117）中，ACE-III、FUCAS和Tinetti平衡显著预测了IADL表现（调整后R = 0.729）。在轻度NCD组（n = 41）中，显著预测因素包括性别、FUCAS、GDS、Tinetti平衡和TUG（调整后R = 0.725）。在重度NCD组（n = 76）中，ACE-III、FUCAS和Tinetti平衡仍然是显著预测因素（调整后R = 0.634）。女性以及在其他变量上表现较差与较低的IADL得分相关。：整体认知衰退、日常问题解决情境中的执行功能障碍以及平衡受损是轻度和重度NCD患者IADL表现的关键决定因素。女性和抑郁症状进一步预测了轻度NCD组的IADL表现。这些发现凸显了需要多学科评估和干预策略，以促进患有NCD的老年人的健康和自主性，并保持其功能独立性。
