Advanced Activities of Daily Living (AADLs) and cognitive performance in community-dwelling elderly persons: Data from the FIBRA Study - UNICAMP

Sposito, Giovana; Neri, Anita Liberalesso; Yassuda, Mônica Sanches

doi:10.1590/1809-9823.2016.15044

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Revista Brasileira de Geriatria e Gerontologia

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Sumário

Original Articles • Rev. bras. geriatr. gerontol. 19 (1) • Jan-Feb 2016 • https://doi.org/10.1590/1809-9823.2016.15044 copy

Advanced Activities of Daily Living (AADLs) and cognitive performance in community-dwelling elderly persons: Data from the FIBRA Study - UNICAMP

Authorship SCIMAGO INSTITUTIONS RANKINGS

Objective

The aim of this study was to investigate the relationship between participation in advanced activities of daily living (AADLs) and cognitive performance in community-dwelling elderly persons.

Method

The data presented is drawn from the population-based study entitled Frailty Profile of Elderly Brazilians (FIBRA-Unicamp). The sample comprised 2,549 older adults without cognitive impairments suggestive of dementia. Data was collected relating to socio-demographic characteristics (sex, age, years of education and family income), health status (number of diseases and depressive symptoms), cognitive performance (Mini-Mental State Examination - MMSE) and self-reported social, physical and intellectual AADLs.

Results

Mean MMSE scores were significantly higher among men, younger individuals and those with more years of education, higher income, fewer diseases and fewer depressive symptoms. Multivariate linear regression analysis and hierarchical regression analysis showed that years of education, family income and participation in intellectual AADLs were positively associated with cognitive performance.

Conclusion

The findings suggest that these factors may have a protective role in cognitive aging and that participation in intellectual AADLs can represent a feasible strategy for the promotion of mental health among older adults.

Activities of Daily Living; Social Participation; Motor Activity; Cognition; Elderly

Variable	Category	n (%)	Average (±sd)
Gender	Male	874 (34.29)
	Female	1.675 (65.71)
Age (years)	65-69	965 (37.86)	72.32 (±5.55)
	70-74	796 (31.23)
	75-79	483 (18.95)
	80+	305 (11.97)
Years of study	0	504 (19.79)	4.37 (±3.99)
	1-4	1.254 (49.23)
	5-8	458 (17.98)
	≥9	331 (13.00)
Family Income (MS)	≤1	242 (10.99)	3.97 (±4.92)
	1.1-3	1.066 (48.41)
	3.1-5	485 (22.03)
	5.1-10	274 (12.44)
Number of diseases	0	313 (12.29)	2.02 (±1.33)
	1-2	1.366 (53.65)
	≥3	867 (34.05)
Depressive symptoms	No	2.022 (79.54)	3.53 (±2.68)
	Yes	520 (20.46)
Physical AADLs	0-2	679 (26.64)	3.94 (±2.15)
	3-4	969 (38.01)
	5	352 (13.81)
	≥6	549 (21.54)
Social AADLs	0-4	852 (33.42)	5.53 (±2.21)
	5-6	836 (32.80)
	7	360 (14.12)
	≥8	501 (19.65)
Intellectual AADLs	0-1	852 (33.42)	2.19 (±1.04)
	2	836 (32.80)
	3	360 (25.89)
	≥4	250 (9.81)
Total number of AADLs	0-9	799 (31.35)	11.67 (±4.03)
	10-11	514 (20.16)
	12-14	634 (24.87)
	15	602 (23.62)

		Total MMSE
	n	Average (±sd)	p-value
Gender			<0.001
Male	874	25.40 (±2.97)
Female	1.675	24.76 (±3.11)
Age (years)			<0.001(A)
65-69	965	25.43 (±2.94)
70-74	796	25.03 (±3.06)
75-79	486	24.54 (±3.16)
≥80	305	24.14 (±3.14)
Years of study			<0.001(B)
0	504	21.06 (±2.84)
1-4	1.254	25.21 (±2.23)
5-8	458	26.55 (±1.76)
≥9	331	27.91 (±1.27)
Family income (MS)			<0.001(C)
≤1	242	23.48 (±3.23)
1.1-3	1.066	24.21 (±3.12)
3.1-5	485	25.76 (±2.67)
5.1-10	274	26.66 (±2.34)
>10	135	27.60 (±1.68)
Number of diseases			0.006(D)
0	313	25.14 (±2.88)
1-2	1.366	25.13 (±3.05)
≥3	867	24.70 (±3.17)
Depressive symptoms			<0.001
No	2.022	25.26 (±2.98)
Yes	520	23.95 (±3.20)

	Physical AADLs	Social AADLs	Intel. AADLs.	Total AADLs
	Average (±sd)
Gender		Social AADLs	Intel. AADLs.	Total AADLs
Male (n=874)	3.65 (2.45)	5.51 (2.20)	2.03 (0.92)	11.19 (4.12)
Female (n=1.675)	4.10 (1.97)	5.54 (2.22)	2.28 (1.09)	11.91 (3.96)
p	<0.001	0.730	<0.001	<0.001
Age (years)
65-69 (n=965)	4.30 (2.22)	5.73 (2.24)	2.26 (1.07)	12.29 (4.19)
70-74 (n=796)	3.92 (2.10)	5.55 (2.15)	2.17 (1.03)	11.64 (3.92)
75-79 (n=483)	3.74 (2.04)	5.43 (2.15)	2.16 (1.05)	11.33 (3.81)
≥80 (n=305)	3.19 (1.99)	5.01 (2.28)	2.11 (0.91)	10.31 (3.76)
p	<0.001 (A)	<0.001 (B)	0.142	<0.001 (C)
Years of study
0(n=504)	3.63 (2.00)	4.74 (1.99)	1.43 (0.75)	9.80 (3.51)
1-4 (n=485)	4.07 (2.12)	5.32 (2.11)	2.23 (0.98)	11.61 (3.91)
5-8 (n=458)	4.07 (2.24)	6.03 (2.14)	2.51 (0.99)	12.60 (3.86)
≥9(n=331)	3.79 (2.32)	6.82 (2.29)	2.79 (1.06)	13.40 (4.26)
p	<0.001 (D)	<0.001 (E)	<0.001(E)	<0.001 (F)
Family income (MS)
≤1(n=242)	3.95 (2.07)	4.95 (2.12)	1.88 (0.96)	10.77 (3.76)
1.1-3(n=1.066)	3.83 (2.09)	5.19 (2.08)	2.00 (1.01)	11.00 (3.86)
3.1-5(n=485)	4.19 (2.27)	5.80 (2.19)	2.32 (1.01)	12.30 (4.04)
5.1-10(n=274)	4.08 (2.23)	6.32 (2.26)	2.65 (0.98)	13.05 (4.05)
>10 (n=135)	3.96 (2.39)	7.07 (2.30)	2.77 (1.09)	13.79 (4.36)
p	0.096	<0.001 (G)	<0.001(H)	<0.001 (I)
Number of diseases
0(n=313)	4.06 (2.39)	5.65 (2.29)	2.14 (0.95)	11.86 (4.20)
1-2 (n=1.366)	4.06 (2.15)	5.61 (2.22)	2.23 (1.06)	11.90 (4.05)
≥3(867)	3.71 (2.03)	5.36 (2.15)	2.15 (1.04)	11.22 (3.88)
p	<0.001 (J)	0.020 (L)	0.195	<0.001 (M)
Depressive symptoms
No (n=2.022)	4.07 (2.18)	5.80 (2.19)	2.27 (1.04)	12.14 (4.04)
Yes (n=520)	3.45 (1.94)	4.50 (1.95)	1.90 (0.97)	9.84 (3.42)
p	0.001	0.001	0.001	0.001

Variable	Category	Beta (SE)	p	R ^²2. Reuben DB, Laliberte L, Hiris J, Mor V. A hierarchical exercise scales to measure function at the Advanced Activities of Daily Living (AADL) level. J Am Geriatr Soc 1990;38(8):855-61.
Education		0.55 (0.02)	<0.001	0.4305
Family income		0.11 (0.02)	<0.001	0.0117
Gender	Female	-149.54 (24.49)	<0.001	0.0076
Age		-0.08 (0.02)	<0.001	0.0060
Intellectual AADLs	Less active	164.42 (30.07)	<0.001
	Very active	238.22 (34.36)	<0.001
	Super active	225.79 (46.19)	<0.001	0.0143
Depressive symptoms	Yes	-90.57 (29.19)	0.002	0.0023

		Block 1	Block 2	Block 3
Variables	Categories	Beta (SE)	p	R²2. Reuben DB, Laliberte L, Hiris J, Mor V. A hierarchical exercise scales to measure function at the Advanced Activities of Daily Living (AADL) level. J Am Geriatr Soc 1990;38(8):855-61.(partial)	Beta (SE)	p	R²2. Reuben DB, Laliberte L, Hiris J, Mor V. A hierarchical exercise scales to measure function at the Advanced Activities of Daily Living (AADL) level. J Am Geriatr Soc 1990;38(8):855-61.(partial)	Beta (SE)	p	R²2. Reuben DB, Laliberte L, Hiris J, Mor V. A hierarchical exercise scales to measure function at the Advanced Activities of Daily Living (AADL) level. J Am Geriatr Soc 1990;38(8):855-61.(partial)
				0.4557			0.4593			0.4724
Education		0.60 (0.02)	<0.001	0.4305	0.59 (0.02)	<0.001	0.4305	0.58 (0.002)	<0.001	0.4305
Family income		0.13 (0.02)	<0.001	0.0117	0.12 (0.02)	<0.001	0.0117	0.11 (0.2)	<0.001	0.0117
Gender	Female	-140.30 (234.46)	<0.001	0.0076	-133.07 (24.46)	<0.001	0.0076	-149.54 (24.49)	<0.001	0.0076
Age		-0.08(0.02)	<0.001	0.0059	-0.08 (0.02)	<0.001	0.0059	-0.08 (0.02)	<0.001	0.0059
Depressive s.	Yes				-111.85 (29.38)	<0.001	0.0036	-90.57 (29.19)	0.002	0.0036
Intel. ADDLs.	Less active							164.42 (30.07)	<0.001
	More active							238.22 (34.36)	<0.001
	Super active							225.79 (46.19)	<0.001	0.0131

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[1] Correspondence Mônica Sanches Yassuda E-mail:yassuda@usp.br