Geriatric Rehabilitation
Geriatric Rehabilitation
Oral Presentation
Shlomit Rotenberg, PhD, OT
Post Doctoral Fellow
Rotman Research Institute, Baycrest
Toronto, Ontario
Adina Maeir, PhD, OT
Associate Professor and School Chair, School of Occupational Therapy, Faculty of Medicine
The Hebrew University
Jerusalem, Yerushalayim
Deirdre Dawson, PhD, OT Reg. (Ont.)
Interim Chair & Professor
Department of Occupational Science & Occupational Therapy, University of Toronto
Toronto, Ontario
This study examined reported changes in participation in IADL, social and leisure activities of 115 community dwelling older adults reporting memory problems. The relationship between activity participation and objective and subjective cognition was also examined.
Participants adults were divided into three groups based on their objective cognitive status: high / moderate / low cognitive functioning. We found that older adults with high cognitive functioning (i.e. no objective cognitive deficits) reported significantly more preserved participation compared to individuals with cognitive impairments; however they too reported withdrawal from participation compared to their own past participation, 5-10 years before. The presence of subjective cognitive complaints explained an additional 9% of the variance in participation, beyond that explained by objective impairments.
Our findings suggest that although older adults with subjective cognitive decline are independent in instrumental activities of daily living, they report reduced participation in social and leisure activities. Therefore, participation should be assessed by healthcare professionals, even in the absence of objective cognitive deficits.
Objective:
The aims of this study were to:
(1) examine changes in participation level of older adults reporting memory problems;
(2) investigate differences in participation between individuals with high-cognitive functioning (CF), moderate-CF and low-CF;
(3) explore whether subjective cognition explains additional variance in participation after accounting for objective cognitive impairments.
Design:
This is a secondary analysis of data from two studies. (study-1 performed in Canada[1], study-2 preformed in Israel[2]), using a cross-sectional study design.
Setting :
This study was performed in community settings. Participants were recruited from a research subject pool, a community psycho-education program and from community based geriatric clinics.
Participants (or Animals, Specimens, Cadavers):
115 older adults (60+) were divided into 3 groups: high-CF (Montreal Cognitive Assessment (MoCA; [3])≥ 26; n=66); moderate-CF (MoCA=20-25; n=34); and low-CF (MoCA≤19; n=15).
Interventions : Interventions: Not applicable.
Main Outcome Measure(s):
The Activity Card Sort[4] was used to measure participation in instrumental activities of daily living (IADL), social and leisure activities.The Multifactorial Memory Questionnaire[5] was used to measure subjective cognition.
Results : Individuals with high-CF reported withdrawal from 21% (±13.7) of their daily activities over the previous 5-10 years. Individuals with moderate-CF and low-CF reported a withdrawal from 30% ±16.0 and 42% ±20.2 of their daily activities, respectively. A significant between group difference was found on participation withdrawal (F(2, 107)=2.107, p=0.00). Participation significantly correlated with both objective (r=.431, p<.01) and subjective (r=.241-.392, p<.05) cognition. The presence of subjective cognitive complaints explained an additional 9% of the variance in participation, beyond that explained by objective impairments.
Conclusions:
Assessing participation, specifically in social and leisure activities, is highly important in older adults reporting cognitive problems, even in the absence of objective cognitive impairments.
