• Title/Summary/Keyword: ADL impairment

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A Comparative Study of Changes in Cognitive Function, Depression and Activities of Daily Living in Patients with Dementia, Mild Cognitive Impairment and Ischemic Stroke (치매, 경도인지장애, 허혈성 뇌졸중 환자에서 인지기능, 우울 및 일상생활수행능력의 변화 비교)

  • Jung, Mi-Sook;Oh, Eun-Young;Cha, Kyeong-In
    • Journal of Digital Convergence
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    • v.20 no.3
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    • pp.517-527
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    • 2022
  • This study aimed to compare changes in cognitive function, depression and ability to perform activity of daily living (ADL) in patients with dementia, mild cognitive impairment (MCI), and ischemic stroke (IS) and to identify factors associated with changes in instrumental ADL. A total of 86 patients (dementia=30, MCI=32, and IS=24) were included to analyse cognitive function, depression, and basic and instrumental ADL obtained at the time of diagnosis and 1 year after baseline. Repeated measures analysis of variance and multiple linear regression were used. A significant group by time interaction was found in executive function (p=.037) and instrumental ADL (p=.023) across groups. The MCI group has little change in executive function and instrumental ADL from the baseline to 1 year after diagnosis while other two groups showed changes with the dementia group showing declines and the group of IS having improvement in these factors over time. Changes in executive function(p=.030) and basic ADL (p<.001) explained 26.9% in the variance of changes in instrumental ADL. These findings showed a different changing pattern in executive function during the first year after diagnosis of dementia, MCI, and IS which have cognitive changes as their main symptoms, probably leading to a different changing pattern in instrumental ADL. Healthcare professionals should routinely assess for executive function and instrumental ADL problems and intervene to maintain and improve these functional outcomes immediately after disease.

Relationship of Activity of Daily Living(ADL) and Psychological Factors in Rheumatoid Arthritis (만성 류마티스 환자의 일상생활 활동과 심리적 요인과의 관계)

  • Kim Jong-Im;Kim In-Ja
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.2 no.2
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    • pp.155-168
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    • 1995
  • Many arthritis patients experience physical and psychological impairment. The influence psychological factors on physical functioning beyond disease & demographic factors has been investigated. Unlike others studied the relationship between just two variables (i. e., depression & helplessness or self-efficacy & depression), the relationships among several variables such as depression, helplessness and self-efficacy were examined altogether. Foully-two patients were examined to identify the relationship between the variables. It was found that ADL is significantly negatively related to depression and helplessness, and positively related to self-efficacy. And ADL was more strongly correlated with self-efficacy and helplessness than depression. Contrary to ADL, pain was significantly negatively related to self-efficacy, and positively related to depression and helplessness. Then stepwise regression analysis was performed to identify the variables to predict ADL. It revealed that helplessness was the only significant predictor of ADL. Finally, it is suggested that the inclusion of the method to increase self-efficacy & to decrease helplessness in any nursing intervention is very important.

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A Study on ADL, IADL, and Cognitive Function of Low-income Community Dwelling Elderly (도시 저소득층 노인의 ADL, IADL 및 인지기능과의 관계)

  • Yoo, Moon-Sook;Kim, Hye-Kyung;Jo, Eun-Mi;Kim, Yong-Soon
    • Journal of Home Health Care Nursing
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    • v.14 no.1
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    • pp.5-10
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    • 2007
  • Purpose: The purpose of the study was to analyze the ADL, IADL and cognitive function of low-income elderly who are receiving the visiting nurse service in the community. Method: Study participant were 2,413 community-dwelling elderly who live in S City. The data were collected from 5th Jan. to 28th Feb. 2006. The cross-sectional descriptive survey was done using a structured questionnaire through interviews by visiting nurses. Result: The average scores of ADL and IADL was respectively high, which indicates a relatively independent everyday life. However, the score of cognitive function was 21.87(normal range is over 23). There was a significantly positive correlation among ADL, IADL and cognitive function with the pearson correlation coefficients. Conclusion: It is concluded that elder subjects who are women, old aged, and live alone should be watched carefully for the cognitive impairment. In addition, the government should apply early detection and management system for cognitive impaired people who live in the community.

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The Effect of an Exercise Program on Activities of Daily Living (ADL), Balance and Cognition in Elderly individuals with Alzheimer’s Disease and Vascular Dementia (치매노인의 일상생활동작과 균형 및 인지능력에 대한 운동프로그램의 효과)

  • Son, Ho-Hee;Oh, Jung-Lim;Park, Rae-Joon
    • The Journal of Korean Physical Therapy
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    • v.22 no.1
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    • pp.53-60
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    • 2010
  • Purpose: The purpose of our study was to evaluate the effects of an exercise program on activities of daily living (ADL), balance and cognition in elderly individuals with Alzheimer’s disease and vascular dementia. Methods: Thirty-two patients with mild to moderate cognitive impairment were assigned to one of two groups: an exercise group (n=16) and a control group (n=16). The exercise group carried on regular exercise for 60 minutes a day, 4-5 times per week for 8 weeks. The exercise group participated in an exercise program (treadmill training and physical training). ADL, balance and cognitive function were evaluated before and at the end of the program using the Korean modified Bathel Index (K-MBI), the Functional independence measure (FIM), the Berg balance scale (BBS), the Balance performance monitor (BPM), and the Mini mental state examination (MMSE) in both groups. Results: There were significant exercise-induced improvements in ADL and Balance from pre to post tests; but not in MMSE. Conclusion: Exercise programs can improve ADL and balance in elderly with Alzheimer’s disease and vascular dementia.

A Case Report of a Patient with Mild Cognitive Impairment Treated with Gugijihwang-tang (구기지황탕 투여 후 호전된 경도인지장애 환자 1례에 대한 증례보고)

  • Park, Mi-so;Kang, Seock-man;Yoo, Dai-won;Chae, In-cheol;Kim, Gyeong-soon;Seong, Hyun-joo;Chung, Kwang-yeol;Yoo, Ho-ryong
    • The Journal of Internal Korean Medicine
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    • v.42 no.5
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    • pp.1082-1093
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    • 2021
  • Objective: Alzheimer's disease is characterized by progressive, irreversible brain damage and cognitive decline. Although the diagnosis and treatment of the prodromal symptoms of dementia are important, no treatment for mild cognitive impairment has been currently established. Herein, we report the case of an 80-year-old female patient with memory complaints treated with Gugijihwang-tang, a traditional Korean medicine herbal formula, as an add-on medication. Case Presentation: The patient was diagnosed with mild cognitive impairment based on clinical examinations using the Mini-Mental State Examination (MMSE), the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Activities of Daily Living (ADL) Scale, Global Deterioration (GDR) Scale, and Clinical Dementia Rating (CDR) Scale. She was treated with Gugijihwang-tang bis in die for 12 months while continuing her original medications, including 5-mg donepezil and 590-mg acetyl-l-carnitine. The MMSE score in the Korean Version of the CERAD Assessment Packet increased from 21 to 27 during the 12-month treatment period, and the CERAD 2 score increased from 33 to 62. The instrumental ADL scale score improved from 11 to 5. Other clinical examination results also showed improvement. The patient was satisfied and experienced no significant adverse events related to the Gugijihwang-tang treatment. Conclusion: This case suggests that Gugijihwang-tang could be considered as a treatment method for patients with mild cognitive impairment.

Health Status of Institutional Elderly in a Rural Area (일부 농촌지역 시설노인의 건강상태)

  • Nam, Hae-Sung;Park, Kyeong-Soo;Rhee, Jung-Ae
    • Journal of agricultural medicine and community health
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    • v.24 no.2
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    • pp.291-299
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    • 1999
  • This study was conducted to evaluate the health status including mainly cognitive function and activities of daily living of institutional elderly in a rural area. We studied 466 subjects dwelling in ten institutions at Chonnam province, Korea. The participants consist of 148 males(31.8%) and 318 females(68.2%). We collected the information of socioeconomic state, mini-mental state examination(MMSE), activities of daily living(ADL), instrumental activities of daily living(IADL), and Dartmouth Primary Care Cooperative Information Project(COOP) chart. The results were followed: 1. Severe cognitive function impairment was appeared in 45 males(30.4%) and 115 females(36.2%). 2. The percentage of fully independent in the six ADL items was 50.0% of males and 42.8% of females, but 31.1% of males and 26.1% of females were fully dependent. 3. Males had more impairment in mode of transportation among IADL, but females had most impairment in laundry. 4. Observing health status by COOP chart, both had more grade in feeling and social activity than physical fitness.

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Risk factors for functional disability among community dwelling elderly (지역사회 재가 노인의 기능장애 위험요인)

  • Song, Hyun-jong
    • Korean Journal of Health Education and Promotion
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    • v.32 no.3
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    • pp.109-120
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    • 2015
  • Objectives: The purpose of this study was to investigate risk factors for chronic ADL, IADL disability. The study explored clinical and socio-demographic risk factors of functional status decline. Methods: Data from the Survey of Living Condition of Elderly 3-year panel study were analyzed. The study subjects were 5,928 community-dwelling people aged 65 years or older who were no disability in ADL and IADL at baseline. Predisposing factors, pathology, impairment, and functional limitations were regarded as risk factors. Logistic regression analysis was used. Results: During the 3-year study period, 3.9% participants developed chronic ADL disability, 9.4% participants were IADL disabled. After controlling for predisposing factor, the best predictors for ADL disability at 36 months were fall as a pathology factor, cognitive decline, disability judgement, lower limb functional limitation. Comorbidity, fall, cognitive decline, disability judgement, lower limb and upper limb functional limitation were risk factors for IADL disability. Conclusions: Health promotion program focusing elderly is essential to prevent ADL and IADL disability. Mobilizing physical activity should be included in health promotion program for elderly.

The Effect of Upper Extremity Training with a Focus on Functional Reaching, on Trunk Control and ADL Performance in Post-Stroke Hemiplegic Patients

  • Song, Bo-Kyung
    • The Journal of Korean Physical Therapy
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    • v.23 no.3
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    • pp.71-77
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    • 2011
  • Purpose: In this study, we tried to determine the effect of upper extremity training such as functional reaching on improved trunk control and ADL performance in post-stroke hemiplegic patients. Methods: We randomly selected 11 stroke patients in the hospital, who had a problem with the upper extremity, trunk and ADL performance. The patients were divided into the conservative training group and the functional reaching training group. We applied general occupational therapy only in the conservative training group whereas we applied upper extremity training with a focus on functional reaching in the functional reaching training group. To compare the two groups we used several assessment tools such as Modified Barthel Index (MBI), total Trunk Impairment Scale (TIS), static TIS, dynamic TIS and coordinative TIS. Results: The results obtained were as follows: (1) In the functional reaching training group, there was a statistically significant difference in the total TIS score, dynamic TIS score, and MBI. (2) We compared the results obtained before training with the changes in the results obtained after training and found that there was a relation between the assessment outcomes. Especially, static TIS score showed a relation in both groups. Conclusion: Functional reaching training influenced both the trunk control and ADL performance. Especially, the functional reaching training group demonstrated better static trunk control ability than the conservative treatment group.

An Analysis on Factors Affecting Korean Elderly People's ADL (우리나라 노인인구의 ADL 결정요인에 관한 연구)

  • Lee, Mee-Ae
    • The Korean Journal of Community Living Science
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    • v.21 no.2
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    • pp.201-210
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    • 2010
  • Over the past few decades, the proportion of elderly people in Korea has been rapidly increasing. In particular, rural areas are experiencing aging of communities more rapidly compared to urban areas. However, public policy for the elderly does not respond to the needs of rural elderly. To distribute health care resources equitably, it is necessary to gather reliable information on the health status of the elderly. The purpose of this study is to explore factors affecting Korean elderly people's ADL functional status. The data sources are from 2004 Elderly Living Condition Survey. The Analysis sample consists of 3,278 cases. Analysis results show that there is a significant residential variability in education, monthly stipend, living arrangement, subjective health status, regular food in-take, and regular exercise. Logistic regression analysis results also show that 'cognitive ability'(exp(B)=6.603), 'subjective health status'(exp(B)=4.576), 'age'(exp(B)=2.610), and 'living arrangement'(exp(B)=.589) are factors affecting ADLs. Namely, when a respondent's cognitive ability is limited, subjective health status is poor, or if their age is over 75, the probability of having a limited ADL has been 6.6 times, 4.6 times, and 2.6 times higher than otherwise. Among these variables, cognitive ability was the best explanation. In contrast, respondents who live with a spouse or adult children have a lower probability of having limited ADL compared with those who live alone. Considering that the most critical criteria in determining eligibility for social welfare services is ADLs, the development of appropriate ADL assessment tools is in an urgent need. Without the accurate assessment on ADLs, particularly on rural as well as the urban elderly, it seems to be hard to achieve effectiveness in the health care policy for the elderly.

Factors Influencing Cognitive Impairment in Elders with Dementia Living at Home (재가치매노인의 인지장애 영향 요인)

  • Ha, Eun-Ho;Park, Kyung-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.18 no.3
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    • pp.317-327
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    • 2011
  • Purpose: The purpose of this study was to contribute data toward prevention from advancing dementia and also prevention of deterioration in cognitive impairment by constructing an optimal prediction model and verifying factors influencing cognitive impairment in elders with dementia who reside at home. Methods: The participants in this study were 351 elders who were registered at dementia day care centers in 11 regions of Metropolitan Incheon. Collected data were analyzed using SPSS Statistics 17.0 and SAS 9.1. Bootstrap method using the Clementine program 12.0 was applied to build an optimum prediction model. Results: Gender and education (general characteristics), alcohol, urinary/fecal incontinence, exercise, weight, and ADL (state of health), and depression (psychological state) were found to have an affect on cognitive impairment in these elders. Conclusion: Study results indicate nine key factors that affect cognitive impairment of elders with dementia who reside at home and that could be useful in prevention and management nursing plans. These factors could also be used to expand the role of nurses who are working in community day care centers, and can be applied in the development and provision of various programs to aid retention and improve cognitive function as well as preventing deterioration of cognition.