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KMID : 1100220070060020042
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Dementia and Neurocognitive Disorders
2007 Volume.6 No. 2 p.42 ~ p.47
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Changes in the Instrumental Activities of Daily Living According to the Severity of Dementia in Stroke Patients and Their Relationship to Cognitive Functions
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Oh Eun-A
Parl Jae-Seol
Yu Kyung-Ho
Lee Byung-Chul
Kang Yeon-Wook
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Abstract
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Background: Although many stroke patients suffer from both impairments in instrumental activities of daily living (IADL) and cognitive dysfunctions, there has been little investigation into the relationship between IADL deficits and cognitive ability in stroke patients. This study was conducted in order to examine the relationship between IADL deficits and the severity of dementia in stroke patients and to determine the cognitive functions that are strongly related to the IADL.
Methods: The subjects included 148 stroke patients who were given a comprehensive neuropsychological evaluation. They were divided into four groups (normal, questionable, mild, and moderate dementia groups) based on their CDR scores. Their caregivers completed the K-IADL and Modified Barthel Index.
Results: The results of the evaluations indicated that the questionable dementia group showed significantly greater impairment than the normal group on four items (household chores, cooking, hobbies, and fixing the house) in the KIADL. The mild dementia group showed significantly greater impairment than the questionable dementia group on six items (using transportation, managing finances, using the telephone, responsibility for own medication, recent memory, and watching TV) in the K-IADL. The moderate dementia group showed greater impairment than the mild dementia group on all of the items in the K-IADL. Hierarchical multiple regression analyses revealed that the RCFT-copy score is the best predictor of K-IADL score, regardless of the severity of dementia.
Conclusion: These results showed that impairment in the IADL can be seen even in very mild levels of cognitive deficit. The results also suggest that visuospatial ability is significantly related to the IADL.
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KEYWORD
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Stroke, Instrumental activities of daily living (IADL), K-IADL, Visuospatial ability
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