None listed
Conditions
Brief summary
AIM The aim of this study is to investigate the ability of the Australian Modified Lawton’s IADL scale to differentiate cognitive impairment by determining ‘cut-off’ scores between Normal Cognition (NC), Mild Cognitive Impairment (MCI), and Dementia (D). HYPOTHESIS The Australian Modified Lawton’s IADL scale scores will have significant association with the diagnoses of MCI and D, hence contribute to the assessment and diagnosis of older persons presenting with cognitive decline according to standard diagnostic criteria. STUDY DESIGN This is a prospective single-blind single-centre study of patients newly referred to the Memory Clinic. METHOD The study cohort consists of older persons with no significant physical disability referred for assessment of subjective or objective cognitive decline to the Memory Service. The participants will undergo an occupational therapy (OT) clinic assessment which includes scoring the Australian Modified Lawton’s IADL scale and Timed Up and Go (TUG)assessment. The assessment will consist of a comprehensive interview of usual daily living activities and performance of several ADL based tasks. The carer is invited to be part of the interview. They will be provided with an information sheet on the research project. The occupational therapist is blinded to the diagnosis because the assessment occurs prior to any diagnosis by medical clinicians. The OT assessment is followed by medical assessment including cognitive assessment in the outpatient Memory Clinic. This will include completion of a Mini Mental State Examination (MMSE), according to the standard procedure. The final cognitive diagnosis is determined by the Geriatrician, according to DSM V criteria. The Australian Modified Lawton’s IADL scale scores are then analysed to determine the range of scores on the scale stratified by the three diagnostic groups of NC, MCI and D and to determine the between-group cut off points.
Interventions
Like most western countries, Australia is currently facing a dementia epidemic. The prevalence of dementia in Australia is expected to reach over 1.1 million in 2050 (Alzheimer's Australia, 2009). By the 2060s, spending on dementia is set to outstrip that of any other health condition (Alzheimer's Australia, 2015)..
Dementia syndrome affects a person in the three domains of cognition, behaviour and function. Impairment of functional abilities represents a crucial and necessary component of dem
Like most western countries, Australia is currently facing a dementia epidemic. The prevalence of dementia in Australia is expected to reach over 1.1 million in 2050 (Alzheimer's Australia, 2009). By the 2060s, spending on dementia is set to outstrip that of any other health condition (Alzheimer's Australia, 2015).. Dementia syndrome affects a person in the three domains of cognition, behaviour and function. Impairment of functional abilities represents a crucial and necessary component of dementia diagnosis (McGrory S, Shenkin S, Austin E & Starr J, 2014). Therefore, functional or daily living skills assessment must play a major role in contributing to cognitive diagnosis. However, how a quantitative measurement of activities of daily living (ADL) can contribute to the differential diagnoses, similar to the use of cognitive function tests, has not been extensively studied. The Lawton’s Instrumental Activities of Daily Living (IADL) Scale is a popular, reliable and validated instrument to assess independent living, and has been endorsed by the Australian Government for the use in various Aged Care Service Programmes. The aim of this study is to investigate the ability of the Australian Modified Lawton’s IADL scale (revised version of the Lawton’s IADL Scale) to differentiate cognitive diagnoses by determining ‘cut-off’ scores between Normal Cognition (NC), Mild Cognitive Impairment (MCI), and Dementia (D). The availability of this objective measure would contribute significantly to an earlier and more confident cognitive diagnosis. The Timed Up and Go (TUG) is a commonly used measure of functional mobility and dynamic balance. Recently the TUG has been associated with the assessment of patients for early cognitive changes, discriminating between patients with normal cognition (NC), MCI and D. A secondary aim is to compare performance on the TUG between elderly subjects with NC, MCI and D to determine if the TUG could add value to the assessment of patients in a memory clinic setting. An Occupational Therapist (OT) will assess Sir Charles Gairdner Hospital (SCGH) Memory Clinic patients prior to medical assessment and therefore clinical diagnosis. The Australian Modified Lawton’s IADL scores are then compared to the eventual diagnosis made by the Geriatrician (Principal Investigator) and the multidisciplinary team. This analysis will determine the range of scores on the IADL scale for the three diagnostic groups, NC, MCI and D, and the cut-off points between groups.
Sponsors
Sir Charles Gairdner Hospital Occupational Therapy
Eligibility
Sex/Gender
All
Healthy volunteers
Yes
Inclusion criteria
Inclusion criteria - Patients newly referred to the Memory Service, Day Therapy Unit Department of Rehabilitation and Aged Care at SCGH. - Sufficient English to communicate and participate in discussion and demonstration of daily living skills.
Exclusion criteria
Exclusion criteria - Comorbid medical conditions with significant physical impairment. - Major psychiatric disorder and/or behavioural problems - Significant cerebrovascular disease - Significant impairment of vision, hearing or communication
Outcome results
None listed