Pronounced impairment of activities of daily living in posterior cortical atrophy

Ahmed, Samrah, Culley, Siobhan, Blanco-Duque, Cristina, Hodges, John R., Butler, Christopher and Mioshi, Eneida (2020) Pronounced impairment of activities of daily living in posterior cortical atrophy. Dementia and Geriatric Cognitive Disorders, 49 (1). 48–55. ISSN 1420-8008

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Introduction : The impact of several dementia syndromes on activities of daily living (ADLs) has been well documented, but no study has yet investigated functional ability in posterior cortical atrophy (PCA). The primarily visual nature of deficits in this condition is likely to have a pronounced impact on ADLs. Objective : The aim of this study was to profile functional change in PCA and identify predictors of change. Method : Twenty-nine PCA patients and 25 patients with typical Alzheimer’s disease (AD) and their caregivers were included in this cross-sectional study. ADLs were assessed using the Disability Assessment for Dementia (DAD), administered to caregivers, assessing basic ADLs (e.g., eating, dressing) and instrumental ADLs (e.g., managing finances, meal preparation). The predictive utility of cognitive domains (Addenbrooke’s Cognitive Examination), behavioural impairment (Cambridge Behavioural Inventory-Revised) and demographic variables on ADL ability was also examined. Results : PCA patients showed significantly reduced total ADL scores compared to AD patients (medium effect size, d = –0.7; p < 0.05), with significantly more impairment on basic ADLs (large effect size, d = –0.8; p < 0.05) but similar impairment on instrumental ADLs (medium effect size, d = –0.5; p > 0.05). A model combining patient mood, disinhibition, apathy, symptom duration, and memory and attention/orientation scores explained the variance of scores in functional decline (61.2%), but the key factor predicting ADL scores was attention/orientation (p = 0.048). Conclusion : This study shows the profound impact of PCA on ADLs and factors underpinning patients’ disability. Attention/orientation deficits were found to correlate and contribute to variance in ADL scores. Future work to develop tailored interventions to manage ADL impairment in PCA should take these findings into account.

Item Type: Article
Uncontrolled Keywords: activities of daily living,alzheimer s disease,attention,memory,posterior cortical atrophy,geriatrics and gerontology,cognitive neuroscience,psychiatry and mental health,sdg 3 - good health and well-being ,/dk/atira/pure/subjectarea/asjc/2700/2717
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups: Faculty of Medicine and Health Sciences > Research Groups > Dementia & Complexity in Later Life
Faculty of Medicine and Health Sciences > Research Centres > Norwich Institute for Healthy Aging
Faculty of Medicine and Health Sciences > Research Centres > Lifespan Health
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Depositing User: LivePure Connector
Date Deposited: 29 Apr 2020 00:03
Last Modified: 19 Oct 2023 02:40
DOI: 10.1159/000506125


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