Cognitive functioning as a predictor of functional disability in later life

Abstract

Objective: The contribution of cognitive functioning on multiple levels of functional disability and mortality over two years as well as individual activities of daily living (ADLs) and instrumental activities of daily living (IADLs) tasks, in a sample of older U.S. adults was examined.

Methods: A total of 4,077 U.S. adults (1,493 males and 2,584 females) aged > or =70 years (mean = 76.35 years) from the Second Longitudinal Study of Aging (1997/1998-1999/2000) were examined using an adapted Telephone Interview of Cognitive Status (TICS), ADLs, and IADLs.

Results: Multivariate logistic regression investigated cognition as a predictor of five mutually exclusive levels of functional disability. People with the lowest level of cognition had greater odds of mortality at follow-up (adjusted odds ratio [AOR] = 2.86, 95% confidence interval [CI] = 1.94-4.20), ADL and IADL disability (AOR = 1.58, 95% CI = 1.15-2.16), ADL disability (AOR = 1.83, 95% CI = 1.27-2.64), or IADL disability (AOR = 1.22, 95% CI = 0.86-1.71) than those who were disability-free. Cognitive functioning was not predictive of individual ADL tasks but was predictive of the IADL tasks of preparing meals, shopping for groceries, managing money, telephone use, light housework, and medications but not heavy housework.

Conclusion: Persons with lower levels of cognitive functioning were more likely to die or become disabled than those with higher levels of cognition. Changes in cognitive functioning might serve as an early indicator of neurologic and medical factors.