The relationship among attention, daily behavior and disease severity in patients with Alzheimer's disease
Item
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Title
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The relationship among attention, daily behavior and disease severity in patients with Alzheimer's disease
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Identifier
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d_2009_2013:2c842b7babe8:10746
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identifier
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11080
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Creator
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Kaplan, Lillian,
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Contributor
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Nancy S. Foldi
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Date
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2011
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Language
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English
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Publisher
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City University of New York.
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Subject
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Clinical psychology | Cognitive psychology | Alzheimer disease | Attention | Instrumental activities of daily living
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Abstract
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Introduction. Complex instrumental activities of daily living (IADL) and basic activities of daily living (BADL) are typically impaired in Alzheimer disease (AD). It is unclear, however, how attention versus global cognitive impairments selectively impact functional decline. We hypothesized that performance on attention tasks would predict functional impairment, and specifically be predictive of IADL. Method. Twenty-seven newly-diagnosed participants with AD were assessed on (1) global cognition: Mattis Dementia Rating Scale-2 (DRS-2); (2) attention: (a) RT on simple detection, (b) covert orienting, (c) speed and errors on executive attention, D-KEFS Trail Making Test (TMT) Condition-4; (3) a) caregiver ratings of IADL/BADL: Modified Lawton-Brody, Neuropsychiatric Inventory (NPI). Results. Forty eight percent of the participants had only IADL impairment, while the remaining participants had both IADL and BADL deficits. There were no differences in demographics or cognitive status between those with and without BADL deficits. Hierarchical regression revealed that errors on the TMT Condition- 4 accounted for the majority of IADL variability. After accounting for the TMT Condition-4 errors, the changes in variability of IADL associated with DRS-2 and NPI were minimal. Neither global cognitive scores nor attentional measures predicted BADL performance. Conclusions. IADL impairments are primary deficits at the time of diagnosis of AD, and as hypothesized, a measure of executive attention best predicted the variable daily demands of IADL. As global cognitive scores did not predict the more variable IADL impairment, these findings suggest that measures of higher executive attention are more sensitive to IADL, and may better inform clinicians and caregivers of potential difficulty with daily tasks faced by patients with early AD.
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Type
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dissertation
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Source
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2009_2013.csv
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degree
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Ph.D.
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Program
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Psychology
