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To explore baseline activities of daily living (ADL) profiles and their association with memory decline over time in cognitively healthy, community-dwelling older adults.
Observational panel study.
This study analysed data from Waves 7–10 of the English Longitudinal Study of Ageing (the search was performed on May 28, 2024), including 2925 older adults aged above 65 with no dementia or cognitive impairments at baseline (Wave 7, 2014–2015). To categorise participants by their daily functional abilities at baseline, latent class analysis was conducted to derive participants' activities of daily living profiles. A linear mixed model was used to explore whether these baseline activity profiles might predict different memory decline rates (trajectories) over time, accounting for baseline demographic factors (gender, age, ethnicity, education, marital status and chronic diseases).
Social demographics (younger age, female gender, white ethnicity, higher education and being partnered) and ADL profiles outweigh health conditions in predicting participants' memory function. Different baseline profiles were linked to different memory decline trajectories. An impairment profile with grocery shopping capability was linked to slower memory decline.
This study showed that ADL profiles had a substantial correlation with memory decline, accounting for the significant impact of sociodemographic factors. An impairment profile that preserved grocery shopping abilities appeared to offer protective benefits and potentially slow memory decline.
Strengthening nursing strategies that support older adults in maintaining the ability to grocery shop, such as guiding caregivers to promote involvement rather than shopping for the older adults entirely, or accompanying older adults grocery shopping as part of community nursing care, might help delay age-related memory decline in this population.
Patients or members of the public were not directly involved in the study's design, conduct, reporting, or dissemination plans.
The interaction between dementia and changes in health status accelerates the progression of dementia and health deterioration. Although health indicators exist for older adults, comprehensive ones for dementia are lacking.
To (1) establish core health indicators for older adults with dementia, (2) develop an integrated health assessment toolkit for older adults with dementia, and (3) test the feasibility and applicability of the integrated health assessment toolkit.
This study involved two phases. In the first phase, using the Delphi method, opinions from 10 experts were synthesized to establish core health indicators for older adults with dementia. In the second phase, with a descriptive research approach, an integrated health assessment toolkit was developed, evaluated by 10 daycare case managers for feasibility, and then pilot tested with 50 older adults with dementia across three daycare centers.
The core health indicators for older adults with dementia covered 18 indicators in five domains: (1) cognitive and behavioral impairment, (2) sensory and perceptual impairment, (3) disease and dysfunction, (4) functional fitness deterioration, and (5) social isolation. After two rounds of assessments, experts rated the criteria's importance and clarity at 0.94 and 0.89 on the scale-level content validity index/universal agreement (S-CVI/UA), respectively. In the second phase, the integrated health assessment toolkit was developed, which integrated five observational assessment scales and six physical function measures. The average applicability scores ranged from 7.80 to 9.90 out of 10. In the pilot test, the assessment process proceeded smoothly without any adverse events. However, 10 participants did not comply with wearing the actigraphy device.
The core health indicators and the corresponding health assessment toolkit are feasible to assess the health of older adults with dementia that could provide valuable insights and guide future interventions to enhance their well-being.
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