Background
Methods
Design
Participants
Measures
Procedure
Data analysis
Results
Sample characteristics
Total | |||
---|---|---|---|
Demographic
| |||
Women | N (%) | 683 |
(68.2)
|
Age (year) | Mean (SD) |
83.4
|
(5.7)
|
Single as marital status | N (%) | 703 |
(70.2)
|
General somatic health
1
| |||
Good | N (%) | 155 |
(15.6)
|
Fair | N (%) | 392 |
(39.2)
|
Poor | N (%) | 346 |
(34.6)
|
Very poor | N (%) | 106 |
(10.6)
|
Cognitive functioning
| |||
MMSE | Mean (SD) | 24.5 |
(4.8)
|
Diagnoses
| |||
MCI | N (%) | 277 |
(27.7)
|
Dementia | N (%) | 415 |
(41.5)
|
Neuropsychiatric sub-syndrome score
| |||
Agitation | Mean (SD) | 1.7 |
(4.6)
|
Psychosis | Mean (SD) | 0.5 |
(2.0)
|
Affective | Mean (SD) | 2.9 |
(5.3)
|
Use of psychotropic medication
| |||
Antipsychotics | N (%) | 34 |
(3.4)
|
Antidepressants | N (%) | 154 |
(15.4)
|
Anxiolytics | N (%) | 86 |
(8.6)
|
Sedatives | N (%) | 218 |
(21.8)
|
Antidementia | N (%) | 56 |
(5.6)
|
Change of P-ADL functioning over the follow-up period
Time point | Min, Max | Mean (SD) | ICC municipality (%) |
---|---|---|---|
P-ADL | |||
T1 | 6, 23 | 9.2 (3.5) | |
T2 | 6, 25 | 10.3 (4.4) | 5.6 |
T3 | 6, 30 | 11.4 (5.2) | |
I-ADL | |||
T1 | 0, 8 | 5.5 (2.3) | |
T2 | 0, 8 | 4.8 (2.5) | 8.0 |
T3 | 0, 8 | 4.6 (2.7) |
The association between cognitive functioning and P-ADL functioning
Unadjusted regression coefficients | Adjusted regression coefficients | |||
---|---|---|---|---|
Coeff. (95% CI) | p-value2 | Coeff. (95% CI) | p-value2 | |
Effect of main variables3 | ||||
Time | 0.27 (0.21; 0.33) |
<0.001
| 0.29 (0.23; 0.34) |
<0.001
|
MMSE at T1 | −0.28 (−0.33; −0.23) |
<0.001
| −0.12 (−0.18; −0.05) |
<0.001
|
MMSE *Time | −0.008 (−0.01; −0.006) |
<0.001
| −0.009 (−0.01; −0.006) |
<0.001
|
Effect of additional variables at T14 | ||||
Socio –demographic information
| ||||
Women | −0.91 (−1.30; −0.52) |
<0.001
| −0.57 (−0.92; −0.21) |
0.002
|
Age (years) | 0.11 (0.07; 0.14) |
<0.001
| 0.06 (0.04; 0.10) |
<0.001
|
Single | −0.83 (−1.23; −0.43) |
<0.001
| −0.31 (−0.68; 0.06) | 0.101 |
General somatic health
| ||||
Very poor | 4.32 (3.60; 5.05) |
<0.001
| 3.32 (2.66; 3.97) |
<0.001
|
Poor | 2.88 (2.35; 3.41) |
<0.001
| 2.04 (1.56; 2.52) |
<0.001
|
Fair | 1.59 (1.09; 2.10) |
<0.001
| 0.97 (0.52; 1.42) |
<0.001
|
Good | Reference | Reference | ||
Diagnoses
| ||||
Dementia | 3.98 (3.58; 4.38) |
<0.001
| 1.17 (0.53; 1.80) |
<0.001
|
MCI | 0.98 (0.55; 1.40) |
<0.001
| −0.10 (−0.53; 0.34) | 0.667 |
No | Reference | Reference | ||
Neuropsychiatric sub-syndrome score
| ||||
Agitation | 0.15 (0.11; 0.19) |
<0.001
| 0.04 (−0.008; 0.09) | 0.106 |
Psychosis | 0.44 (0.35; 0.53) |
<0.001
| 0.18 (0.08; 0.28) |
<0.001
|
Affective | 0.15 (0.12; 0.19) |
<0.001
| 0.03 (−0.01; 0.06) | 0.162 |
Use of psychotropic medication
| ||||
Antipsychotics | 1.55 (0.60; 2.50) |
0.001
| 0.55 (−0.27; 1.37) | 0.187 |
Antidepressants | 1.12 (0.63; 1.61) |
<0.001
| 0.51 (0.06; 0.95) |
0.026
|
Anxiolytics | 1.00 (0.34; 1.65) |
0.003
| 0.20 (−0.38; 0.77) | 0.506 |
Sedatives | 0.49 (0.03; 0.94) |
0.036
| 0.17 (−0.23; 0.56) | 0.410 |
Cognitive enhancers | 1.91 (1.14; 2.67) |
<0.001
| −0.61 (−1.31; 0.09) | 0.088 |
Unadjusted regression coefficients | Adjusted regression coefficients | |||
---|---|---|---|---|
Coeff. (95% CI) | p-value2 | Coeff. (95% CI) | p-value2 | |
Effect of main variables3 | ||||
Time | 0.13 (0.08; 0.17) |
<0.001
| 0.08 (0.04; 0.13) |
<0.001
|
MMSE (at 3 time points) | −0.30 (−0.34; −0.26) |
<0.001
| −0.13 (−0.19; −0.08) |
<0.001
|
MMSE*Time | −0.004 (−0.006; −0.002) |
<0.001
| −0.002 (−0.004; −0.0005) |
0.012
|
Effect of additional variables at T14 | ||||
Socio –demographic information
| ||||
Women | 0.91 (−1.30; −0.52) |
<0.001
| −0.49 (−0.82; −0.16) |
0.003
|
Age (years) | 0.11 (0.07; 0.14) |
<0.001
| 0.04 (0.01; 0.07) |
0.003
|
Single | −0.83 (−1.23; −0.43) |
<0.001
| −0.17 (−0.51; 0.16) | 0.311 |
General somatic health
| ||||
Very poor | 4.32 (3.60; 5.05) |
<0.001
| 2.99 (2.39; 3.59) |
<0.001
|
Poor | 2.88 (2.35; 3.41) |
<0.001
| 1.77 (1.34; 2.21) |
<0.001
|
Fair | 1.59 (1.09; 2.10) |
<0.001
| 0.65 (0.24; 1.06) |
0.002
|
Good | Reference | Reference | ||
Effect of additional variables at 3 time-points4 | ||||
Diagnoses
| ||||
Dementia | 4.42 (4.04; 4.80) |
<0.001
| 1.31 (0.76; 1.86) |
<0.001
|
MCI | 0.96 (0.54; 1.39) |
<0.001
| 0.18 (−0.22; 0.58) | 0.369 |
No | Reference | Reference | ||
Neuropsychiatric sub-syndrome score
| ||||
Agitation | 0.23 (0.19; 0.27) |
<0.001
| 0.07 (0.03; 0.10) |
<0.001
|
Psychosis | 0.41 (0.33; 0.48) |
<0.001
| 0.06 (−0.01; 0.13) | 0.098 |
Affective | 0.17 (0.13; 0.20) |
<0.001
| 0.04 (0.01; 0.08) |
0.007
|
Use of psychotropic medication
| ||||
Antipsychotics | 2.92 (2.07; 3.78) |
<0.001
| 0.81 (0.11; 1.50) |
0.023
|
Antidepressants | 1.61 (1.15; 2.07) |
<0.001
| 0.33 (−0.06; 0.72) | 0.095 |
Anxiolytics | 1.30 (0.71; 1.90) |
<0.001
| 0.20 (−0.28; 0.68) | 0.410 |
Sedatives | 0.81 (0.37; 1.24) |
<0.001
| 0.15 (−0.19; 0.50) | 0.388 |
Cognitive enhancers | 1.78 (1.08; 2.49) |
<0.001
| −1.09 (−1.68; −0.49) |
<0.001
|
Effect of additional variable at T2 & T34 | ||||
Nursing home care | 6.45 (5.87; 7.03) |
<0.001
| 2.84 (2.19; 3.49) |
<0.001
|
Change of I-ADL functioning over the follow-up period
The association between cognitive functioning and I-ADL functioning
Unadjusted regression coefficients | Adjusted regression coefficients | |||
---|---|---|---|---|
Coeff. (95% CI) | p-value2 | Coeff. (95% CI) | p-value2 | |
Effect of main variables3 | ||||
Time | −0.13 (−0.17; −0.09) |
<0.001
| −0.13 (−0.17; −0.10) |
<0.001
|
Time* Time | 0.0007 (0.00007; 0.001) |
0.029
| 0.0006 (0.00001; 0.001) |
0.046
|
MMSE at T1 | 0.24 (0.21; 0.26) |
<0.001
| 0.07 (0.04; 0.10) |
<0.001
|
MMSE *Time | 0.003 (0.002; 0.004) |
<0.001
| 0.003 (0.002; 0.004) |
<0.001
|
Effect of additional variables at T14 | ||||
Socio –demographic information
| ||||
Women | 0.82 (0.59; 1.04) |
<0.001
| 0.62 (0.43; 0.80) |
<0.001
|
Age (years) | −0.08 (−0.10; −0.06) |
<0.001
| −0.06 (−0.07; −0.04) |
<0.001
|
Single | 0.71 (0.48; 0.95) |
<0.001
| 0.35 (0.16; 0.54) |
<0.001
|
General somatic health
| ||||
Very poor | −2.33 (−2.75; −1.91) |
<0.001
| −1.51 (−1.85; −1.17) |
<0.001
|
Poor | −1.72 (−2.03; −1.42) |
<0.001
| −1.05 (−1.29; −0.80) |
<0.001
|
Fair | −1.03 (−1.32; −0.74) |
<0.001
| −0.55 (−0.78; −0.32) |
<0.001
|
Good | Reference | Reference | ||
Diagnoses
| ||||
Dementia | −3.05 (−3.26; −2.84) |
<0.001
| −1.40 (−1.73; −1.08) |
<0.001
|
MCI | −0.84 (−1.06; −0.62) |
<0.001
| −0.22 (−0.45; −0.003) |
0.047
|
No | Reference | Reference | ||
Neuropsychiatric sub-syndrome score
| ||||
Agitation | −0.10 (−0.12; −0.07) |
<0.001
| 0.02 (−0.006; 0.04) | 0.155 |
Psychosis | −0.35 (−0.40; −0.30) |
<0.001
| −0.16 (−0.20; −0.11) |
<0.001
|
Affective | −0.13 (−0.15; −0.11) |
<0.001
| −0.04 (−0.06; −0.02) |
<0.001
|
Use of psychotropic medication
| ||||
Antipsychotics | −1.29 (−1.83; −0.75) |
<0.001
| −0.49 (−0.91; −0.08) |
0.019
|
Antidepressants | −0.77 (−1.06; −0.49) |
<0.001
| −0.34 (−0.57; −0.11) |
0.003
|
Anxiolytics | −0.76 (−1.15; −0.38) |
<0.001
| −0.20 (−0.50; 0.10) | 0.183 |
Sedatives | −0.09 (−0.35; 0.17) | 0.509 | 0.07 (−0.13; 0.27) | 0.490 |
Cognitive enhancers | −2.46 (−2.91; −2.02) |
<0.001
| −0.62 (−0.99; −0.25) |
0.001
|
Unadjusted regression coefficients | Adjusted regression coefficients | |||
---|---|---|---|---|
Coeff. (95% CI) | p-value2 | Coeff. (95% CI) | p-value2 | |
Effect of main variables3 | ||||
Time | −0.06 (−0.09; −0.02) |
<0.001
| −0.07 (−0.10; −0.03) |
<0.001
|
Time*Time | 0.0007 (0.00009; 0.001) |
0.023
| 0.0006 (0.0001; 0.001) |
0.016
|
MMSE (at 3 time points) | 0.25 (0.22; 0.27) |
<0.001
| 0.07 (0.04; 0.10) |
<0.001
|
MMSE*Time | 0.0009 (−0.0001; 0.002) | 0.081 | 0.001 (0.0002; 0.002) |
0.021
|
Effect of additional variables at T14 | ||||
Socio –demographic information
| ||||
Women | 0.82 (0.59; 1.04) |
<0.001
| 0.63 (0.46; 0.80) |
<0.001
|
Age (years) | −0.08 (−0.10; −0.06) |
<0.001
| −0.04 (−0.06; −0.03) |
<0.001
|
Single | 0.71 (0.48; 0.95) |
<0.001
| 0.29 (0.11; 0.46) |
0.001
|
General somatic health
| ||||
Very poor | −2.33 (−2.75; −1.91) |
<0.001
| −1.34 (−1.65; −1.03) |
<0.001
|
Poor | −1.72 (−2.03; −1.42) |
<0.001
| −0.91 (−1.14; −0.69) |
<0.001
|
Fair | −1.03 (−1.32; −0.74) |
<0.001
| −0.43 (−0.64; −0.21) |
<0.001
|
Good | Reference | Reference | ||
Effect of additional variables at 3 time-points4 | ||||
Diagnoses
| ||||
Dementia | −3.28 (−3.47; −3.08) |
<0.001
| −1.50 (−1.79; −1.21) |
<0.001
|
MCI | −0.76 (−0.98; −0.55) |
<0.001
| −0.26 (−0.47; −0.06) |
0.012
|
No | Reference | Reference | ||
Neuropsychiatric sub-syndrome score
| ||||
Agitation | −0.13 (−0.15; −0.11) |
<0.001
| 0.005 (−0.01; 0.02) | 0.634 |
Psychosis | −0.28 (−0.33; −0.24) |
<0.001
| −0.07 (−0.11; −0.03) |
<0.001
|
Affective | −0.14 (−0.15; −0.12) |
<0.001
| −0.05 (−0.07; −0.04) |
<0.001
|
Use of psychotropic medication
| ||||
Antipsychotics | −1.83 (−2.34; −1.33) |
<0.001
| −0.75 (−1.12; −0.39) |
<0.001
|
Antidepressants | −0.97 (−1.24; −0.70) |
<0.001
| −0.23 (−0.43; −0.02) |
0.028
|
Anxiolytics | −0.95 (−1.30; −0.59) |
<0.001
| −0.29 (−0.54; −0.04) |
0.026
|
Sedatives | −0.29 (−0.55; −0.04) |
<0.0251
| 0.03 (−0.15; 0.21) | 0.768 |
Cognitive enhancers | −2.38 (−2.79; −1.98) |
<0.001
| −0.46 (−0.78; −0.14) |
0.005
|
Effect of additional variable at T2 & T3 2 | ||||
Nursing home care | −3.70 (−4.09; −3.31) |
<0.001
| −1.16 (−1.54; −0.79) |
<0.001
|