Background
Methods
Study population and setting
Usual and corrected IADL score
Other covariates
Statistical analysis
Results
Characteristics of the study sample
n or mean | % or [95%CI] | Usual IADL | p value | C-IADL | p value | |
---|---|---|---|---|---|---|
Total | 4.25 | 4.61 | ||||
Age (mean, 95% CI) | 79.89 | [79.58–80.20] | < 0.001 | < 0.001 | ||
Gender | < 0.001 | < 0.001 | ||||
Men | 917 | 38.35 | 3.49 | 4.26 | ||
Women | 1474 | 61.65 | 4.72 | 4.82 | ||
Marital status | < 0.001 | < 0.001 | ||||
Single | 99 | 4.14 | 5.39 | 5.47 | ||
Married/in couple | 1296 | 54.2 | 3.87 | 4.45 | ||
Divorced/separated | 205 | 8.57 | 5.17 | 5.26 | ||
Widowed | 742 | 31.03 | 4.49 | 4.56 | ||
Unspecified | 49 | 2.05 | 4.53 | 4.86 | ||
Educational level | < 0.001 | < 0.001 | ||||
Nil | 443 | 18.53 | 3.47 | 3.73 | ||
Primary | 836 | 34.96 | 4.11 | 4.41 | ||
Secondary | 787 | 32.92 | 4.61 | 4.98 | ||
Tertiary | 325 | 13.59 | 4.81 | 5.40 | ||
Lifestyle at baseline | < 0.001 | < 0.001 | ||||
At home with its husband/spouse | 1266 | 52.95 | 3.92 | 4.53 | ||
At home with relatives | 160 | 6.69 | 3.16 | 3.24 | ||
At home, alone, with relatives in the neighborhood | 684 | 28.61 | 4.71 | 4.79 | ||
At home, alone, without relatives in the neighborhood | 200 | 8.36 | 5.63 | 5.68 | ||
Other lifestyle | 81 | 3.39 | 4.32 | 4.36 | ||
MMSE score (mean, 95% CI) | 20.18 | [19.92–20.43] | < 0.001 | < 0.001 | ||
[0,10[ | 157 | 6.57 | 1.92 | 2.12 | ||
[10,20[ | 826 | 34.55 | 3.20 | 3.49 | ||
[20,26[ | 828 | 34.63 | 4.54 | 4.92 | ||
[26,30] | 580 | 24.26 | 5.97 | 6.42 | ||
NPI score (mean, 95% CI) | 17.4 | [16.76–18.04] | < 0.001 | < 0.001 | ||
Diagnosis stage | < 0.001 | < 0.001 | ||||
Absence of trouble | 16 | 0.67 | 5.13 | 5.90 | ||
Subjective cognitive complaint | 691 | 28.9 | 5.45 | 5.88 | ||
Mild neurocognitive disorders | 700 | 29.28 | 4.98 | 5.37 | ||
Major neurocognitive disorders | 975 | 40.78 | 2.86 | 3.13 | ||
Other cases | 9 | 0.38 | 5.00 | 5.25 | ||
Etiology | < 0.001 | < 0.001 | ||||
Etiology not yet established | 1107 | 46.3 | 4.82 | 5.25 | ||
Alzheimer’s disease | 576 | 24.09 | 3.28 | 3.51 | ||
Alzheimer’s disease with cerebrovascular component | 131 | 5.48 | 2.99 | 3.31 | ||
Cognitive disorders of vascular origin | 198 | 8.28 | 3.38 | 3.75 | ||
Lewy body disease | 41 | 1.71 | 2.95 | 3.36 | ||
Fronto temporal dementia | 10 | 0.42 | 1.50 | 1.65 | ||
Parkinson’s disease, and Parkinson’s syndroma | 54 | 2.26 | 3.22 | 3.65 | ||
Psychiatric disorders | 132 | 5.52 | 5.81 | 6.11 | ||
Other disorders | 78 | 3.26 | 4.46 | 4.94 | ||
No trouble | 64 | 2.68 | 7.02 | 7.26 |
Distribution of IADL and C-IADL according other covariates
Gender disparities on instrumental daily living activities
Total | Men | Women | ||||
---|---|---|---|---|---|---|
n = 2391 | % | n = 917 | % | n = 1474 | % | |
Number of answers “has never carried out … “ | ||||||
0 | 1509 | 63.11 | 286 | 31.19 | 1223 | 82.97 |
At least 1 activity | 882 | 36.88 | 631 | 68.81 | 251 | 17.03 |
Detailed answers by item of IADLa | ||||||
Has never used phone | 10 | 0.42 | 7 | 0.76 | 3 | 0.2 |
Has never taken his/her medicine | 48 | 2.01 | 24 | 2.62 | 24 | 1.63 |
Has never handle his/her finance | 400 | 16.73 | 178 | 19.41 | 222 | 15.06 |
Has never done laundry | 572 | 23.92 | 563 | 61.4 | 9 | 0.61 |
Has never done shopping | 70 | 2.93 | 66 | 7.2 | 4 | 0.27 |
Has never prepared meals | 309 | 12.92 | 304 | 33.15 | 5 | 0.34 |
Has never done housekeeping | 240 | 10.04 | 237 | 25.85 | 3 | 0.2 |
Agreement measurement between the two scores
Mean difference (d) | SD | Lower limits agreement | Upper limits agreement | % of observations inside limits agreement | ICC | 95% CI ICC | |
---|---|---|---|---|---|---|---|
Total | −0.35 | 0.70 | −1.72 | 1.01 | 93.52 | 0.98 | 0.978–0.982 |
Sex | |||||||
Men | −0.77 | 0.93 | −2.61 | 1.07 | 94.77 | 0.96 | 0.956–0.966 |
Women | −0.10 | 0.25 | −0.59 | 0.40 | 93.28 | 0.99 | 0.997–0.998 |
Diagnosis | |||||||
Absence of trouble | −0.77 | 0.97 | −2.68 | 1.13 | 93.75 | 0.93 | 0.801–0.976 |
Subjective cognitive complaint | −0.42 | 0.79 | −1.97 | 1.13 | 92.90 | 0.97 | 0.962–0.972 |
Mild Neurocognitive disorder | −0.40 | 0.76 | −1.97 | 1.12 | 93.71 | 0.97 | 0.966–0.975 |
Major neurocognitive disorder | −0.27 | 0.55 | −1.35 | 0.81 | 94.46 | 0.98 | 0.98–0.984 |
Other case | −0.25 | 0.43 | −1.10 | 0.60 | 100.00 | 0.99 | 0.965–0.998 |
Sensitivity of agreement to patients’ characteristics
Adjusted ORb | 95% CI | p value | ||
---|---|---|---|---|
Gender | ||||
Men | ref. | |||
Women | 86.024 | 21.121 | 350.367 | < 0.000 |
Lifestyle at baseline | ||||
At home with its husband/spouse | ref. | |||
At home with relatives | 10.173 | 1.347 | 76.834 | 0.025 |
At home, alone, with relatives in the neighborhood (and other lifestyle)a | 16.947 | 4.13 | 69.54 | < 0.000 |
At home, alone, without relatives in the neighborhood | 4.074 | 0.951 | 17.458 | 0.058 |
Diagnosis stage | ||||
Absence of trouble | 0.338 | 0.081 | 1.403 | 0.135 |
Subjective cognitive complaint | ref. | |||
Mild neurocognitive disorders (and other cases)a | 1.127 | 0.737 | 1.722 | 0.581 |
Major neurocognitive disorders | 2.535 | 1.597 | 4.024 | < 0.000 |
Relationships between patients’ characteristics and functional level assessed with both scores
Outcome = IADL | Outcome = C-IADL | |||||
---|---|---|---|---|---|---|
ba | SE | P Value | ba | SE | P value | |
Age | −0.054 | 0.005 | < 0.0001 | −0.054 | 0.006 | < 0.0001 |
Gender | ||||||
Men | ref. | ref. | ||||
Women | 1.089 | 0.085 | < 0.0001 | 0.545 | 0.09 | < 0.0001 |
Marital status | ||||||
Married/in couple | ref. | ref. | ||||
Single | 0.755 | 0.235 | 0.001 | 0.618 | 0.247 | 0.012 |
Divorced/separated | 0.671 | 0.188 | < 0.0001 | 0.53 | 0.197 | 0.007 |
Widowed | 0.635 | 0.16 | < 0.0001 | 0.599 | 0.168 | < 0.0001 |
Unspecified | 0.506 | 0.267 | 0.058 | 0.349 | 0.28 | 0.214 |
Educational level | ||||||
Nil | ref. | ref. | ||||
Primary | 0.187 | 0.109 | 0.085 | 0.202 | 0.114 | 0.077 |
Secondary | 0.318 | 0.112 | 0.005 | 0.324 | 0.118 | 0.006 |
Tertiary | 0.313 | 0.142 | 0.027 | 0.333 | 0.149 | 0.025 |
Lifestyle at baseline | ||||||
At home with its husband/spouse | ref. | ref. | ||||
At home with relatives | −0.935 | 0.196 | < 0.0001 | −1.186 | 0.206 | < 0.0001 |
At home, alone, with relatives in the neighborhood and other lifestyle | −0.032 | 0.161 | 0.844 | −0.291 | 0.169 | 0.085 |
At home, alone, without relatives in the neighborhood | 0.423 | 0.197 | 0.031 | 0.162 | 0.206 | 0.432 |
MMSE | ||||||
[0,10[ | −2.282 | 0.186 | < 0.0001 | −2.421 | 0.195 | < 0.0001 |
[10,20[ | −1.535 | 0.119 | < 0.0001 | − 1.56 | 0.125 | < 0.0001 |
[20,26[ | −0.865 | 0.104 | < 0.0001 | − 0.863 | 0.11 | < 0.0001 |
[26, 30] | ref. | ref. | ||||
NPI score | −0.03 | 0.002 | < 0.0001 | −0.03 | 0.003 | < 0.0001 |
Diagnosis stage | ||||||
Subjective cognitive disorders | ref. | ref. | ||||
Mild neurocognitive disorders and other cases | 0.056 | 0.103 | 0.589 | 0.032 | 0.108 | 0.768 |
Major neurocognitive disorders | −0.879 | 0.122 | < 0.0001 | − 0.982 | 0.128 | < 0.0001 |
Absence of trouble | 0.167 | 0.462 | 0.718 | 0.411 | 0.486 | 0.397 |
Etiology | ||||||
Alzheimer’s disease | ref. | ref. | ||||
Alzheimer’s disease with cerebrovascular component | −0.188 | 0.174 | 0.283 | − 0.124 | 0.183 | 0.498 |
Cognitive disorders of vascular origin | −0.343 | 0.151 | 0.023 | −0.358 | 0.158 | 0.024 |
Lewy body disease | −0.006 | 0.291 | 0.983 | 0.103 | 0.305 | 0.736 |
Fronto temporal dementia | −1.904 | 0.579 | 0.001 | −2.165 | 0.608 | < 0.0001 |
Parkinson’s disease, and Parkinson’s syndroma | − 1.034 | 0.26 | < 0.0001 | − 1.084 | 0.273 | < 0.0001 |
Psychiatric disorders | 0.416 | 0.189 | 0.028 | 0.433 | 0.198 | 0.029 |
Other disorders | −0.033 | 0.224 | 0.883 | 0.054 | 0.236 | 0.817 |
Etiology not yet established | 0.412 | 0.109 | < 0.0001 | 0.498 | 0.115 | < 0.0001 |
No trouble | 1.238 | 0.259 | < 0.0001 | 1.127 | 0.272 | < 0.0001 |