Assessment of instrumental activities of daily living in patients with cognitive impairment based on their ability to use household appliances

Abstract

BackgroundDetecting life disability is crucial in diagnosing dementia; however, early detection has proven challenging with previous assessment scales. This study focused on an individual's ability to use household appliances as a means of detecting life disability.ObjectiveThe objectives of this study are threefold: (1) to compare the ability to use household appliances between the non-dementia and dementia groups, (2) to determine whether the level of life disability based on the ability to use appliances is at the level of diagnosed dementia or non-dementia, and (3) to explore the impact of age and gender on the ability to use appliances.MethodsWe selected 13 essential household appliances for elderly individuals and proposed an instrumental activities of daily living (IADL) assessment tool to evaluate their usage. Our sample consisted of 98 patients with cognitive impairment, divided into a non-dementia group (N = 34) and a dementia group (N = 64). Most participants in the dementia group had Alzheimer's disease or related conditions. Through multiple logistic regression, the model equation aimed to determine whether a subject's functional disability indicated a potential dementia diagnosis.ResultsThe optimal model equation identified the microwave oven and air conditioner as key factors, achieving an area under the curve (AUC) of 0.78. Additionally, analysis by age and gender enhanced the discriminative power of the results.ConclusionsOur proposed scoring system can efficiently determine the degree of life disability by assessing appliance usage, demonstrating comparable discriminatory ability to existing scales.

Keywords: Alzheimer's disease; early dementia; early detection; instrumental activities of daily living; life disability; mild cognitive impairment.

Figure 1.

Ability to use each household appliance in non-dementia and dementia groups. Panel A shows the percentage of responses in the non-dementia group, while Panel B illustrates the percentage of responses in the dementia group. The ability to use each item is rated on a four-point scale from 0 to 3, where 3 indicates that the patient can use the appliances appropriately by himself/herself, 2 indicates that the patient can use the device on their own only for some simple operations, 1 indicates that the patient uses the device with help or under the supervision of a caregiver, and 0 indicates that the patient is unable to use the device at all. (A) Non-dementia group. (B) Dementia group.

Figure 2.

ROC curve for each model. The ROC curve for model (a) – all cases: the AUC is 0.78. The ROC curve for model (b) –male and (c) –female: the AUC for model (b) is 0.85 and model (c) is 0.80. The ROC curve for model (d) – under 82 years and (e) – over 82 years: the AUC for model (d) is 0.70 and model (e) is 0.86. ROC curve: receiver operating characteristic curves; AUC: area under the curve.