Qualitative Assessment of Instrumental Activities of Daily Living in Older Persons with Very Mild Dementia: The Kurihara Project

BACKGROUND/AIMS We investigated quantitative/qualitative changes of instrumental activities of daily living (IADL) in people with a Clinical Dementia Rating (CDR) of 0.5. METHODS IADLs were evaluated in older residents: CDR of 0 (healthy) and CDR 0.5 (questionable/very mild dementia). The subjects with CDR 0.5 were divided into 2 types: the very mild Alzheimer's disease (vmAD) type and the other type including very mild subcortical vascular dementia. IADLs were evaluated quantitatively using the Lawton and the original qualitative IADL scales. RESULTS CDR 0.5/vmAD type subjects had impairment of only one Lawton item (Shopping) compared to CDR 0 subjects. However, the CDR 0.5/vmAD type group and the CDR 0.5/other type group showed impairment of 3 items in the qualitative assessment (Shopping, Food preparation, and Mode of transportation). CONCLUSION We suggest using both quantitative/qualitative IADL scales for assessing older adults with very mild dementia.