Factors Associated with a Decline in Activities of Daily Living in Patients with Dementia at Geriatric Hospitals: A 6 Month Prospective Study

ABSTRACT

BACKGROUND: Decreased activities of daily living (ADL) in elderly people are related to decreased quality of life and death and are a clinically important issue. However, few studies have investigated the various characteristics and risk factors for a decline in ADL among elderly in-patients in geriatric hospitals in Korea. METHODS: In total, 163 elderly in-patients with dementia in three geriatric hospitals located in Incheon, Gwangju and Yongin, Korea were surveyed prospectively for associated factors of a decline in ADL after 6 months. RESULTS: On average, the subjects were 79.4+/-7.6 years old, and 67.5% were female. Approximately 63% had Alzheimer type dementia, 36.8% only attended primary school, 73.0% were widowed, and 38.7% had been admitted to hospitals for less than 1 year. The Korean version of the Mini Mental State Examination (K-MMSE) score was 14.1+/-6.5, and the clinical dementia rating was 1.9+/-0.9. In total, 8.6% were bed-ridden and 59.5% and 64.6% had never experienced fecal and urinary incontinence, respectively. Total ADL scores declined after 6 months follow-up, and significantly associated factors were low K-MMSE score, fecal incontinence, and co-existence of fecal and urinary incontinence. CONCLUSION: Low K-MMSE scores, fecal incontinence, and the co-existence of fecal and urinary incontinence were associated with ADL declines in elderly in-patients with dementia in long-term care hospitals located in three cities in Korea.