Relation between Cognitive Impairment and Activity of Daily Living in the Elderly of Nursing Home and Community

ABSTRACT

BACKGROUND: Due to the increase in average life expectancy, the number of elderly people in the population has also increased and it is argued that this has led to a rise in chronic regression type diseases or dementia and related psychoneurological diseases, together with the growing occurrence of cognitive function disorders. However, it can be said that research in Korea towards systematic general function assessment or machinery for diagnosis is insufficient. Accordingly, the authors of this paper, investigated elderly people, both institutionalized and shill living in the community for their cognitive functions and their ability to carry out daily life skills. Afterwards, the early diagnosis of mental illness and rehabilitation management for elderly patients was put into operation for this research. METHODS: During October of 1997 a certain retirement home in Kyonggi-do and a public health centre in Seoul were visited and forty patients from the home, and forty-five patients from the health centre, all over 65 years of age, were the objects of tests for cognition functions using the mini-mental status examination -Korea(MMSE-K), Their ability to carry out activity of daily living was tested through the modified Ballhel index for measurement, comparison and analysis. RESULTS: The group from the institution had an average MMSE-K of 24.05 with no significant difference between gender, age and degree of education. The health centre group's MMSE-K of 26.16 was a higher ,score(p<0.05), by men and by at least elementary ,school education. If we look at different classifications, the institutionalized group included 13 people(32.5%) ar a normal level, 18 people (45.0%) with mildly impairments, 9 people(17.5%) had moderately impairments and no severly handicapped patients. Looking at the community elderly, 23 people(51.1%) were at a normal level, 19 people (42.2%) had middle impairments, 3 people(6.7%) had moderately impairments and there were no severly impairments. With the MBI, the institutionalized group had an average of 95.9 and the community group had an average of 98.62 so both ,scored highly(p<0.05). If the MBI of the two group's dependency is compared, 17 people(42.5%) of the institution's elderly were independent in activity of daily living, 17 people(42.5%) were minimal dependent and the remaining 6 people(15.%) were mild dependent. 30(66.7%) of the community elderly were independent in daily living activity, 14 people (31.1%) were mild dependent and 1 people(2.2%) war mild dependent. Even the elderly with normal cognitive functions had disorders with their daily living activity Therefore a sample of the patients have above average damaged cognitive functions and severe living activity disorders are being seen in both groups. CONCLUSION: Both the community and institutionalized elderly had resonable cognition and the institutionalized groups had especially high levels. It is now believed that there is a relation between this and the lack of suitable evaluation in Korea. Even if the daily living activity disorders were not severe, they were observed in both groups, so henceforth, if cognitive function tests were made with consideration given to age and gender, and activity of daily living tests were implemented efficiently, the overall health and well-being of the elderly, and therefore demands for medical treatment and social services, could be decided and put into operation.