Year: 2025
Type: article
Abstract: BACKGROUND: Functional ability is a key indicator of cognitive health, distinguishing cognitively unimpaired (CU) aging, mild cognitive impairment (MCI), and dementia. However, sociocultural factors such as gender roles, education, and age-related differences influence activity participation, complicating assessments. The Activities of Daily Living Questionnaire-Technologies (T-ADLQ) evaluates three domains of functional ability: instrumental activities of daily living (iADL), basic activities of daily living (bADL), and advanced activities of daily living (aADL). It includes a response option, "Never did this activity/Don't know" (ND/DK), which may reflect disparities unrelated to cognitive impairment. METHOD: This study analyzed ND/DK responses in the GERO cohort, a prospective study in Santiago, Chile, following 291 dementia-free older adults with cognitive complaints (≥70 years) for three years to assess cognitive, functional, psychosocial, and medical factors. We examined how gender, education, and age influenced functional ability assessments using a test for equality of proportions to compare ND/DK response distributions. RESULT: Men were significantly more likely to report never engaging in household tasks such as taking pills (4.1% vs. 0.5%, p = 0.0049), cooking (24.5% vs. 1.0%, p <0.001), housekeeping (10.2% vs. 1.0%, p = 0.0004), and laundry (53.1% vs. 1.9%, p <0.001). Conversely, women had higher ND/DK responses in home repairs (42.0% vs. 19.1%, p = 0.0029), employment (23.2% vs. 6.1%, p = 0.0071), driving (72.5% vs. 20.4%, p <0.001), and ATM usage (58.0% vs. 34.7%, p = 0.0033). Participants with <6 years of education had significantly higher ND/DK responses in financial management (9.4% vs. 3.0%, p = 0.0393), driving (83.0% vs. 56.9%, p = 0.0003), and technology use (computer access: 84.9% vs. 61.4%, p = 0.0013; email access: 96.2% vs. 68.8%, p <0.001). Individuals aged ≥80 showed higher ND/DK rates in home maintenance (7.7% vs. 1.6%, p = 0.0147), mobile phone use (33.9% vs. 13.7%, p = 0.0003), and internet access (78.5% vs. 57.4%, p = 0.0024). CONCLUSION: Sociocultural factors strongly influence functional ability assessments, with notable disparities by gender, education, and age. These findings highlight the need to interpret ND/DK responses carefully to prevent misclassification of functional impairment in cognitive aging evaluations. Additionally, improving assessment tools to account for sociocultural variations is essential for more accurate evaluations.
Source: Alzheimer s & Dementia
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,200
OpenAlex ID: W7117248299
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