Occupational performance issues in older adults with subjective cognitive decline

Abstract

Purpose

To describe and categorize difficulties in daily activities of older adults with subjective cognitive decline (SCD) compared to individuals with mild cognitive impairment (MCI).

Methods

Deductive quantitative content analysis was used to classify reported issues in the performance of meaningful daily activities, in older adults with SCD (n = 67; age= 70 ± 6.3) or MCI (n = 42; age= 72 ± 6.6). The occupational performance issues were identified using the Canadian Occupational Performance Measure, a semi-structured interview, and categorised using the International Classification of Functioning, Disability and Health (ICF).

Results

Both groups identified issues in all nine ICF “Activities and Participation” domains, with no significant group effects on seven of them. The most frequently affected “Activities and Participation” domains in both groups were “Self-care” (e.g. exercise and diet); “Community, social and civic life” (e.g. social-leisure activities); and "General tasks and demands” (e.g. time management). Over 90% of the issues in both groups were described in the context of difficulties in “Mental functions” (e.g. memory and higher-level cognitive functions).

Conclusions

Older adults with SCD, although independent, identified a variety of daily activities that they are not performing satisfactorily, remarkably similar in nature to the occupational performance issues described by older adults with MCI.

Implications for Rehabilitation

• Older adults with SCD identified difficulties in performing social and leisure activities, maintaining healthy lifestyle behaviours, and managing multiple daily tasks.

• The daily challenges described by older adults with SCD are similar in nature to those identified by those with MCI.

• Older adults with SCD and MCI describe their daily challenges are related not only to memory problems, but also to executive dysfunction.

• Interventions for older adults with SCD should aim to improve self-identified problems in everyday functioning.

Keywords:

• Activities of Daily Living
• Cognitive Decline
• Goals
• Leisure Activities Mild Cognitive Impairment
• Social Participation

Acknowledgements

The authors thank Dr. Susan Vandermorris for assisting in participant group classification and commenting on the manuscript. C. Leung and H. Quach participated in this research as part of their MScOT research project at the University of Toronto.

Disclosure statement

The authors declare no conflict of interests.

Additional information

Funding

A grant from the Canadian Institutes of Health Research (# 366538) supported the parent RCT and S. Rotenberg as a postdoctoral fellow.