COGNITIVE-FUNCTIONING AND THE INCIDENCE OF LIMITATIONS IN ACTIVITIES OF DAILY LIVING IN AN ELDERLY COMMUNITY SAMPLE

Although it is well-known that cognitive impairment in the elderly is usually accompanied by limitations in activities of daily living (ADL) , it is not known whether cognitive impairment predicts the onset of n ew ADL limitations, The purpose of this analysis was to determine whet her poor scores on a brief measure of cognitive functioning at baselin e (1982) would predict the onset of persistent limitations in ADL duri ng the subsequent 3 years, in a probability sample of community-dwelli ng elderly persons living in New Haven, Connecticut, who were initiall y free of ADL limitations (n = 1,856), Cognitive functioning was asses sed with Pfeiffer's Short Portable Mental Status Questionnaire, Persis tent incident ADL limitations were defined as the onset of one or more ADL limitations after 1982, with no subsequent reports of zero ADL li mitations, Compared with persons who scored zero to one errors on the Short Portable Mental Status Questionnaire at baseline, persistent, in cident ADL limitations occurred more frequently in persons who scored four or more errors (odds ratio for mates = 2.72, 95% confidence inter val 1.36-5.43; odds ratio for females = 2.60, 95% confidence interval 1.52-4.44) after adjustment for the confounding effects of housing typ e, age, race, history of chronic health conditions, and incident healt h conditions, These results suggest that knowledge of scores on brief cognitive function tests can be used to forecast service needs and to develop intervention programs to prepare for the possible onset of ADL limitations.