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Cognitive and Noncognitive Determinants of Everyday Activities in a Racially Diverse Population of Older Persons Receiving Health Services

Rovner, Barry W. MD*; Casten, Robin J. PhD; Leiby, Benjamin E. PhD

The Journal of Nervous and Mental Disease: July 2012 - Volume 200 - Issue 7 - p 627–631
doi: 10.1097/NMD.0b013e31825bfc5b
Original Articles

We examined the relationship of cognitive, medical, psychological, and behavioral factors with everyday functioning in a racially diverse older community population recruited from health service agencies. Everyday functioning was characterized as a latent variable composed of 15 instrumental activities of daily living (IADL). The mean (SD) age of the participants (N = 237) was 78.3 (8.1) years; 67% were women, 34% were African-American, 18 (7.6%) met criteria for a depressive disorder, and 61 (27.0%) met criteria for dementia. Worse verbal memory, older age, depression, and number of medical conditions were independently associated with worse IADL ability. The final model explained 60% of the variability. As the population ages and the prevalence of impaired cognition and disability rises, identifying cognitive and noncognitive determinants of disability becomes increasingly important. Interventions to optimize episodic memory, medical status, and treatment of depression may slow down the pathway to disability in older persons.

*Departments of Psychiatry and Neurology, Jefferson Medical College, Philadelphia, PA; †Department of Psychiatry and Human Behavior, Jefferson Medical College, Philadelphia, PA; and ‡Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Jefferson Medical College, Philadelphia, PA.

Send reprint requests to Barry W. Rovner, MD, Jefferson Hospital for Neuroscience, 900 Walnut St, 2nd Floor, Philadelphia, PA 19107. E-mail:

© 2012 Lippincott Williams & Wilkins, Inc.