Abstract
Purpose: Functional assessment plays a critical role in monitoring dementia progression. However, the early identification of individuals who are at risk of rapidly deteriorating into severe functional dependency remains a significant challenge in dementia care. This study aimed to address this issue by examining the association between cognitive impairment and functional ability among older adults with dementia.
Methods: This study employed a cross-sectional survey design, recruiting 258 older adults from 22 adult daycare centers in southern Taiwan. Data collected included demographic characteristics (age, sex, education, marital status, and cohabitation status), chronic diseases, cognitive impairment, psychiatric and behavioral symptoms, and functional ability across the domains of initiation, planning, and performance. The inclusion criteria were: (1) age ≥ 65 years, and (2) a clinical diagnosis of dementia or cognitive impairment screened using the Short Portable Mental Status Questionnaire. Data were analyzed using multiple regression, latent profile analysis, latent class analysis, and correspondence analysis.
Results: Education (β = 0.36, t = 6.38, p < .001) and functional ability (β = 0.48, t = 9.51, p < .001) were significant predictors of cognitive ability after controlling for demographic factors, jointly explaining 41.7% of the variance (F = 25.59, p < .001). Correspondence analysis further indicated that deficits in hygiene-related planning, coupled with impairments in the planning of instrumental activities of daily living, were strongly associated with severe cognitive impairment among older adults with dementia.
Conclusion: The findings suggest that hygiene-planning deficits (e.g., difficulties in preparing water, towels, and soap for self-care) may serve as an early warning indicator of accelerated functional decline in older adults with dementia. These insights offer valuable implications for the early detection of decline and the development of personalized care plans in dementia practice.
Notes
References:
1. Altieri, M., Garramone, F., & Santangelo, G. (2021). Functional autonomy in dementia of the Alzheimer’s type, mild cognitive impairment, and healthy aging: A meta-analysis. Neurological Sciences, 42(5), 1773-1783. https://doi.org/10.1007/s10072-021-05142-0
2. Brothers, S. L., & Suchy, Y. (2022). Daily assessment of executive functioning and expressive suppression predict daily functioning among community-dwelling older adults. Journal of the International Neuropsychological Society, 28(9), 974-983. https://doi.org/10.1017/S1355617721001156
3. Hartle, L., Mograbi, D. C., Fichman, H. C., Faria, C. A., Sanchez, M. A., Ribeiro, P. C. C., & Lourenço, R. A. (2022). Predictors of functional impairment and awareness in people with dementia, mild cognitive impairment and healthy older adults from a middle-income country. Frontiers in Psychiatry, 13, 941808. https://doi.org/10.3389/fpsyt.2022.941808
4. Jiang, C., Hu, C., & Li, D. (2023). Linking chronic diseases, cognitive impairment and depressive symptoms in Chinese older adults: A three-wave population-based longitudinal study. Journal of Affective Disorders, 324, 496-501. https://doi.org/10.1016/j.jad.2022.12.150
5. Martyr, A., Ravi, M., Gamble, L. D., Morris, R. G., Rusted, J. M., Pentecost, C., Matthews, F. E., Clare, L., & IDEAL study team. (2024). Trajectories of cognitive and perceived functional decline in people with dementia: Findings from the IDEAL programme. Alzheimer’s & Dementia, 20(1), 410-420. https://doi.org/10.1002/alz.13448
6. Tung, H. T., Chen, K. M., & Belcastro, F. (2025). Development of core health indicators and integrated health assessment toolkit for older adults with dementia. Worldviews on Evidence-Based Nursing, 22(4), e70060(1-9). https://doi.org/10.1111/wvn.70060
Sigma Membership
Lambda Beta at-Large
Lead Author Affiliation
Kaohsiung Medical University, Sanmin District, Kaohsiung, Taiwan
Type
Poster
Format Type
Text-based Document
Study Design/Type
Cross-Sectional
Research Approach
Quantitative Research
Keywords:
Long-Term Care, Public and Community Health, Primary Care, Dementia, Functional Status
Recommended Citation
Chen, Kuei-Min and Chen, Szu-Yu, "Early Indicators of Transition to Severe Dependency in Older Adults with Dementia" (2026). International Nursing Research Congress (INRC). 7.
https://www.sigmarepository.org/inrc/2026/posters_2026/7
Conference Name
37th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Toronto, Ontario, Canada
Conference Year
2026
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2026-07-22
Early Indicators of Transition to Severe Dependency in Older Adults with Dementia
Toronto, Ontario, Canada
Purpose: Functional assessment plays a critical role in monitoring dementia progression. However, the early identification of individuals who are at risk of rapidly deteriorating into severe functional dependency remains a significant challenge in dementia care. This study aimed to address this issue by examining the association between cognitive impairment and functional ability among older adults with dementia.
Methods: This study employed a cross-sectional survey design, recruiting 258 older adults from 22 adult daycare centers in southern Taiwan. Data collected included demographic characteristics (age, sex, education, marital status, and cohabitation status), chronic diseases, cognitive impairment, psychiatric and behavioral symptoms, and functional ability across the domains of initiation, planning, and performance. The inclusion criteria were: (1) age ≥ 65 years, and (2) a clinical diagnosis of dementia or cognitive impairment screened using the Short Portable Mental Status Questionnaire. Data were analyzed using multiple regression, latent profile analysis, latent class analysis, and correspondence analysis.
Results: Education (β = 0.36, t = 6.38, p < .001) and functional ability (β = 0.48, t = 9.51, p < .001) were significant predictors of cognitive ability after controlling for demographic factors, jointly explaining 41.7% of the variance (F = 25.59, p < .001). Correspondence analysis further indicated that deficits in hygiene-related planning, coupled with impairments in the planning of instrumental activities of daily living, were strongly associated with severe cognitive impairment among older adults with dementia.
Conclusion: The findings suggest that hygiene-planning deficits (e.g., difficulties in preparing water, towels, and soap for self-care) may serve as an early warning indicator of accelerated functional decline in older adults with dementia. These insights offer valuable implications for the early detection of decline and the development of personalized care plans in dementia practice.
Description
This presentation introduces the results of a cross-sectional survey research that investigated the relationship between cognitive impairment and functional ability in 258 older adults with dementia. Findings suggested hygiene-planning deficits (e.g., difficulties preparing water, towels, and soap for self-care) could be an early warning sign of accelerated functional decline in older adults with dementia.