Abstract
Purpose: Cognitive decline is a clinically significant issue among older adults with dementia, often compromising their functional independence and quality of life. However, limited research has explored how functional fitness and daily function contribute to cognitive performance in this population. This study aimed to validate a structural model of cognitive function among older adults with dementia, focusing on the roles of functional fitness and daily function as key influencing factors.
Methods: A cross-sectional study was conducted among 258 older adults with dementia recruited from adult daycare centers. Participants were identified either through a physician’s clinical diagnosis of dementia or by screening positive for cognitive impairment using the Short Portable Mental Status Questionnaire. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Functional fitness was measured using the Short Physical Performance Battery (SPPB), which included balance, 4-meter gait speed, and the 5-time sit-to-stand test, as well as handgrip strength and the 2-minute step test for cardiorespiratory endurance. Daily function, including activities of daily living (ADL) and instrumental activities of daily living (IADL), was assessed using the Disability Assessment for Dementia (DAD). The hypothesized structural relationships among these constructs were analyzed using partial least squares structural equation modeling (PLS-SEM).
Results: Participants had a mean age of 81.27 ± 7.05 years and were mostly female (73.3%) and widowed (64.7%). The mean MoCA score was 9.99 ± 4.94, with 50.4% showing severe impairment. The PLS-SEM analysis indicated that disease and dysfunction represented by ADL and IADL, and functional fitness represented by gait speed, handgrip strength, and the cardiorespiratory endurance, significantly predicted cognitive function. The final model explained 33.5% of the total variance.
Conclusion: Higher functional fitness and better daily function were associated with better cognitive performance in older adults with dementia. These findings highlight the importance of maintaining independence and physical capability to support cognitive health in adult daycare settings. Accordingly, future health interventions and management strategies for this population should emphasize training programs that enhance functional fitness, activities of daily living, and instrumental activities of daily living.
Notes
References:
1. Aranda, M. P., Kremer, I. N., Hinton, L., Zissimopoulos, J., Whitmer, R. A., Hummel, C. H., Trejo, L., & Fabius, C. (2021). Impact of dementia: Health disparities, population trends, care interventions, and economic costs. Journal of the American Geriatrics Society, 69(7), 1774-1783. https://doi.org/10.1111/jgs.17345
2. 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
3. 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.
4. Nam, S., Downer, B., Bae, S., & Hong, I. (2022). Social, behavioural, and functional characteristics of community-dwelling South Korean adults with moderate and severe cognitive impairment. International Journal of Methods in Psychiatric Research, 31(2), e1908. https://doi.org/10.1002/mpr.1908
5. 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
6. Xiao, Q., Shadyab, A. H., Rapp, S. R., Stone, K. L., Yaffe, K., Sampson, J. N., Chen, J. C., Hayden, K. M., Henderson, V. W., & LaCroix, A. Z. (2022). Rest-activity rhythms and cognitive impairment and dementia in older women: Results from the women’s health initiative. Journal of the American Geriatrics Society, 70(10), 2925-2937. https://doi.org/10.1111/jgs.17926
Sigma Membership
Lambda Beta at-Large
Lead Author Affiliation
Kaohsiung Medical University, Sanmin District, Kaohsiung, Taiwan
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Cross-Sectional
Research Approach
Quantitative Research
Keywords:
Long-Term Care, Public and Community Health, Health Equity or Social Determinants of Health, Older People, Aged, Physical Fitness, Cognition, Dementia
Recommended Citation
Chen, Kuei-Min and Tung, Hsiao-Ting, "Modeling Cognitive Function with Functional Fitness and Daily Function: A PLS-SEM Approach" (2026). International Nursing Research Congress (INRC). 20.
https://www.sigmarepository.org/inrc/2026/presentations_2026/20
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
Modeling Cognitive Function with Functional Fitness and Daily Function: A PLS-SEM Approach
Toronto, Ontario, Canada
Purpose: Cognitive decline is a clinically significant issue among older adults with dementia, often compromising their functional independence and quality of life. However, limited research has explored how functional fitness and daily function contribute to cognitive performance in this population. This study aimed to validate a structural model of cognitive function among older adults with dementia, focusing on the roles of functional fitness and daily function as key influencing factors.
Methods: A cross-sectional study was conducted among 258 older adults with dementia recruited from adult daycare centers. Participants were identified either through a physician’s clinical diagnosis of dementia or by screening positive for cognitive impairment using the Short Portable Mental Status Questionnaire. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA). Functional fitness was measured using the Short Physical Performance Battery (SPPB), which included balance, 4-meter gait speed, and the 5-time sit-to-stand test, as well as handgrip strength and the 2-minute step test for cardiorespiratory endurance. Daily function, including activities of daily living (ADL) and instrumental activities of daily living (IADL), was assessed using the Disability Assessment for Dementia (DAD). The hypothesized structural relationships among these constructs were analyzed using partial least squares structural equation modeling (PLS-SEM).
Results: Participants had a mean age of 81.27 ± 7.05 years and were mostly female (73.3%) and widowed (64.7%). The mean MoCA score was 9.99 ± 4.94, with 50.4% showing severe impairment. The PLS-SEM analysis indicated that disease and dysfunction represented by ADL and IADL, and functional fitness represented by gait speed, handgrip strength, and the cardiorespiratory endurance, significantly predicted cognitive function. The final model explained 33.5% of the total variance.
Conclusion: Higher functional fitness and better daily function were associated with better cognitive performance in older adults with dementia. These findings highlight the importance of maintaining independence and physical capability to support cognitive health in adult daycare settings. Accordingly, future health interventions and management strategies for this population should emphasize training programs that enhance functional fitness, activities of daily living, and instrumental activities of daily living.
Description
This presentation presents the results of a cross-sectional model examining factors associated with cognitive function among 258 older adults with dementia attending daycare centers. The analysis revealed that both daily function and functional fitness were significant contributors to cognitive performance, explaining one-third of the variance. These findings underscore the importance of promoting independence and physical capacity to support cognitive health in dementia care.