Cross-Domain Variability of Cognitive Performance in Very Old Nursing Home Residents and Community Dwellers: Relationship to Functional Status

Background: Recent evidence suggests that cross-domain variability in cognition may be related to subsequent cognitive decline beyond mean performance levels in cognitive tasks. Objectives: To examine age-related changes in cross-domain variability across cognitive task performance in very old nursi...

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Bibliographic Details
Published in:Gerontology (Basel) 2005-05, Vol.51 (3), p.206-212
Main Authors: Rapp, Michael A., Schnaider-Beeri, Michael, Sano, Mary, Silverman, Jeremy M., Haroutunian, Vahram
Format: Article
Language:English
Subjects:
Age Factors
Aged
Aged, 80 and over
Behavioural Science Section
Cognition - physiology
Female
Health Status
Hospitals
Humans
Life Style
Male
Multivariate Analysis
Neuropsychological Tests
Nursing Homes
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Summary:Background: Recent evidence suggests that cross-domain variability in cognition may be related to subsequent cognitive decline beyond mean performance levels in cognitive tasks. Objectives: To examine age-related changes in cross-domain variability across cognitive task performance in very old nursing home residents in contrast to community-dwelling older adults. To explore the relationship between cross-domain variability in cognition and functional disability in very old age. Methods: 204 very old (82.00 ± 8.51 years) residents from the Jewish Home and Hospital, Bronx, N.Y., and 376 community-dwelling older adults of similar age (86.75 ± 5.84 years) were tested on a cognitive battery. Cross-domain variability scores were computed across the cognitive tasks. Functional disability measures were derived from the CDR (Clinical Dementia Rating) Scale. Results: Whereas oldest old community-dwelling adults showed a decrease in variability across domains with age, variability increased with age in nursing home residents, irrespective of the level of cognitive performance. Cross-domain variability was associated with functional disability beyond the effects of age, gender, education, dementia status, residential status, and level of cognitive performance. Conclusion: Findings suggest that cross-domain variability in cognition is related to functional decline with age. Cross-domain variability in cognition may be a prominent predictor for the development of functional decline in very old adults.
ISSN:0304-324X
1423-0003
DOI:10.1159/000083995