Prognostic factors for functional independence in older adults with mild dementia: Results from the Canadian study of health and aging

We investigated the prevalence of and prognostic factors for functional independence in personal activities of daily living in a population-based sample of 90 seniors with mild dementia from the Canadian Study of Health and Aging. Personal activities of daily living were assessed from the report of proxy respondents at baseline and at the 5-year follow-up (or retrospectively if death had occurred). Sixteen (17.8% of the total group of 90) subjects maintained their personal activities of daily living independence over the full 5-year period or up to 3 months before death (15.1% if the four subjects reclassified as not demented at the second wave are excluded). An age of 75-84 years (vs. those 65-74 years of age and 85+ years of age; odds ratio 12.9, 95% confidence interval 2.7, 112.7), the absence of gait-balance-movement problems (odds ratio 5.2, 95% confidence interval 1.3, 25.8), the presence of extrapyramidal signs (odds ratio 9.5), and fewer years of formal education (odds ratio 3.6) were favorable prognostic factors in our multivariate modeling. An absence of sensory problems was a statistically significant favorable prognostic factor in bivariate analysis. Prior studies on the time required for patients with dementia to progress to functional milestones used clinic-based samples. Our findings, which have potential public health implications, need to be confirmed and expanded upon.