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Life activity patterns and mild cognitive impairment in older adults
Author(s) -
Wu ChaoYi,
Gothard Sarah,
Mattek Nora,
Wright Kirsten M,
Kaye Jeffrey A,
Dodge Hiroko H,
Beattie Zachary
Publication year - 2021
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1002/alz.051423
Subject(s) - bedroom , activities of daily living , occupancy , gerontology , dementia , cognitive impairment , psychology , clinical dementia rating , cognition , medicine , audiology , geography , physical therapy , ecology , disease , archaeology , pathology , biology , neuroscience
Background Shifting and diminished circadian and activity rhythms characterize older adults with cognitive impairment, but studies rarely consider both temporal and spatial aspects of life activity patterns. We examined hourly in‐home and out‐of‐home activity patterns using latent group trajectory models to characterize older adults with and without mild cognitive impairment (MCI). Method One hundred and seven older adults (19 with MCI) living alone (age=81.1±7.8, 76.6% women) from the Oregon Center for Aging & Technology (ORCATECH) were included. MCI was determined by the Clinical Dementia Rating (CDR) score = 0.5. In‐home and out‐of‐home activities were collected via passive infrared motion sensors in each room and contact sensors on the doors to the home for one month. Daily life activity patterns were estimated based on: 1) the hourly average amount of time the participant spent in each major life space (bathroom; bedroom; kitchen; living room) and out‐of‐home, and 2) the hourly average number of trips the participant made to each room and out‐of‐home. Result Latent trajectory models identified two distinct patterns for three features: time spent out‐of‐home (high/low outdoor), time spent in the kitchen (high/low kitchen occupancy), and trips to the bathroom (more/fewer bathroom trips) from 5 am to 1 pm. Older adults with MCI were more likely to follow a pattern of low outdoor time ( β =‐2.65; p =0.03), high kitchen occupancy ( β =1.68; p=0.01), and more bathroom trips ( β =1.60; p =0.02) than those with intact cognition. There were no differences in the bedroom patterns or time spent in the bathroom in older adults with and without MCI from 5 am to 1 pm. Potential covariates were controlled in the models (age, gender, years of education, sleep duration, gait speed, and the number of rooms in the house). Conclusion Different social and mealtime activity patterns from early morning to early afternoon may signal cognitive changes and contraction of life‐space. These may be caused by environmental, as well as chronobiological changes accompanying MCI. Unobtrusive measurement of in‐home and out‐of‐home activity patterns may be useful for integrating with chronotherapies in developing strategies to mitigate potential daily mal‐entrainment for older adults at risk for MCI and dementia.