To clarify the characteristic of impaired and unimpaired Instrumental Activities of daily living (IADL) processes with the severity of cognitive impairment in community-dwelling older adults with Alzheimer’s disease (AD) using the Process Analysis of Daily Activity for Dementia (PADA-D).

Cross-sectional study.

13 medical and care centers in Japan.

115 community-dwelling older adults with AD.

The severity of cognitive impairment was classified by Mini-Mental State Examination (20 ≥ mild group, 20 < moderate group ≥ 10, 10 < severe group), and IADL scores and eight IADL items in PADA-D were compared among three groups after adjusting for covariates. Rate of five feasible processes included in each IADL of PADA-D was compared.

IADL score showed a decrease in independence with the severity of AD except for Use modes of transportation and Managing finances, which was especially pronounced in Shopping (F = 25.58), Ability to use the telephone (F = 16.75), and Managing medication (F = 13.1). However, when the PADA-D was examined by process, some processes that were impaired and unimpaired with the severity of cognitive impairment were clear. For example, Plan a meal was impaired (ES = 0.29) with the severity, but Prepare the food was not in Cooking performance.

We suggested that detailed process analysis in IADLs can clarify the characteristic of processes that are impaired and unimpaired with the severity of cognitive impairment in older adults with AD living in the community. Our findings may be useful for rehabilitation and care in IADL to continue living at home.

使用痴呆症日常活动过程分析 (PADA-D) 来阐明患有阿尔茨海默病 (AD) 的社区老年人的受损和未受损工具性日常生活活动 (IADL) 过程的特征以及认知障碍的严重程度。

横断面研究。

日本有13个医疗保健中心。

115 名患有 AD 的社区老年人。

采用简易精神状态检查对认知障碍严重程度进行分级（20≥轻度组、20<中度组≥10、10<重度组），调整后比较三组IADL评分及PADA-D中的8个IADL项目对于协变量。比较了 PADA-D 的每个 IADL 中包含的五个可行过程的比率。

IADL 得分显示，独立性随着 AD 的严重程度而下降，但使用交通方式和财务管理除外，这在购物（F = 25.58）、使用电话的能力（F = 16.75）和管理药物（F = 13.1）。然而，当通过过程检查 PADA-D 时，可以清楚地看到一些随着认知障碍的严重程度而受损和未受损的过程。例如，“计划一顿饭”的严重程度会受到影响（ES = 0.29），但“准备食物”则不会出现在烹饪性能中。

我们建议，IADL 中的详细过程分析可以阐明社区中患有 AD 的老年人中受损和未受损的过程的特征以及认知障碍的严重程度。我们的研究结果可能有助于 IADL 的康复和护理，以继续在家生活。