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[Relation between global cognitive performance and dependency evaluated by the AGGIR scale].

S Lafont1, P Barberger-Gateau, C Sourgen

  • 1INSERM U330 146, Bordeaux.

Revue D'Epidemiologie Et De Sante Publique
|April 24, 1999
PubMed
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Cognitive performance significantly impacts dependency in older adults, as assessed by the AGGIR model. The model may underestimate dementia-related functional decline, suggesting a need for improved assessment methods.

Area of Science:

  • Gerontology
  • Cognitive Science
  • Public Health

Background:

  • The AGGIR model is a French standardized tool for assessing dependency and determining eligibility for the Prestation Spécifique Dépendance (PSD).
  • Understanding the relationship between cognitive function and dependency is crucial for accurate assessment and resource allocation in elderly care.

Purpose of the Study:

  • To investigate the association between cognitive performances and dependency status using the AGGIR model in older adults.
  • To evaluate the sensitivity of the AGGIR model in capturing functional impairments related to dementia.

Main Methods:

  • A cohort of 1,052 individuals aged 73 and above from the Paquid cohort was analyzed.
  • The AGGIR model, assessing 8 disability measures and 2 cognitive measures (intellectual coherence, orientation), classified subjects into six Iso-Resources Groups (GIR).

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  • Cognitive performance was further assessed using the Mini Mental State Examination (MMSE).

    • Main Results:

    • 85% of subjects were fully independent (GIR 6), while only 6.1% were classified as dependent (GIR 1-3).
    • Among dependent individuals, 57.8% had a dementia diagnosis.
    • Lower MMSE scores were associated with an increased risk of dependency (OR=1.4, p < 0.001), even in the absence of a dementia diagnosis. Low cognitive performance and dyspnea were key factors in dependency classification.

    Conclusions:

    • A significant relationship exists between cognitive performance and dependency as measured by the AGGIR model.
    • The AGGIR model may lack sensitivity in accounting for dementia-related functional impairments.
    • Incorporating Instrumental Activities of Daily Living (IADL) assessments could enhance the AGGIR model's ability to meet the needs of dependent individuals, particularly those with dementia.