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Updated: Jun 8, 2026

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit
Published on: September 30, 2020
Changes in activity and interest in the third and fourth age: associations with health, functioning and depressive
Kathryn Betts Adams1, Amy Restorick Roberts, Marilyn B Cole
1Mandel School of Applied Social Sciences, Case Western Reserve University, Cleveland, OH 44106, USA. kathryn.adams@case.edu
Abstract:
This study examines the changes in activity investment among older adults and the role of these changes in the relationship between health limitations and depression. Residents of six senior living facilities (N = 178) completed questionnaires including the Geriatric Depression Scale, health and functioning measures and the Revised Change in Activity and Interest Index (CAII-R) which measures self-perceived changes in the level of investment in social and leisure activities among older adults. Respondents indicated more disengagement from CAII-R subscales Active Instrumental (AI) and Active Social (AS) and increased engagement in Passive Social Spiritual. Fourth Age adults (age 80+) reported greater reductions in AI than Third Age adults (age 64-79). Reduced AS investment had the strongest association with depression and mediated the relationship between poor health or functioning and depression. These categories of activity may guide occupational therapy practitioners and other health providers in selecting the focus of intervention for older clients according to their identified life stage. The study provides evidence of distinct differences in interests within the parameters of normal aging and a baseline from which to assess the impact of illness and disability on the activity choices for clients in different life stages.
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