Self-perceived problems in daily activities and strategy building in people with different stages of dementia

People with dementia experience severe problems in their daily lives. However, little is known about self-perceived problems in the course of dementia. The aim of our study was to assess self-perceived problems with daily activities as well as individually developed strategies of older people of different cognitive status.

Semi-structured interviews were conducted with 25 participants (mean age 67.6 years, 56% female, 24% healthy, 28% mild dementia, 48% severe dementia). Questions addressed problems in daily activities, their occurrence and the behaviour toward them, and their developed strategies. Information was summarized quantitatively and evaluated using the chi-squared and Kruskal-Wallis tests.

Self-perceived problems included awareness of physical and cognitive deficits in managing daily life, disturbing factors, and lost autonomy. Increased cognitive impairment was associated with more problems in daily life, even though people with severe dementia seemed not to recognize them. The most frequently reported strategies included orderliness, doing things immediately, and the use of external aids. While healthy people and those with mild dementia developed strategies, those with severe dementia reported only few strategies.

Our findings indicate that self-perceived problems in daily life and strategy development are strongest in mild dementia, while people with more severe dementia tend to perceive no problems at all while correctly reflecting their current state of dependency. Importantly, despite memory loss during early stages of dementia, strategies are still being developed. Accordingly, strategies for daily living should be taught in early dementia to sustain an independent lifestyle.