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Related Concept Videos

Primary Healthcare Services01:30

Primary Healthcare Services

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Primary care promotes wellness and prevents disease. This care includes health promotion, education, protection (such as immunizations), early disease screening, and environmental considerations. Settings providing this type of healthcare include physician offices, public health clinics, school nursing, and community health nursing.
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Levels of Health Promotion and Illness Prevention01:26

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Health promotion allows a person to control the determinants of health, resulting in an improved health status. It enhances the quality of life and reduces premature deaths. Health promotion and illness prevention programs help people make beneficial choices to reduce the risk of disease and disabilities. There are three health promotion and illness prevention levels: primary, secondary, and tertiary prevention.
In primary prevention, actions taken before disease onset prevent the disease from...
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Preventive Healthcare Services01:30

Preventive Healthcare Services

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Preventive healthcare services keep people healthy via frequent check-ups, screening, and counseling. They primarily aid in disease prevention rather than treating an acute or chronic illness. Preventive treatment also keeps individuals productive and energetic, allowing them to work well into their retirement years. Examples of preventive care services include:
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Principles of Disease Surveillance01:26

Principles of Disease Surveillance

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Disease surveillance is the systematic collection, analysis, and interpretation of health data essential to the planning, implementation, and evaluation of public health practice. This process integrates data dissemination to entities responsible for preventing and controlling disease, injury, and disability. Surveillance systems provide crucial information for action, helping public health authorities make informed decisions to manage and prevent outbreaks, ensure public safety, optimize...
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Healthcare Agencies II01:17

Healthcare Agencies II

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There are various healthcare agencies in the United States—some of which are managed by religious institutions and others by different government branches.
Parish nursing is a growing specialty nursing profession that focuses on holistic healthcare, health promotion, and illness prevention. It blends professional nursing practice with a health ministry, focusing on health and healing within the context of a Christian community. Parish nurses serve as health educators, referral sources,...
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Methods Of Healthcare Delivery System01:26

Methods Of Healthcare Delivery System

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At the different levels of the healthcare system, we see varying methods of healthcare used. These methods include managed care systems, case management, and primary healthcare.
Managed Care System:
The managed care system is designed to control the cost while maintaining the quality of care. The patient's care from admission to discharge is planned by the primary care provider or the case manager, also known as the gatekeeper. In a managed care system, the number of care providers is...
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Determining Soil-transmitted Helminth Infection Status and Physical Fitness of School-aged Children
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Public Health.

Oshadi M Jayakody1, Helena M Blumen2, Cuiling Wang3

  • 1Albert Einstein College of Medicine, Bronx, NY, USA.

Alzheimer'S & Dementia : the Journal of the Alzheimer'S Association
|December 23, 2025
PubMed
Summary
This summary is machine-generated.

Difficulty with Instrumental Activities of Daily Living (IADLs) signals early cognitive decline risk in older adults. Even moderate challenges, like managing finances, indicate higher chances of developing memory and non-memory related impairments.

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Area of Science:

  • Gerontology
  • Neuroscience
  • Public Health

Background:

  • Alzheimer's disease and related dementias (ADRD) develop over decades, with subtle early signs in Instrumental Activities of Daily Living (IADLs).
  • Identifying pre-clinical ADRD indicators is crucial for timely intervention and research.

Purpose of the Study:

  • To investigate the association between specific IADL impairments and the risk of cognitive impairment in older adults without a diagnosed ADRD.
  • To identify early warning signs of cognitive decline through functional assessments.

Main Methods:

  • Utilized data from the US Health and Retirement Study (n=10,346) for adults aged 65+ without ADRD.
  • Employed latent class analysis to group participants based on self-reported IADL difficulties (managing money, medication, shopping, etc.).
  • Applied Cox proportional hazards models to assess the risk of memory and non-memory related cognitive impairment associated with IADL groups, adjusting for covariates.

Main Results:

  • Identified three IADL groups: high functioning (86%), moderate difficulty (10%), and low functioning (4%).
  • The low functioning IADL group exhibited a 2-2.5 times higher risk of both memory and non-memory cognitive impairment.
  • The moderate functioning group showed increased risk for memory (HR 2.0) and non-memory (HR 1.6) impairment compared to the high functioning group.

Conclusions:

  • Moderate difficulties in specific IADLs, such as managing money, are linked to increased cognitive impairment risk in older adults.
  • These IADLs can serve as potential early risk indicators for pre-clinical ADRD.
  • IADL assessments may be valuable as clinical trial endpoints for pre-clinical ADRD populations.