[Dementias and daily competence: effects beyond ADL and IADL]

Using a time-budget method in a 3 year longitudinal study with a control group design, substantial reductions in the engagement of nonobligatory instrumental, social, and leisure activities could be found in a group of mildly to moderately demented patients. Controlling these changes for differences in baseline parameters, the dementia-specific reduction was about 1 1/2 hours compared to a non-psychiatric control group. These clinically relevant changes in activity levels underscore the importance of these activity domains with regard to the development of diagnostically useful indicators at the early stages of dementia. Time-budget methods seem to be particularly useful to close the diagnostic gap with regard to the assessment of everyday competence indicators especially at early stages of the dementia illness.