Early identification of cognitive impairment in older adults from Advanced Activities of Daily Living (AADL): A scoping review

IF 3.9 3区医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Public Health Pub Date : 2025-06-23 DOI:10.1016/j.puhe.2025.105822

H. Gao , J. Harris , D. Maupin , S. Schneider , R. Hernandez , H. Jin

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引用次数: 0

Abstract

Objectives

Rapid technological advancements and societal shifts have reshaped older adults’ daily lives. Emerging evidence suggests that Advanced Activities of Daily Living (AADL)—complex tasks beyond basic Activities of Daily Living (ADL) and Instrumental ADL (IADL)—may signal cognitive impairment earlier than traditional measures. This scoping review aims to identify AADL that could serve as early indicators of cognitive impairment.

Study design

Scoping review.

Methods

This review followed Arksey and O'Malley's framework and adhered to the PRISMA-ScR guideline. We systematically searched Web of Science, PubMed, and PsycINFO for relevant studies published between 2013 and 2023.

Results

From 16,185 initially identified articles, 45 studies conducted across 11 countries were included after thorough screening and eligibility assessment. These studies examined eight domains of AADL (e.g., digital technology use, social engagement, cultural activities, naturalistic driving), across cognitive impairment stages from mild cognitive impairment (MCI) to dementia. Findings highlighted that frequent engagement in certain leisure, social, and intellectually stimulating activities (e.g., reading, playing board games, volunteering) was consistently associated with a reduced risk of cognitive decline. Digital behavioural indicators (e.g., computer usage patterns, naturalistic driving metrics, survey response times) showed promising predictive potential for early cognitive impairment identification, with several studies reporting good predictive accuracy (e.g., AUC >0.80).

Conclusions

AADL indicators hold promise for early detection and potential prevention of cognitive impairment among older adults. Future research should explore the feasibility, acceptability, and clinical integration of AADL assessments into routine geriatric care and public health practice, particularly in low- and middle-income countries.

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从日常生活高级活动（AADL）中早期识别老年人认知障碍：一项范围综述

快速的技术进步和社会变革重塑了老年人的日常生活。新出现的证据表明，高级日常生活活动（AADL）——超出基本日常生活活动（ADL）和工具性日常生活活动（IADL）的复杂任务——可能比传统的测量方法更早地表明认知障碍。本综述旨在确定AADL可以作为认知障碍的早期指标。研究设计范围审查。方法本综述遵循Arksey和O'Malley的框架，并遵循PRISMA-ScR指南。我们系统地检索了Web of Science、PubMed和PsycINFO在2013年至2023年间发表的相关研究。结果从最初确定的16,185篇文章中，经过彻底筛选和资格评估，纳入了11个国家的45项研究。这些研究考察了AADL的八个领域（例如，数字技术使用、社会参与、文化活动、自然驾驶），涵盖了从轻度认知障碍（MCI）到痴呆的认知障碍阶段。研究结果强调，经常参加某些休闲、社交和智力刺激活动（如阅读、玩棋盘游戏、志愿服务）与降低认知能力下降的风险始终相关。数字行为指标（如计算机使用模式、自然驾驶指标、调查响应时间）显示出早期认知障碍识别的预测潜力，有几项研究报告了良好的预测准确性（如AUC >；0.80）。结论saadl指标具有早期发现和预防老年人认知障碍的潜力。未来的研究应探索将AADL评估纳入常规老年护理和公共卫生实践的可行性、可接受性和临床整合，特别是在低收入和中等收入国家。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Public Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

0.00%

发文量

280

审稿时长

37 days

期刊介绍： Public Health is an international, multidisciplinary peer-reviewed journal. It publishes original papers, reviews and short reports on all aspects of the science, philosophy, and practice of public health.