Cognitive, physical and emotional determinants of activities of daily living in nursing home residents—a cross-sectional study within the PROCARE-project

Wollesen B, Schott N, Klotzbier T, Bischoff LL, Cordes T, Rudisch J, Otto AK, Zwingmann K, Hildebrand C, Joellenbeck T, Vogt L, Schöne D, Weigelt M, Voelcker-Rehage C (2023)

Publication Type: Journal article

Publication year: 2023

Journal

European Review of Aging and Physical Activity Springer Verlag (Germany)

Book Volume: 20

Article Number: 17

Journal Issue: 1

DOI: 10.1186/s11556-023-00327-2

Abstract

Background: Interdependencies of health, fitness, cognition, and emotion can promote or inhibit mobility. This study aimed to analyse pathways and interactions between individual subjective and objective physical performance, cognition, and emotions with activities of daily living (ADLs) as mobility indicators in multimorbid nursing home residents. Methods: The study included n = 448 (77.1% females, age = 84.1 ± 7.8 years) nursing home residents. To describe the participant's demographics, frailty, number of falls, and participating institutions' socioeconomic status (SES) were assessed. ADLs were measured with the Barthel Index (BI; dependent variable). Independent variables included objective physical performance, subjective physical performance, cognition, and emotions. A structural equation model (SEM) with maximum likelihood estimation was conducted with AMOS. Direct and indirect effects were estimated using standardized coefficients (significance level of 0.05). Results: Indices showed (Chi2(148) = 217, PCMIN/DF = 1.47; p <.001; Comparative Fit Index =.940; Tucker Lewes Index =.902, RMSEA =.033) that the model fitted the data adequately. While there was no direct association between emotions, subjective physical performance, and ADLs, objective physical performance and cognition predicted higher ADLs (p <.01). Emotions had a strong relationship with subjective physical performance, and cognition had a moderate relationship with objective physical performance. Discussion and conclusion: Objective performance and cognition predicted higher functional status, as expressed by higher BI scores. ADLs, such as mobility, dressing, or handling tasks, require motor and cognitive performance. Subjective performance is an important predictor of ADLs and is only partly explained by objective performance, but to a large extent also by emotions. Therefore, future interventions for nursing home residents should take a holistic approach that focuses not only on promoting objective physical and cognitive performance but also on emotions and perceived physical performance. Trial registration: Trial registration number: DRKS00014957.

Authors with CRIS profile

Daniel Schöne Lehrstuhl für Medizinische Physik und Mikrogewebetechnik

Involved external institutions

Universität Hamburg (UHH) DE Germany (DE) Universität Stuttgart DE Germany (DE) Universität Vechta DE Germany (DE) Westfälische Wilhelms-Universität (WWU) Münster DE Germany (DE) Technische Universität Chemnitz DE Germany (DE) Karlsruhe Institute of Technology (KIT) DE Germany (DE) Universität Paderborn DE Germany (DE) Goethe-Universität Frankfurt am Main DE Germany (DE)

How to cite

APA:

Wollesen, B., Schott, N., Klotzbier, T., Bischoff, L.L., Cordes, T., Rudisch, J.,... Voelcker-Rehage, C. (2023). Cognitive, physical and emotional determinants of activities of daily living in nursing home residents—a cross-sectional study within the PROCARE-project. European Review of Aging and Physical Activity, 20(1). https://dx.doi.org/10.1186/s11556-023-00327-2

MLA:

Wollesen, Bettina, et al. "Cognitive, physical and emotional determinants of activities of daily living in nursing home residents—a cross-sectional study within the PROCARE-project." European Review of Aging and Physical Activity 20.1 (2023).

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