IMPACT OF COGNITIVE DYSFUNCTION ON ACTIVITY OF DAILY LIVING PERFORMANCE AND QUALITY OF LIFE AMONG COMMUNITY DWELLING OLDER ADULTS

Background: Cognitive dysfunction among community-dwelling older adults is a growing public health burden in India, where the elderly population is projected to double by 2050. It erodes functional independence and subjective well-being, yet localised data from North Indian urban communities quantifying the triadic relationship between cognitive status, activities of daily living (ADL) performance, and health-related quality of life (QoL) remain scarce.

Objectives: This study was designed to (1) determine the severity of cognitive dysfunction among community-dwelling older adults. (2) Assess the activity of daily living dependency in community-dwelling older adults and to determine the association between cognitive dysfunction and ADL performance. (3) Evaluate the quality of life and to examine the relationship between cognitive dysfunction and quality of life.

Methods: A cross-sectional observational study recruited 68 community-dwelling adults aged 60–85 years near Mahatma Gandhi University of Medical Sciences and Technology, Jaipur, via purposive sampling. Instruments included the Montreal Cognitive Assessment (MoCA) for cognitive screening, the Bristol Activities of Daily Living Scale (Bristol ADL) for functional performance, and the RAND SF-36 Health Survey for QoL. Physical comorbidity was evaluated using a five-domain composite index. Analyses comprised descriptive statistics, Pearson correlations, independent-samples t-tests, multiple linear regression, and binary logistic regression.

Results: Mean MoCA score was 20.46 ± 3.51, with 82.4% showing mild cognitive impairment (score <26). The mean Bristol ADL score was 13.43 ± 6.54, indicating moderate dependency. MoCA negatively correlated with Bristol ADL (r = −0.74, p < 0.001) and all eight SF-36 domains. Age (β = 0.451, p < 0.001) and MoCA (β = −0.472, p < 0.001) independently predicted ADL dependency. MoCA dominantly predicted six QoL domains (e.g., Energy/Fatigue β = 0.503, p < 0.001). Body Pain alone predicted cognitive dysfunction classification (Wald = 4.255, p = 0.039).

Conclusion: Cognitive dysfunction profoundly impacts ADL and multidimensional QoL in Jaipur's older adults. Findings advocate routine MoCA and Bristol ADL screening in community occupational therapy, alongside client-centred reablement programs targeting cognitive, psychosocial, and energy domains to foster autonomy and aging in place.