How Cognitive Decline Impacts Daily Activities and Independence
Many people deal with cognitive decline as they age. Unfortunately, it affects self-image and relationships, as well as seniors’ daily activities and independence. Cognitive decline often affects Activities of Daily Living (ADLs). In this blog post, we explain the relationship between cognitive decline and ADLs, and suggest ways to help maintain cognition while promoting autonomy and quality of life.
Difference between normal aging, Mild Cognitive Impairment, and Dementia
It is important to understand the differences in cognitive abilities among seniors. Normal aging typically involves minor memory slips, slowed thinking, and occasional difficulty multitasking, none of which interfere with everyday life.
Mild Cognitive Impairment (MCI) shows more noticeable issues with memory, language, or reasoning, but individuals can generally maintain independence. Not all with MCI will develop dementia, but the risk is increased compared to normal aging.
Dementia causes significant decline in thinking, memory, and judgment, disrupting daily functioning. Symptoms can worsen over time and may include confusion, wandering, personality changes, and major communication challenges.
What are ADLs?
Activities of Daily Living (ADLs) are tasks essential to daily functioning and to maintaining independence and quality of life. There are two kinds of ADLs: Basic Activities of Daily Living (BADLs) and Instrumental Activities of Daily Living (IADLs). BADLs are routine functions, such as dressing, eating, and bathing. IADLs are higher-level activities, such as following a recipe, using public transportation, or managing finances. Both BADLs and IADLs are necessary for personal autonomy and for being a functioning member of a community.
What happens when cognition starts to decline?
The ability to complete BADLs and IADLs is based on cognitive functions, specifically attention, executive function, language, and memory. When cognition begins to decrease, IADLs start to become harder to complete. This can manifest in many ways. A few examples are:
- Lapses in attention, such as an appliance being left on or an object being misplaced
- Lapses in memory causing someone to forget to take their medication
- Lowered awareness of mistakes, such as not realizing when boarding the wrong train or bus
- Executive function impairment, affecting the ability to plan and anticipate a problem, such as not bringing a coat in the winter
When functional cognition, which is the cognitive ability to accomplish everyday tasks by relying on metacognition and executive function, begins to worsen, a loss of independence occurs. This affects not only the person with the cognitive deficit but also caregivers, as it increases their workload.
How to support ADLs
Although cognitive decline is not completely preventable, seniors can build habits, routines, and environmental supports to maintain independence, brain function, and overall well-being.
- Setting them up with evidence-based cognitive exercises that their providers can customize to fit their individual skills needed for ADLs
- Encouraging seniors to maintain a consistent routine to avoid confusion
- Incorporating calendars, reminders, and labels to assist with memory
- Decluttering their living environment to lower the possibility of disorganization and falls
- Supporting their physical wellbeing by promoting physical movement, light exercise, and nutrient-dense meals
- Having them spend time with friends, family members, or community groups
Conclusion
Cognitive decline can hinder daily activities that younger adults take for granted. Recognizing its impact on older adults’ autonomy can help them access support sooner. Routines, reminders, safer homes, and healthy habits help preserve independence, dignity, and quality of life.
