THE CONCEPT OF EVERYDAY ACTIVITIES IN NEUROCOGNITIVE DISORDERS: ITS IMPORTANCE IN DIAGNOSIS AND NON-PHARMACOLOGICAL INTERVENTION.

Activities of daily living (ADLs) are of paramount importance in neurocognitive disorders, both in the diagnosis as well as in non-pharmacological interventions. Despite the multiple evaluations that have been developed, their content and format varies considerably and many of these evaluations have insufficient or even lacking data on their psychometric properties, making them limited for diagnostic and treatment purposes in neurocognitive disorders. This dissertation aimed to gain knowledge about how to perform an accurate evaluation of ADLs in older persons with neurocognitive disorders. Firstly, a new evaluation of basic (b-) and instrumental (i-) ADLs was developed and validated, showing a high discriminative accuracy in differentiating between cognitively healthy older persons, persons with Mild Cognitive Impairment (MCI) and mild Alzheimer’s Disease. Secondly, it was investigated whether performance-based measurements of ADLs are superior to report-based measurements of ADLs in differentiating between cognitively healthy ageing, MCI and mild dementia. Thirdly, it was examined which measures of executive functioning significantly account for the variance in everyday functioning in order to improve understanding of the cognitive underpinnings of ADLs. And lastly, it was determined if a multicomponent rehabilitation programme for community-dwelling persons with dementia ameliorates everyday functioning, by assessing b-, i- and advanced (a-)ADLs. This dissertation offers directions for using ADLs in diagnosing and rehabilitating older persons with neurocognitive disorders and recommends a stepwise and semi-structured approach in assessing and addressing everyday activities in neurocognitive disorders.