Activities of daily living performance in persons with dementia comparing care partners' and clinicians' appraisal and associated factors

Introduction: Persons living with dementia require assistance in making day-to-day and health care decisions. Health care professionals select treatments based on the care partner (CP) report of the person's function; however, the accuracy of CPs' appraisal has received limited exploration. Methods: Retrospective analyses of observational, programmatic data were performed across 161 dyads (CPs and persons with dementia) participating in an evidence-based, community-level dementia intervention program. We examined the differences in the appraisal of activities of daily living performance by CPs versus occupational therapists specialized in dementia treatment and investigated factors related to this discrepancy. Results: The discrepancy in the assessment of function is common between CPs and clinicians. CPs tend to overestimate the abilities of persons with dementia. Appraisal discrepancy was most strongly associated with (1) sex of the person with dementia, (2) timing of assessment performance, (3) number of behavioral symptoms of the person with dementia, and (4) cognitive abilities of the person with dementia. Discussion: Many factors influence the ability of CPs to appraise the function of persons with dementia. The inaccurate appraisal could result in insufficient daily assistance for, or even unnecessary health care utilization, of the person with dementia. Timeliness of intervention is crucial as their health status may change quickly.