ORIGINAL RESEARCH article
Front. Aging Neurosci.
Sec. Neurocognitive Aging and Behavior
This article is part of the Research TopicPanoramic View of Cognitive Impairment: Interdisciplinary Cognitive Research, Volume IIView all 3 articles
Cognitive Impairment and Dependency in Activities of Daily Living: A Cross-Lagged Analysis
Provisionally accepted
- 1Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- 2Department of Clinical Research Management, West China Hospital, Sichuan University, Chengdu, China
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Background: This study investigates the bidirectional relationship between cognitive function and Activities of Daily Living (ADL) at varying levels of cognitive impairment. Specifically, it explores how cognitive function affects Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL) over time, and how changes in ADL impact cognitive function. Method: A retrospective analysis of clinical data was conducted using cross-lagged panel models to examine the relationships between cognitive function and ADL. Cognitive function was measured using the Montreal Cognitive Assessment, while ADL were assessed via standardized measures of both BADL and IADL at two time points. Participants were grouped according to the severity of their initial cognitive impairment, allowing for comparative analysis across different levels of impairment. Results: Cross-lagged analyses revealed that lower baseline cognitive function was significantly associated with increased ADL dependency at follow-up (β = -0.302, p < 0.001), with a stronger association for IADL (β = -0.318, p < 0.001) than for BADL (β = -0.274, p < 0.001). Subgroup analyses indicated that these associations were most pronounced in individuals with moderate cognitive impairment. Conclusions: This study highlights the significant association between cognitive function and ADL, with lower baseline cognitive function predicting increased dependency, particularly in IADL. The findings emphasize the importance of early cognitive health interventions to prevent further decline in daily functioning, especially in individuals with moderate cognitive impairment.
Keywords: Cognitive impairment1, Activities of daily living2, cognition3, cross-lagged analysis4, longitudinal study5
Received: 10 Jul 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Fu, Ji, Li, Chen, Liu and Kuang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Weihong Kuang, kwhhlj@scu.edu.cn
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