Multidimensional assessment in mild to moderate dementia: a 1-year longitudinal study

Objective: To investigate changes in cognitive, neuropsychological, physical, and functional aspects, and quality of life in older adults with mild to moderate dementia over 1 year. Methods: This longitudinal study, approved by an Ethics Committee, included community-dwelling individuals aged ≥ 65 years with dementia classified as stage 1 or 2 according to the Clinical Dementia Rating. Personal, sociodemographic, clinical, and anthropometric data were collected. Cognitive and neuropsychological aspects were assessed using the Mini-Mental State Examination and the Cornell Scale for Depression in Dementia. Quality of life, strength, and functional status were assessed using the Quality of Life in Alzheimer’s Disease scale, handgrip strength test, gait speed, Katz Index, and Pfeffer Functional Activities Questionnaire. Assessments were conducted at baseline and after 1 year. Paired Student’s t-test and the McNemar test were used (p < 0.05). Results: A total of 51 older adults, with a mean age of 81.1 (SD, 7.8) years, were included, of whom 47 were reassessed. No significant changes were observed in cognitive (p = 0.139) or neuropsychological (p = 0.306) aspects. Handgrip strength decreased significantly (p = 0.022). No significant differences were found in gait speed (p = 0.052), basic activities of daily living (p = 0.791), or instrumental activities of daily living (p = 0.084). A significant change was observed in caregiver-perceived quality of life (p = 0.004). Conclusion: We observed a decline in muscle strength and a negative impact on caregiver-perceived quality of life, highlighting the importance of integrated follow-up for both older adults with dementia and their caregivers.