ABSTRACT

Objective: The purpose of this study was to analyze the relationship between cognitive function, dependence on activity of daily life (ADL), and behavioral and psychological symptoms of dementia (BPSD) in older adults, and to investigate the mediating effect of ADL dependence. Methods: A secondary data analysis was conducted using 2015 data from an older adult cohort database (DB) provided by the Korea National Health Insurance Service. Those who received a diagnosis of dementia more than once between 2002 and 2015 and had a grade of 1 to 5 in terms of long-term care service were selected. In addition, a total of 12,363 data were used for analysis. Cognitive function, BPSD, and ADL dependence were extracted. A path model was established to analyze the relationship between the three major variables and the mediating effect of ADL dependence, and the direct effects of each path, the total effect, and indirect effects of the full model were calculated. Results: As a result of a path analysis, the effect between cognitive function and ADL dependence showed a value of .616 (p < .0001), the effect between cognitive function and BPSD was .199 (p < .0001), and the effect between ADL dependence and BPSD was .039 (p = .0005). The total effect of the path model of the three variables was .223 (p < .0001), and the indirect effect was .024 (p = .0005). In addition, there was a partial mediating effect of ADL dependence. Conclusion: As a result of analyzing the mediating effect of ADL dependence through a path model, the ADL dependence partially mediated the effect of cognitive function on BPSD. These results suggest that a program promoting ADL function may be useful for alleviating the BPSD in people with dementia. It is hoped that this study will be used as a basis for the need and development of intervention programs.