Factors Influencing the Problem of Cognitive Function in Older Adults at the End of Life

Abstract

Objectives: This study investigated factors influencing the problem of cognitive function in older adults in the last month before death. Methods: This cross-sectional and correlational study analyzed secondary data from 2008-2018 Korean older adults population survey data (Korean Longitudinal Study of Aging). The study included older adults aged 65 and older who died of disease, and excluded those with dementia or memory impairment as a chronic disease. Complex-sample logistic regression was conducted using 999 older adults. Statistical analyses were performed using IBM SPSS 26.0 statistical software package. Statistical significance was set at p<0.05. Results: Age at the time of death was 79.45±.27 years old, and 24.5% of older adults have the problem of cognitive function in the last month before death in this study. In the multivariate logistic regression analysis, age at the time of death, stroke, fall experienced before death, dependence on activities of daily living (ADL) during 3 months before death, main bearer of medical expenses, and type of insurance were significant factors influencing the problem of cognitive function. The model explained 13.7% (Cox and Snell R2) and 20.5% (Nagelkerke R2) of the problem of cognitive function in older adults at the end of life. The fitting results of the model were satisfactory and significant (F=4.096, p<.001). Conclusions: The study findings indicate that age at death, stroke, falls experienced before death, dependence on ADL during the last three months before death, main bearer of medical expenses, and type of insurance significantly influence the problem of cognitive function in older adults at the end of life. Based on the results of this study, future research could focus on developing more targeted intervention plans to alleviate the problem of cognitive function in older adults at the end of life and improve their quality of life before death.