Cognitive impairment among functionally limited elderly people in the community: future considerations for long-term care policy.

Analysts question whether measures gauging performance of activities of daily living (ADLs) by the functionally limited elderly in the community capture the range of disabilities resulting from cognitive impairment. Data from the National Long-term Care Survey indicate that only one-half of those with severe cognitive deficits would be eligible for long-term care coverage under commonly proposed, ADL-based criteria. Tests of older people's limitations to carry out instrumental ADLs and brief cognitive assessment instruments have drawbacks as alternative measures of cognitive impairment. Extending coverage to more elderly people with severe deficits requires additional eligibility criteria, which, in turn, calls for expanded or reconsidered assessments of cognitive functioning.