Effects on activities of daily living and instrumental activities of daily living independence in patients with Alzheimer's disease when the main nursing caregiver consciously provides only minimal nursing care.

The study included only patients hospitalized in one university hospital dementia ward, so it may not apply to people with Alzheimer's disease living at home or in other settings. It was cross-sectional, using assessments only soon after hospital admission, so it cannot show that minimal caregiver help caused higher independence or how independence changed over time. Caregiver minimal-care status was based on caregiver report during an interview, not on observed caregiver behavior or a randomized instruction to caregivers. ADL and IADL scores were also obtained from caregiver interviews, so patient performance was not directly measured. The severe dementia group had only 4 patients in the minimal-care group, so no ADL/IADL comparisons were made for that group. The authors also note that higher independence at admission might have influenced which caregivers reported minimal care, so the direction of association is unclear.

The authors declared no conflicts of interest. No funding source is stated.

Do not conclude that instructing caregivers to provide minimal care will improve ADL/IADL independence. The study compared existing caregiver reports at admission and did not test an intervention or follow patients over time.