Functioning and Disability in Community-Living People with Perceived Cognitive Impairment or Dementia: A Mixed Methods Study using the World Health Organization Disability Assessment Schedule.

The sample size was small (26 PwCI and 26 NOK) and drawn from only two municipalities in northern Sweden, which may limit how well these findings apply to other regions or populations. The interviewer was a physiotherapist and ICF expert, which may have influenced how participants described their difficulties or what they chose to share. Six pairs of participants were interviewed together, which might have affected the independence of their responses. The study used a modified version of the WHODAS 2.0, excluding questions about work and school since all participants were retired, and removing the 30-day time constraint, which deviates from the standard assessment protocol. Four PwCI who did not report cognitive problems had MMSE scores indicating impairment, suggesting that some participants may not have been fully aware of their condition or able to accurately self-report.

The authors have no conflicts of interest to declare.

Do not assume that a patient's self-report of low disability means they are functioning independently. Next-of-kin in this study rated disability nearly three times higher than the patients did. Relying solely on the patient's perspective may miss significant safety risks and unmet needs in daily living.