June 2024 - 3 min read

Measuring IADLs and ADLs to Discriminate Between Normal Aging and Cognitive Decline

Seventy-six percent (76%) of patients with dementia remain undiagnosed. But how do you distinguish between the natural changes of aging and the early signs of cognitive decline? Both can present similar symptoms. Adding to the complexity, individuals known as the “worried well,” often seek medical advice for perceived memory issues, and those with dementia frequently lack awareness of their cognitive decline. Subtle differences in the nature and severity of these symptoms necessitate careful assessment and accurate diagnosis.

Here’s what you need to know.

Understanding Normal Aging vs. Early Cognitive Decline

As people age, some cognitive changes are normal. It’s common for older adults to experience mild forgetfulness, slower processing speeds, and occasional difficulty in multitasking. However, significant memory loss, confusion, and difficulty performing daily tasks may indicate early stages of dementia. Here’s a comparative table that provides insight into the differences.


While normal aging involves gradual cognitive changes like slower task-management and mild forgetfulness, dementia is characterized by more severe impairments that interfere with activities of daily living, such as significant memory loss, difficulty with familiar tasks, disorientation, and mood changes. Recognizing these differences helps in making informed decisions about when to seek further evaluation and support, ensuring better care and quality of life for those affected.

The Role of Cognitive Assessments

Regular cognitive assessments are essential to monitor and address cognitive health accurately. Assessments, like Qr8 Cognition Suite:

  • establish baseline cognitive function and identify early signs of decline
  • differentiate between normal aging and more serious conditions like dementia, and
  • help healthcare providers track changes over time.

Routine evaluations not only identify cognitive deficits but also offer reassurance to the "worried well"—those concerned about their cognitive health despite the normal changes that occur with aging.

Identifying Cognitive Decline in Daily Activities

For those suffering from dementia, assessing both Instrumental Activities of Daily Living (IADL) and Activities of Daily Living (ADL) is crucial. In the earlier stages of dementia, IADLs serve as important indicators of cognitive health, while ADLs become more critical as cognitive decline progresses. ADLs, including basic self-care tasks like bathing, dressing, and eating, are fundamental for daily functioning. In contrast, IADLs involve more complex activities such as managing finances, cooking, and using transportation, reflecting an individual's ability to live independently within the community.


Dementia typically manifests as a loss of independence in at least one IADL. Both ADLs and IADLs are assessed based on a person's ability to perform tasks independently. This assessment is conducted through structured interviews with the patient or their caregiver, or using standardized questionnaires such as those employed in tools like Qr8 Cognition Suite.

Final Thoughts

Identifying cognitive decline early is essential for providing effective care and support for patients with dementia. By understanding the differences between normal aging and early cognitive decline, utilizing appropriate assessment tools, and implementing proactive interventions, healthcare professionals can significantly influence patient outcomes.

For more information on cognitive assessments, early detection strategies, and automating ADL and IADL assessments, contact Qr8 Health to learn how our tools and resources can help you identify undiagnosed patients with dementia in your care.

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