We review the actual status of instrumental activity of daily living (IADL) and its factors among community dwelling older adults with dementia, and discuss rehabilitation using IADL. Complex IADLs, such as medication management, are impaired in subjective memory complaint and mild cognitive impairment stages. Process analysis of daily activities (PADA-D) revealed that IADL independence was high for processes requiring procedural memory, and low for processes requiring complex cognitive functions. Significant interaction was observed in the total score of PADA-D and Lawton IADLs in 3-month rehabilitation. The common goal that was improved was laundry. Goal-directed rehabilitation based on utilizing the remaining cognitive functions and processes, and detailed observation of IADL may be effective for rehabilitation.
 Authors' abstract