Functional Disability Profiles in Amnestic Mild Cognitive Impairment

Abstract

Background/Aims: Instrumental activities of daily living (IADL) can be impaired in mild cognitive impairment (MCI), and the severity of functional disability predicts Alzheimer’s disease (AD) in amnestic MCI (aMCI). This study investigated the functional profiles of aMCI in a Chinese population. Methods: The Disability Assessment for Dementia scores of 56 subjects with single-domain aMCI (sd-aMCI) and 94 with multiple-domain aMCI (md-aMCI) were compared with normal controls (n = 64) and mild AD patients (n = 102). Results: Both the sd-aMCI (2.5 ± 2.5) and md-aMCI (3.7 ± 3.5) groups had more impaired IADL items than the controls (0.7 ± 1.7). Their IADL scores were intermediate, between the control and AD groups. sd-aMCI subjects presented deficits in 7 IADL items involving the ‘meal preparation’, ‘telephoning’, ‘finance’, ‘medications’, ‘housework’, and ‘leisure’ subscales. md-aMCI subjects presented deficits in 14 IADL items involving all subscales of daily activities. The Mini-Mental State Examination and Modified Trail-Making Test Part B scores were the major neuropsychological correlates of IADL performance in aMCI. Conclusion: IADL can be impaired in both sd-aMCI and md-aMCI. Including the functional ability assessment in the evaluation of aMCI may help clinicians to provide appropriate suggestions to maintain daily functioning.

The advanced activities of daily living: A tool allowing the evaluation of subtle functional decline in mild cognitive impairment

“…We, as well as others, assumed that a mild decline in cognitive capacities is accompanied by a certain decline in complex functioning [9][10][11]. In this study we found that a-ADL decline, measured by the a-ADL-DI and a-ADL-CDI correlated with cognitive decline as measured by MMSE and CamCog.…”

“…Advanced ADL (a-ADL) are more sophisticated activities, beyond those necessary to live independently. When trying to establish the diagnosis of Alzheimer's disease (AD) in an early stage, assessment of a-ADL can be of great interest since these activities demand high cognitive functioning and are, therefore, more responsive to subtle changes [9][10][11]. However, at this moment it is still uncertain which domains of functioning may be impaired and to what extent.…”

“…Presently, the commonly used instruments often fail to capture the subtle impairments encountered in MCI. Although several relevant studies were carried out the past years [4,11,[14][15][16][17][18][19][20], at this moment there are neither age-specific norms for levels of functioning, nor normal rates of functional decline available.…”

Functional decline in the elderly with MCI: Cultural adaptation of the ADCS-ADL scale

“…However, the unsystematic use and variability of the functional assessments employed have impaired more accurate results. [46][47][48][49] We know that there are many scales for the assessment of ADL in the elderly. However, they were created with the objective of assessing the functional decline in elderly people with dementia, whose deficit proves to be more significant when compared to elderly people with MCI.…”

Atividades avançadas de vida diária e incidência de declínio cognitivo em idosos: Estudo SABE

“…The literature shows that elderly that maintain normal cognitive performance are younger 3 , have higher levels of schooling and income 1,4 , display higher levels of community participation 5 , and perform activities that involve physical, mental, and social stimulation 6 . In addition, alterations in functional capacity can precede cognitive impairment 7,8 .…”