Impairment in instrumental activities of daily living with high cognitive demand is an early marker of mild cognitive impairment: the Sydney Memory and Ageing Study

Reppermund, Simone; Brodaty, Henry; Crawford, John D.; Kochan, Nicole A.; Draper, Brian; Slavin, Melissa J.; Trollor, Julian N.; Sachdev, Perminder S.

doi:10.1017/s003329171200308x

Cited by 123 publications

(157 citation statements)

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“…They found that cognitive decline preceded and predicted subsequent functional decline both prior to and after dementia onset. Others have also reported that cognitive tests can predict future impairment on activities of daily living before onset of dementia [36][37][38] and some studies have even suggested functional changes can predict conversion from MCI to AD [39][40][41]. These studies have shown substantial variability in rates of conversion, consistent with the difficulty in identifying subtle functional changes.…”

Section: Discussionmentioning

confidence: 95%

F3‐02‐01: Cognitive Impairment Precedes and Predicts Functional Impairment in Mild Alzheimer's Disease

Liu‐Seifert

Han

Henley

et al. 2014

Alzheimer's & Dementia

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Abstract.Background: The temporal relationship of cognitive deficit and functional impairment in Alzheimer's disease (AD) is not well characterized. Recent analyses suggest cognitive decline predicts subsequent functional decline throughout AD progression. Objective: To better understand the relationship between cognitive and functional decline in mild AD using autoregressive cross-lagged (ARCL) panel analyses in several clinical trials. Methods: Data included placebo patients with mild AD pooled from two multicenter, double-blind, Phase 3 solanezumab (EXPEDITION/2) or semagacestat (IDENTITY/2) studies, and from AD patients participating in the Alzheimer's Disease Neuroimaging Initiative (ADNI). Cognitive and functional outcomes were assessed using AD Assessment Scale-Cognitive subscale (ADAS-Cog), AD Cooperative Study-Activities of Daily Living instrumental subscale (ADCS-iADL), or Functional Activities Questionnaire (FAQ), respectively. ARCL panel analyses evaluated relationships between cognitive and functional impairment over time. Results: In EXPEDITION, ARCL panel analyses demonstrated cognitive scores significantly predicted future functional impairment at 5 of 6 time points, while functional scores predicted subsequent cognitive scores in only 1 of 6 time points. Data from IDENTITY and ADNI programs yielded consistent results whereby cognition predicted subsequent function, but not vice-versa. Conclusions: Analyses from three databases indicated cognitive decline precedes and predicts subsequent functional decline in mild AD dementia, consistent with previously proposed hypotheses, and corroborate recent publications using similar methodologies. Cognitive impairment may be used as a predictor of future functional impairment in mild AD dementia and can be considered a critical target for prevention strategies to limit future functional decline in the dementia process.

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Section: Discussionmentioning

confidence: 95%

F3‐02‐01: Cognitive Impairment Precedes and Predicts Functional Impairment in Mild Alzheimer's Disease

Liu‐Seifert

Han

Henley

et al. 2014

Alzheimer's & Dementia

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“…Similarly, there are subtle functional deficits, specifically with instrumental activities of daily living (IADLs) that can be identified and predate a diagnosis of MCI (Peres et al ., 2006; Di Carlo et al ., 2007; Reppermund et al ., 2013). Mild cognitive impairment (MCI) is commonly referred to, as a state in which there is cognitive decline in older adults that is not of sufficient magnitude to impact daily life and so meet criteria for dementia (Albert et al ., 2011).…”

Section: Introductionmentioning

confidence: 99%

Subtle changes in daily functioning predict conversion from normal to mild cognitive impairment or dementia: an analysis of the NACC database

Nowrangi

Rosenberg

Leoutsakos

2016

Int. Psychogeriatr.

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Background There are relatively small but observable changes in functional ability in those without Mild cognitive impairment (MCI) or dementia. The present study seeks to understand whether these individuals go on to develop MCI or dementia by assessing the association between baseline Functional Activities Questionnaire (FAQ) and conversion independent and after adjustment for cognitive tests. Methods The NACC database was used to conduct the analysis of which 7,625 participants were initially identified as having more than one visit and who were cognitively normal at their first visit. Cox proportional hazards were used to fit three models that controlled for executive and non-executive cognitive domains. A similar model was used to assess the effect of FAQ subcategories on conversion. Results Of these individuals, 1,328 converted to either MCI or dementia by visit 10. Converters had a total visit 1 FAQ score significantly higher than non-converters indicating more functional impairment at baseline. After adjustment for cognitive tests, the association between visit 1 FAQ and subsequent conversion was not attenuated. Doing taxes, remembering dates, and traveling were individually identified as significant predictors of conversion. Conclusions The FAQ can be used as an indirect measure of functional ability and is associated with conversion to MCI or dementia. There is a selective and significant association between changes in financial ability and conversion that is in accordance with other research of financial capacity.

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“…Recent research refer that Instrumental ADLs are more complex everyday tasks, such as preparing a meal, managing finances or shopping would constitute a good predictor of dementia 10 years prior to its diagnose as its supposed to aid in an early detection of incipient dementia (Reppermund ,Brodaty, Crawford, 2013;Brown, 2011;Beck, Kędziora-Kornatowska, 2013;Binegar, Hynan, Lacritz, Weiner & Cullum, 2009). …”

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confidence: 99%

Aging and Functional Complex Activities: Clinical and Social Perspectives

Labos

Zabala

Taktak

et al. 2017

pijss

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Impairment in instrumental activities of daily living with high cognitive demand is an early marker of mild cognitive impairment: the Sydney Memory and Ageing Study

Abstract: IADL are affected in individuals with MCI, and IADL with a high cognitive demand show impairment predating the diagnosis of MCI. Subtle cognitive impairment is therefore likely to be a major hidden burden in society.

Cited by 123 publications

References 34 publications

F3‐02‐01: Cognitive Impairment Precedes and Predicts Functional Impairment in Mild Alzheimer's Disease

F3‐02‐01: Cognitive Impairment Precedes and Predicts Functional Impairment in Mild Alzheimer's Disease

Subtle changes in daily functioning predict conversion from normal to mild cognitive impairment or dementia: an analysis of the NACC database

Aging and Functional Complex Activities: Clinical and Social Perspectives

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