Longitudinal trajectories of everyday function by diagnostic status.

Abstract

Generalized linear mixed models were used to examine longitudinal trajectories of everyday functional limitations by diagnostic stability/progression. Older adults (N=384) were followed an average 3.6 years; participants were grouped by diagnosis at study baseline and last follow-up (normal cognition, Mild Cognitive Impairment (MCI) or dementia at each time point). At study baseline there were clear group differences; most notably, among participants initially characterized as cognitively normal, those who developed MCI or dementia over follow-up already demonstrated greater functional impairment compared to those who remained cognitively normal. Change in functional impairment progressed slowly in the early disease groups, but showed an accelerated worsening in those converting to dementia.

Self‐rated and informant‐rated everyday function in comparison to objective markers of Alzheimer's disease

“…The ECog has been shown to be sensitive to early functional changes seen in MCI as well as dementia (2, 4, 6). The ECog has been shown to have excellent internal reliability (Cronbach’s alpha = 0.97) as well as good test re-test reliability (r=.82, p<.001) (6).…”

“…Various aspects of validity have been demonstrated via its correlation with other well-known measures of daily function (6), as well as cognitive and neuroimaging indicators of disease (6, 29). Finally, the ECog has been shown to be sensitive to change over time and shows differential rates of change in relation to baseline diagnosis and change in diagnosis over follow-up (4). …”

“…The reliability and validity of these tests has been previously established (30). Within this battery, we focused on memory and executive function due to previous findings that consistently reported relationships between these abilities and everyday functioning (4, 18, 31–33). Memory was assessed using the Rey Auditory Verbal Learning Test (RAVLT) (34).…”

“…While loss of independence in everyday functional abilities is a core feature of AD dementia, there is increasing recognition that mild functional changes occur early in the disease, including within Mild Cognitive Impairment (MCI) (1–3). New evidence suggests subtle functional changes may be detected in individuals who are still considered cognitively normal (4). Early detection of functional decline has prognostic value in predicting future disease progression (5).…”

The Everyday Cognition Scale in Parkinson's Disease

“…However, to date the fi eld has yet to coalesce around a particular measure of daily functioning in PD. Th e Everyday Cognition (ECog) scale (3) is a potentially attractive measure for this purpose that has established utility in samples with mild cognitive impairment (MCI) and Alzheimer's disease (3,4), frontotemporal dementia (5), and prodromal Huntington's disease (6). However, the ECog's clinical utility in PD has not been explored.…”