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. 2017 Jun;65(6):1152-1158.
doi: 10.1111/jgs.14835. Epub 2017 Mar 17.

Early Functional Limitations in Cognitively Normal Older Adults Predict Diagnostic Conversion to Mild Cognitive Impairment

Sarah Tomaszewski Farias  1 , Karen Lau  2 , Danielle Harvey  3 , Katherine G Denny  1 , Cheyanne Barba  1 , Anthony N Mefford  1
Affiliations

Early Functional Limitations in Cognitively Normal Older Adults Predict Diagnostic Conversion to Mild Cognitive Impairment

Sarah Tomaszewski Farias et al. J Am Geriatr Soc. 2017 Jun.

Abstract

Objectives: To examine whether specific types of early functional limitations in cognitively normal older adults are associated with subsequent development of mild cognitive impairment (MCI), as well as the relative predictive value of self versus informant report in predicting diagnostic conversion to MCI.

Design: As a part of a longitudinal study design, participants underwent baseline and annual multidisciplinary clinical evaluations, including a physical and neurological examination, imaging, laboratory work, and neuropsychological testing.

Setting: Data used in this study were collected as part of longitudinal research at the University of California, Davis Alzheimer's Disease Center.

Participants: Individuals diagnosed as having normal cognition at study baseline who had an informant who could complete informant-based ratings and at least one follow-up visit (N = 324).

Measurements: Participants and informants each completed the Everyday Cognition Scale (ECog), an instrument designed to measure everyday function in six cognitively relevant domains.

Results: Self- and informant-reported functional limitations on the ECog were associated with significantly greater risk of diagnostic conversion to MCI (informant: hazard ratio (HR) = 2.0, 95% confidence interval (CI) = 1.3-3.2, P = .002), with self-report having a slightly higher hazard (HR = 2.3, 95% CI = 1.4-3.6, P < .001). When controlling for baseline cognitive abilities, the effect remained significant for self- and informant-reported functional limitations.

Conclusion: Deficits in everyday memory and executive function domains were the strongest predictors of diagnostic conversion to MCI. Detection of early functional limitations may be clinically useful in assessing the future risk of developing cognitive impairment in cognitively normal older adults.

Keywords: functional ability; informant report; mild cognitive impairment; normal cognition; self-report.

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Conflict of interest statement

Conflict of Interest

No potential conflict of interest was reported by the authors.

References

    1. Andersen CK, Wittrup-Jensen KU, Lolk A, Andersen K, Kragh-Sorensen P. Ability to perform activities of daily living is the main factor affecting quality of life in patients with dementia. Health and quality of life outcomes. 2004;2:52. - PMC - PubMed
    1. Peres K, Helmer C, Amieva H, et al. Natural history of decline in instrumental activities of daily living performance over the 10 years preceding the clinical diagnosis of dementia: a prospective population-based study. Journal of the American Geriatrics Society. 2008 Jan;56(1):37–44. - PubMed
    1. Fauth EB, Schwartz S, Tschanz JT, Ostbye T, Corcoran C, Norton MC. Baseline disability in activities of daily living predicts dementia risk even after controlling for baseline global cognitive ability and depressive symptoms. International journal of geriatric psychiatry. 2013 Jun;28(6):597–606. - PMC - PubMed
    1. Brown PJ, Devanand DP, Liu X, Caccappolo E. Functional impairment in elderly patients with mild cognitive impairment and mild Alzheimer disease. Archives of general psychiatry. 2011 Jun;68(6):617–626. - PMC - PubMed
    1. Burton CZ, Vella L, Twamley EW. Clinical and Cognitive Insight in a Compensatory Cognitive Training Intervention. American journal of psychiatric rehabilitation. 2011 Oct 1;14(4):307–326. - PMC - PubMed