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Randomized Controlled Trial
. 2018 Jan;24(1):104-112.
doi: 10.1017/S1355617717000546. Epub 2017 Aug 11.

Self-perceived Difficulties in Everyday Function Precede Cognitive Decline among Older Adults in the ACTIVE Study

Sarah Tomaszewski Farias  1 , Tania Giovannetti  2 , Brennan R Payne  3 , Michael Marsiske  4 , George W Rebok  5 , K Warner Schaie  6 , Kelsey R Thomas  7 , Sherry L Willis  6 , Joseph M Dzierzewski  8 , Frederick Unverzagt  9 , Alden L Gross  10
Affiliations
Randomized Controlled Trial

Self-perceived Difficulties in Everyday Function Precede Cognitive Decline among Older Adults in the ACTIVE Study

Sarah Tomaszewski Farias et al. J Int Neuropsychol Soc. 2018 Jan.

Abstract

Objectives: Careful characterization of how functional decline co-evolves with cognitive decline in older adults has yet to be well described. Most models of neurodegenerative disease postulate that cognitive decline predates and potentially leads to declines in everyday functional abilities; however, there is mounting evidence that subtle decline in instrumental activities of daily living (IADLs) may be detectable in older individuals who are still cognitively normal.

Methods: The present study examines how the relationship between change in cognition and change in IADLs are best characterized among older adults who participated in the ACTIVE trial. Neuropsychological and IADL data were analyzed for 2802 older adults who were cognitively normal at study baseline and followed for up to 10 years.

Results: Findings demonstrate that subtle, self-perceived difficulties in performing IADLs preceded and predicted subsequent declines on cognitive tests of memory, reasoning, and speed of processing.

Conclusions: Findings are consistent with a growing body of literature suggesting that subjective changes in everyday abilities can be associated with more precipitous decline on objective cognitive measures and the development of mild cognitive impairment and dementia. (JINS, 2018, 24, 104-112).

Keywords: Dementia; Everyday function; IADL; Longitudinal; Mild cognitive impairment; Older adult.

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Conflict of interest statement

Authors have no disclosures of conflict of interest.

Figures

Figure 1
Figure 1
Latent change score model in which individual differences in IADL performance at time t predict subsequent change in cognitive performance between time t and t+1 (dotted arrows from IADL to change in cognition), and individual differences in cognition at time t predict subsequent change in IADL performance between time t and t+1 (dotted arrows from cognition to change in IADL). Models were estimated for memory, reasoning, and speed of processing. See Analysis Plan for the details of the model building procedure; the specific stage represented graphically here is shown in model stage 4 in Table 2 for each cognitive outcome.
See this image and copyright information in PMC

References

    1. Albert MS, DeKosky ST, Dickson D, Dubois B, Feldman HH, Fox NC, Snyder PJ. The diagnosis of mild cognitive impairment due to Alzheimer’s disease: Recommendations from the National Institute on Aging-Alzheimer’s Association workgroups on diagnostic guidelines for Alzheimer’s disease. Alzheimer’s & dementia. 2011;7:270–279. - PMC - PubMed
    1. Amariglio RE, Mormino EC, Pietras AC, Marshall GA, Vannini P, Johnson KA, Sperling RA, Rentz DM. Subjective cognitive concerns, amyloid-β, and neurodegeneration in clinically normal elderly. Neurology. 2015;85:56–62. - PMC - PubMed
    1. Andersen CK, Wittrup-Jensen KU, Lolk A, Andersen K, Kragh-Sørensen 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. Aretouli E, Brandt J. Everyday functioning in mild cognitive impairment and its relationship with executive cognition. International Journal of Geriatric Psychiatry. 2010;25:224–233. - PMC - PubMed
    1. Bollen K. Structural equations with latent variables. New York: John Wiley; 1989.

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