Disability in Instrumental Activities of Daily Living in Elderly Patients with Mild Cognitive Impairment and Alzheimer‘s Disease

Hesseberg, Karin; Bentzen, Hege; Ranhoff, Anette Hylen; Engedal, Knut; Bergland, Astrid

doi:10.1159/000351010

Cited by 31 publications

(30 citation statements)

References 55 publications

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“…This may also assist in validating complex IADL change as a further clinical characteristic observed in eMCI. Studies have indeed found increased sensitivity of IADL scoring in the MCI demographic, once scores are split into complex and simple categories [48,49].…”

Section: Discussionmentioning

confidence: 98%

Biomarkers and Functional Decline in Prodromal Alzheimer’s Disease

Robb

Udeh-Momoh

Wagenpfeil

et al. 2017

JAD

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BACKGROUND:Little is known of possible associations between Alzheimer's disease (AD) biomarkers and instrumental activities of daily living (IADL) change over time. OBJECTIVE:The present study seeks to identify relationships between baseline imaging and fluid biomarker profiles, and decline in IADL utilising data collated from the AD Neuroimaging Initiative (ADNI) cohort. METHODS:Generalised estimating equations analysis, adjusted for cognitive deterioration, was applied to a cohort of 509 individuals from all stages of ADNI, including 156 healthy controls, 189 early mild cognitive impairment (MCI) patients and 164 MCI patients. RESULTS:A significant correlation was found between baseline biomarkers -specifically CSF Aβ and FDG PET, and IADL change over a 3-year period in individuals with MCI. Importantly, comparable correlations between presence of pathological biomarker levels and temporal decline in both functional and cognitive performance were also noted. DISCUSSION:We show that distinct baseline biomarkers may predict latent changes in IADL.Our results necessitate a revision of the commonly held view upholding cognitive changes as the predominant endpoint measure associated with presence of abnormal baseline biomarkers.

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Section: Discussionmentioning

confidence: 98%

Biomarkers and Functional Decline in Prodromal Alzheimer’s Disease

Robb

Udeh-Momoh

Wagenpfeil

et al. 2017

JAD

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“…In this cohort that has previously been reported as having high levels of newly-acquired cognitive impairment 11 , the duration of delirium was not associated with either disability outcome (i.e., IADL or ADL status), a finding in contrast to disability outcomes in populations with similar levels of cognitive impairment such as mild cognitive impairment and Alzheimer's disease. 43 While in need of further study in survivors of critical illness, the difference in these outcomes could be explained by differing underlying pathologies between these syndromes, the potential for functional disability to be expressed differently in cognitively impaired ICU survivors than individuals with progressive dementia, the neuropsychiatric domains that are impaired, or simply that the data supporting an association between cognition and functional status are conflicting and in some cases modest. 44 At least 2 studies in medically ill cohorts – one in ICU patients 45 and one in patients following surgery 46 – have demonstrated an association between delirium and ADL disability, in contrast to the current study.…”

Section: Discussionmentioning

confidence: 99%

Depression, post-traumatic stress disorder, and functional disability in survivors of critical illness in the BRAIN-ICU study: a longitudinal cohort study

Jackson

Pandharipande

Girard

et al. 2014

The Lancet Respiratory Medicine

541

352

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Background Critical illness is associated with cognitive impairment, but mental health and functional disabilities in general intensive care unit (ICU) survivors are inadequately characterized and there are a paucity of data regarding the relationship between age and delirium and these outcomes. Methods In this prospective, multisite cohort study, we enrolled medical/surgical ICU patients with respiratory failure or shock, collected detailed demographics and in-hospital variables, and assessed survivors at 3 and 12 months with measures of depression, posttraumatic stress disorder (PTSD) and functional disability. We used linear and proportional odds logistic regression to examine the independent associations between age and delirium duration versus mental health and functional disabilities. Findings We enrolled 821 patients with a median (interquartile range) age of 61 (51, 71), assessing 448 patients and 382 patients 3 and 12 months after discharge. At 3- and 12-month follow-up, 37% (149/407) and 33% (116/347) of subjects reported at least mild depression, driven primarily by somatic rather than cognitive symptoms. Depressive symptoms were common even among those with no proxy reported history of depression, reported at 3- and 12-month follow-up by 30% (76/255) and 29% (62/217) of these individuals. At either follow-up assessment, only 7% (27/415, 24/361) of subjects had symptoms consistent with PTSD. Disabilities in basic activities of daily living (ADLs) and instrumental activities of daily living (IADLs) were present in 32% (139/428) and 26% (108/422) of individuals at 3 months and in 27% (102/374) and 23%(87/372) at 12 months. Mental health and functional difficulties were prevalent in young and old patients. Although older age was frequently associated with mental health and functional disabilities, no consistent association was observed between delirium and these outcomes. Interpretation In contrast with early single-center reports, data from this large, multicenter investigation reveal depression is much more common than PTSD after critical illness and is driven by somatic symptoms indicative of physical disabilities rather than by cognitive symptoms. Poor mental health and functional disability were common, and persistent in up to a quarter of patients.

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“…Assessment of ADL should be a part of a dementia workup, but Hesseberg at al. [5] show that impairment in ADLs is not always considered when diagnosing people with symptoms of dementia. Feedback from colleagues and subjects in our study indicates that the items of the CFI are functions and activities that represent well the functional decline seen in the early stages of dementia.…”

Section: The Importance Of Assessing Early Activity Problemsmentioning

confidence: 99%

The Validity of the Norwegian Version of the Cognitive Function Instrument

Michelet

Engedal

Selbæk

et al. 2018

Dement Geriatr Cogn Disord

Self Cite

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Background/Aims: A timely diagnosis of dementia is important, and the Cognitive Function Instrument (CFI) is a newly developed instrument to screen for cognitive decline. The aim of this study was to evaluate the validity and internal consistency of the Norwegian version of the CFI. Methods: We included 265 participants with dementia, mild cognitive impairment (MCI), subjective cognitive impairment (SCI), and a reference group without subjective or assessed cognitive decline. The participants and their relatives answered the self- and proxy-rated versions of the CFI. Results: The Norwegian CFI had power to discriminate between people with dementia and with MCI, SCI, and the reference group. The proxy version had better power than the self-rated version in our participants (area under the curve [AUC] proxy-rated varying from 0.79 to 0.99, AUC self-rated varying from 0.56 to 0.85). Conclusion: The Norwegian CFI was found to be a useful, valid, and robust instrument.

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Disability in Instrumental Activities of Daily Living in Elderly Patients with Mild Cognitive Impairment and Alzheimer‘s Disease

Cited by 31 publications

References 55 publications

Biomarkers and Functional Decline in Prodromal Alzheimer’s Disease

Biomarkers and Functional Decline in Prodromal Alzheimer’s Disease

Depression, post-traumatic stress disorder, and functional disability in survivors of critical illness in the BRAIN-ICU study: a longitudinal cohort study

The Validity of the Norwegian Version of the Cognitive Function Instrument

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