Functional Activities Questionnaire Items that Best Discriminate and Predict Progression from Clinically Normal to Mild Cognitive Impairment

Marshall, Gad A.; Zoller, Amy; Lorius, Natacha; Amariglio, Rebecca E.; Locascio, Joseph J.; Johnson, Keith A.; Sperling, Reisa A.; Rentz, Dorene M.

doi:10.2174/156720501205150526115003

Cited by 73 publications

(56 citation statements)

References 46 publications

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“…Interestingly, these items were also the ones that most participants felt were more or much more difficult, suggesting that these items are more sensitive to functional impairment in this sample of participants with SCD and MCI. This is in line with research by Marshall et al (2015) who found that the item "assembling tax records" discriminated between healthy and MCI participants, and that lower scores on a "paying bills/balancing checkbook" item predicted progression from healthy to MCI. However, they also found that "heating water and turning off the stove" was sensitive to functional change, whereas in our sample most participants did not find a similar item "using the hob" more difficult.…”

Section: Discussionsupporting

confidence: 90%

“…The most recent criteria for mild cognitive impairment (MCI) due to Alzheimer's disease (AD) recognize the presence of subtle problems performing complex functional tasks; however the preservation of independence in functional abilities is a defining criteria (Albert et al, 2011). Nevertheless, difficulties performing IADL in MCI can be predictive of subsequent dementia (Di Carlo et al, 2016;Korolev et al, 2016;Marshall et al, 2015;Sikkes et al, 2011;Tabert et al, 2002). Assessment of subtle change in IADL could therefore provide vital information at the preclinical and prodromal stage of AD to support timely diagnosis and intervention.…”

Section: Introductionmentioning

confidence: 99%

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Enhancing ‘meaningfulness’ of functional assessments: UK adaptation of the Amsterdam IADL questionnaire

Stringer

Leroi

Sikkes

et al. 2020

Int. Psychogeriatr.

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Objective: Commonly used measures of instrumental activities of daily living (IADL) do not capture activities for a technologically advancing society. This study aimed to adapt the proxy/informant-based Amsterdam IADL Questionnaire (A-IADL-Q) for use in the UK and develop a self-report version.Design: An iterative mixed method cross-cultural adaptation of the A-IADL-Q and the development of a self-report version involving a three-step design: (1) interviews and focus groups with lay and professional stakeholders to assess face and content validity; (2) a questionnaire to measure item relevance to older adults in the U.K.; (3) a pilot of the adapted questionnaire in people with cognitive impairment.Setting: Community settings in the UK.Participants: One hundred and forty-eight participants took part across the three steps: (1) 14 dementia professionals; 8 people with subjective cognitive decline (SCD), mild cognitive impairment (MCI), or dementia due to Alzheimer's disease; and 6 relatives of people with MCI or dementia; (2) 92 older adults without cognitive impairment; and (3) 28 people with SCD or MCI. Measurements:The cultural relevance and applicability of the A-IADL-Q scale items were assessed using a 6-point Likert scale. Cognitive and functional performance was measured using a battery of cognitive and functional measures.Results: Iterative modifications to the scale resulted in a 55-item adapted version appropriate for UK use (A-IADL-Q-UK). Pilot data revealed that the new and revised items performed well. Four new items correlated with the weighted average score ). An exploratory analysis of convergent validity found correlations in the expected direction with cognitive and functional measures. Conclusion:The A-IADL-Q-UK provides a measurement of functional decline for use in the UK that captures culturally relevant activities. A new self-report version has been developed and is ready for testing. Further evaluation of the A-IADL-Q-UK for construct validity is now needed.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Enhancing ‘meaningfulness’ of functional assessments: UK adaptation of the Amsterdam IADL questionnaire

Stringer

Leroi

Sikkes

et al. 2020

Int. Psychogeriatr.

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“…Indeed, in a large-scale population study37 , FCSRT free recall in cognitively normal participants exhibited good sensitivity and fair specificity for AD prediction at 5 years (92% and 64% respectively), but showed poor positive predictive value (~8%). The observation that FAQ scores differed between future converters and controls supports recent evidence that impairment in certain instrumental activities of daily living predicts greater risk of progressing from a diagnosis of cognitively normal to MCI38 .Differences in GMD between subsequent converters and controls were limited to MTL, with the pattern of atrophy in EC showing left-sided predominance, as has been…”

supporting

confidence: 78%

Predicting the future development of mild cognitive impairment in the cognitively healthy elderly

Strange

Zhang

Sierra-Marcos

et al. 2020

Preprint

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Identifying measures that predict future cognitive impairment in healthy individuals is necessary to inform treatment strategies for candidate dementia-preventative and modifying interventions. Here, we derive such measures by studying converters who transitioned from cognitively normal at baseline to mild-cognitive impairment (MCI) in a longitudinal study of 1213 elderly participants. We first establish reduced grey matter density (GMD) in left entorhinal cortex (EC) as a biomarker for impending cognitive decline in healthy individuals, employing a matched sampling control for several dementia risk-factors, thereby mitigating the potential effects of bias on our statistical tests. Next, we determine the predictive performance of baseline demographic, genetic, neuropsychological and MRI measures by entering these variables into an elastic net-regularized classifier. Our trained statistical model classified converters and controls with validation Area-Under-the-Curve>0.9, identifying only delayed verbal memory and left EC GMD as relevant predictors for classification. This performance was maintained on test classification of out-of-sample converters and controls. Our results suggest a parsimonious but powerful predictive model for MCI development in the cognitively healthy elderly.

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“…This decline is typically measured by assessing activities of daily living (ADL), which can be divided into basic (e.g., self-maintenance skills) and instrumental functions (e.g., complex skills). To justify the diagnosis of PDD, ADL disabilities should be primarily caused by cognitive, not motor problems (Marshall et al, 2015). As PD is primarily a movement disorder, the distinction between motor and nonmotor contributions to ADL in PD is an obvious challenge (Cheon, Park, & Kim, 2015).…”

mentioning

confidence: 99%

Assessment of cognitive‐driven activity of daily living impairment in non‐demented Parkinson's patients

Becker

Bäumer

Maetzler

et al. 2018

Journal of Neuropsychology

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The core criterion for Parkinson's disease dementia (PDD) is the impairment in activities of daily living (ADL) function primarily caused by cognitive, not motor symptoms. There is evidence to assume that mild ADL impairments in mild cognitive impairment (PD‐MCI) characterize those patients at high risk for dementia. Data of 216 Parkinson's disease (PD) patients assessed with comprehensive motor and neuropsychological assessments were analysed. Based on linear regression models, subscores of the Functional Activities Questionnaire (FAQ) primarily reflecting patients’ global cognitive status (FAQC) or PD‐related motor severity (FAQM) were developed. A quotient (FAQQ) of both scores was calculated, with values >1 indicating more cognitive‐ compared to motor‐driven ADL impairment. Both FAQC and FAQM scores were higher in PD‐MCI than cognitively normal (PD‐CN) patients, indicating more severe cognitive‐ and motor‐driven ADL impairments in this group. One third (31.6%) of the PD‐MCI group had a FAQQ score >1, which was significantly different from patients with PD‐CN (p = .02). PD‐MCI patients with an FAQQ score >1 were more impaired on tests assessing attention (p = .019) and language (p = .033) compared to PD‐MCI patients with lower FAQQ values. The differentiation between cognitive‐ and motor‐driven ADL is important, as the loss of functional capacity is the defining factor for a diagnosis of PDD. We were able to differentiate the cognitive‐driven from the motor‐driven ADL impairments for the FAQ. PD‐MCI patients with more cognitive‐ compared to motor‐driven ADL impairments may pose a risk group for conversion to PDD and can be targeted for early treatments.

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Functional Activities Questionnaire Items that Best Discriminate and Predict Progression from Clinically Normal to Mild Cognitive Impairment

Cited by 73 publications

References 46 publications

Enhancing ‘meaningfulness’ of functional assessments: UK adaptation of the Amsterdam IADL questionnaire

Enhancing ‘meaningfulness’ of functional assessments: UK adaptation of the Amsterdam IADL questionnaire

Predicting the future development of mild cognitive impairment in the cognitively healthy elderly

Assessment of cognitive‐driven activity of daily living impairment in non‐demented Parkinson's patients

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