Functional and Physical Abilities in the Early Continuum of Cognitive Decline

Abstract

Background/Aims: The early cognitive continuum has been emphasized recently. We sought to characterize the functional and physical aspects of the cognitive continuum in subjects with no cognitive impairment (NCI), subjective cognitive impairment (SCI), nonamnestic (NA-MCI), and amnestic mild cognitive impairment (A-MCI). Furthermore, we identified the potential diagnostic utility of specific functional tasks. Methods: A total of 702 participants, aged ≥65 years and defined as NCI, SCI, NA-MCI, and A-MCI according to the original Petersen criteria, were included. They completed the Korean basic (K-ADL) and Instrumental Activities of Daily Living Scales (K-IADL) and the Performance-Oriented Mobility Assessment (POMA). Results: Significant differences were observed between the different cognitive status groups in three items and total scores on the K-ADL, six items and total scores on the K-IADL and POMA. Controlling for confounding factors revealed that subjects from the A-MCI group performed poorly at bathing, shopping, handling money, and the sum of assorted functional items. Conclusion: These findings demonstrated the declining feature of functional and physical performance according to the cognitive continuum, with A-MCI being discriminative with respect to specific functional tasks as compared to milder cognitive statuses. © 2014 S. Karger AG, Basel

High Prevalence of Stress and Low Prevalence of Alzheimer Disease CSF Biomarkers in a Clinical Sample with Subjective Cognitive Impairment

“…Spooner and Pachana [41] suggested more functionally relevant cognitive tests when assessing ‘neurologically intact' individuals. The relevance of investigating functional characteristics in SCI patients has been recently highlighted [42], and Tales et al [39] proposed that a wider range of brain functions should be measured in SCI (and MCI) diagnostics, based on current knowledge. The high frequency in the current study of help-seeking patients with presence of stress and SCI but absence of objectively measurable cognitive impairment further supports a need of improved assessment of cognition, daily functioning and underlying biological mechanisms in SCI/stress help seekers.…”

Solving the Puzzle of Cognitive Reserve Effects on Cognitive Decline: The Importance of Considering Functional Impairment

“…Importantly, our longitudinal observations empirically corroborate these conceptual predictions. Specifically, functional impairment seems to be a correlate or indicator of the mentioned ongoing pathology [25-27]. Present findings suggest that individuals with relatively little functional impairment may still be in a good overall condition in which also the cognitive system is still able to compensate the ongoing pathology and maintain cognitive functioning (i.e., thereby showing a reduced cognitive decline).…”

“…One avenue in solving this highly debated puzzle of inconsistent results concerns the question whether the relation between cognitive reserve and the rate of cognitive decline may be moderated by certain individual-difference characteristics. For example, in the context of severe cognitive decline and cognitive impairment, consequences with regard to functional impairment, such as difficulties in independently performing one’s activities of daily living, are a crucial issue [25-27]. Interestingly, recent cross-sectional evidence suggests that correlations of cognitive-reserve markers and cognitive functioning level may be stronger in individuals with poorer, compared to those with better functional fitness status (such as strength, agility, and endurance) [28, 29].…”

Assessing the Functional Status of Older Cancer Patients in an Ambulatory Care Visit

“…In people aged 60 years and over, 11% have reported functional difficulty managing money and paying bills [ 13 ]. Even mild cognitive impairment can lead to problems managing money [ 44 ]. Discussions concerning the designation of another person to manage finances are delicate and difficult.…”

“…Determine if the limitations are mentally or physically inspired. Mild cognitive impairment can impinge on driving and handling money [ 44 ]. Depression can be assocaited with functional status changes.…”