MCI is Associated With Deficits in Everyday Functioning

Abstract

The purpose of the present study was to examine the types of impairments in everyday function that accompany mild cognitive impairment (MCI). Data for this study was collected from 434 individuals consecutively evaluated at a university-based Alzheimer's Center. A total of 96 participants were diagnosed with MCI, 105 were cognitively normal, and 233 had dementia. Informant ratings of participants' abilities were obtained across different functional domains reflecting everyday abilities related to memory, language, visual spatial abilities, planning, organization, and divided attention. As expected, the demented group was significantly more impaired than the healthy control and MCI groups across all of the functional domains. The MCI group also showed significantly more functional impairment relative to healthy controls in all of the functional domains. Examination of the effect sizes as a measure of the magnitude of functional impairment in the MCI groups relative to controls showed that the greatest degree of impairment occurred within the Everyday Memory domain. The current findings suggest that individuals with MCI demonstrate deficits in a wide range of everyday functions but that the magnitude of these changes is greatest for those functional abilities that rely heavily on memory. Keywords mild cognitive impairment (MCI); dementia; functional impairmentThe cognitive changes associated with degenerative dementias such as Alzheimer disease (AD) result in progressive declines in the ability to perform activities of daily living (ADL). 1,2 Mild cognitive impairment (MCI), a syndrome intermediate to normality and dementia, has become increasingly well defined and extensively studied as a prodrome to and predictor of dementia. 3 Although numerous studies have examined functional impairments in dementia, far less research has focused on functional change in MCI. The International Working Group on MCI recently noted that there is currently very little known about which aspects of everyday function are affected in MCI. 4 The initial diagnostic criteria for MCI specified intact or "only slightly abnormal ADL. 3 " However, functional change presumably occurs over the course of MCI because it is precisely such cumulative change that leads to eventual conversion to dementia. A few recent studies have, in fact, suggested that mild changes in daily functioning can be detected in MCI groups. 5,6 At present, the natural history of functional change between normal aging and dementia is undefined. This leaves guidelines for rating functional change in MCI The detection of change in everyday function in MCI is dependent on the method of assessment, more so than in dementia where these changes are severe and pervasive. It has been well established that functional impairments in dementia follow a gradient, such that basic self-care activities (eg, eating, dressing, grooming) are affected after higher order functional abilities become impaired. 8,9 Thus, when investigating changes in everyday function associated with MCI ...

The advanced activities of daily living: A tool allowing the evaluation of subtle functional decline in mild cognitive impairment

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“…Presently, the commonly used instruments often fail to capture the subtle impairments encountered in MCI. Although several relevant studies were carried out the past years [4,11,[14][15][16][17][18][19][20], at this moment there are neither age-specific norms for levels of functioning, nor normal rates of functional decline available.…”

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Neurocognitive and Affective Baseline Profile of the Elderly Individuals Living in Long-Term Care Nursing Home Facility: a New Brunswick Study

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