Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-11T01:21:54.084Z Has data issue: false hasContentIssue false

Functional impairment as a defining feature of: amnestic MCI cognitive, emotional, and demographic correlates

Published online by Cambridge University Press:  19 April 2012

Igor Bombin*
Affiliation:
Reintegra Foundation, Oviedo, Spain Department of Psychology, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, University of Oviedo, Oviedo, Spain
Sandra Santiago-Ramajo
Affiliation:
Department of Personality Evaluation and Treatment Psychology, University of Granada, Granada, Spain
Maite Garolera
Affiliation:
Grup de Recerca Consolidat de Neuropsicologia (SRG0941), University of Barcelona, Spain
Eva M. Vega-González
Affiliation:
Reintegra Foundation, Oviedo, Spain
Noemí Cerulla
Affiliation:
Neuropsychology Unit Hospital de Terrassa-Consorci Sanitari de Terrassa, Barcelona, Spain Sant Jordi Day Hospital for Cognitive impairment-Consorci Sanitari de Terrassa, Barcelona, Spain
Alfonso Caracuel
Affiliation:
Department of Personality Evaluation and Treatment Psychology, University of Granada, Granada, Spain
Alicia Cifuentes
Affiliation:
Reintegra Foundation, Oviedo, Spain
M. Teresa Bascarán
Affiliation:
Department of Medicine, Psychiatry Area, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, University of Oviedo, Oviedo, Spain
Julio Bobes
Affiliation:
Department of Medicine, Psychiatry Area, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, University of Oviedo, Oviedo, Spain
*
Correspondence should be addressed to: Dr. Igor Bombin, PhD, Reintegra Foundation, Centro de Rehabilitación Neurológica, C/ Eduardo de Fraga Torrejón, 4, bajo, Oviedo. 33011Spain. Phone: +34 984 08 48 46; Fax: +34 984 08 48 41. Email: ibombin@reintegra-dca.es.

Abstract

Background: Early definitions of mild cognitive impairment (MCI) excluded the presence of functional impairment, with preservation of a person's ability to perform activities of daily living (ADL) as a diagnostic criterion. However, recent studies have reported varying degrees of functional impairment associated with MCI. Hence, we aimed to test the potential functional impairment associated with MCI and its predictors.

Methods: Sixty-nine healthy elderly subjects, 115 amnestic single-domain MCI subjects (a-MCI), and 111 amnestic multi-domain MCI subjects (md-MCI) were assessed using a battery of neuropsychological tests including measures of attention, memory, working memory, executive functions, language, and depression. Additionally, functional ability was assessed by both qualitative (WHO-DAS II) and quantitative (CHART) instruments. Cognitive and functional performance was compared between groups, and regression analyses were performed to identify predictors of functional ability.

Results: The md-MCI group was more impaired than the a-MCI group, and both were more impaired than healthy subjects in all cognitive measures, in total CHART score, CHART cognitive and mobility subscores, and WHO-DAS II communication and participation subscales. For the rest of the functional measures, the md-MCI group was more impaired than healthy controls. Prediction of functional ability by cognitive measures was limited to md-MCI subjects and was higher for the CHART than for the WHO-DAS II. The WHO-DAS II was largely influenced by depressive symptoms.

Conclusions: Functional impairment is a defining feature of MCI and is partially dependent on the degree of cognitive impairment. Quantitative measures of functional ability seem more sensitive to functional impairment in MCI than qualitative measures, which seem to be more related to depression.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ahn, I. S. et al. (2009). Impairment of instrumental activities of daily living in patients with mild cognitive impairment. Psychiatry Investigation, 6, 180184. doi: 10.4306/pi.2009.6.3.180.Google Scholar
Amieva, H., et al. (2004). Annual rate and predictors of conversion to dementia in subjects presenting mild cognitive impairment criteria defined according to a population-based study. Dementia and Geriatric Cognitive Disorders, 18, 8793.Google Scholar
Aretouli, E. and Brandt, J. (2010). Everyday functioning in mild cognitive impairment and its relationship with executive cognition. International Journal of Geriatric Psychiatry, 25, 224233. doi: 10.1002/gps.2325.Google Scholar
Bangen, K. J. et al. (2010). Complex activities of daily living vary by mild cognitive impairment subtype. Journal of the International Neuropsychological Society, 16, 630639. doi: 10.1017/S1355617710000330.Google Scholar
Burton, C. L., Strauss, E., Bunce, D., Hunter, M. A. and Hultsch, D. F. (2009). Functional abilities in older adults with mild cognitive impairment. Gerontology, 55, 570581. doi: 10.1159/000228918.Google Scholar
Federici, S., Meloni, F. and Lo Presti, A. (2009). International literature review on WHODAS II (World Health Organization Disability Assessment Schedule II). Life Span and Disability, 1, 83110.Google Scholar
García Martínez, J. and Sánchez Cánovas, J. (1994). Adaptación del cuestionario de fallos de memoria en la vida cotidiana (MFE). Boletín de Psicología (Valencia), 43, 89107.Google Scholar
Gauthier, S. et al. (2006). International Psychogeriatric Association expert conference on mild cognitive impairment. Lancet, 367, 12621270. doi: 10.1016/S0140-6736(06)68542-5.Google Scholar
Goldberg, T. E. et al. (2010). Performance-based measures of everyday function in mild cognitive impairment. American Journal of Psychiatry, 167, 845853. doi: 10.1176/appi.ajp.2010.09050692.CrossRefGoogle ScholarPubMed
Green, M. F. (1996). What are the functional consequences of neurocognitive deficits in schizophrenia? American Journal of Psychiatry, 153, 321330.Google ScholarPubMed
Loewenstein, D. A. et al. (1989). A new scale for the assessment of functional status in Alzheimer's disease and related disorders. Journal of Gerontology, 44, 114121.Google Scholar
Millis, S. R., Rosenthal, M. and Lourie, I. F. (1994). Predicting community integration after traumatic brain injury with neuropsychological measures. International Journal of Neurosciences, 79, 165167.Google Scholar
Nelson, A. P. and O'Connor, M. G. (2008). Mild cognitive impairment: a neuropsychological perspective. CNS Spectrum, 13, 5664.Google Scholar
Pereira, F. S., Yassuda, M. S., Oliveira, A. M. and Forlenza, O. V. (2008). Executive dysfunction correlates with impaired functional status in older adults with varying degrees of cognitive impairment. International Psychogeriatrics, 20, 11041115. doi: 10.1017/S1041610208007631.Google Scholar
Petersen, R. C. (2004). Mild cognitive impairment as a diagnostic entity. Journal of International Medicine, 256, 183194. doi: 10.1111/j.1365–2796.2004.01388.x.Google Scholar
Petersen, R. C. and Negash, N. (2008). Mild cognitive impairment: an overview. CNS Spectrum, 13, 4553.Google Scholar
Petersen, R. C., Smith, G. E., Waring, S. C., Ivnik, R. J., Tangalos, E. G. and Kokmen, E. (1999). Mild cognitive impairment: clinical characterization and outcome. Archives of Neurology, 56, 303308.CrossRefGoogle ScholarPubMed
Petersen, R. C. et al. (2010). Prevalence of mild cognitive impairment is higher in men. The Mayo Clinic Study of Aging. Neurology, 75, 889897. doi: 10.1212/WNL.0b013e3181f11d85.Google Scholar
Potkin, S. G. (2002). The ABC of Alzheimer's disease: ADL and improving day-to-day functioning of patients. International Psychogeriatrics, 14, 726. doi: 10.1017/S1041610203008640.Google Scholar
Reppermund, S. et al. (2010). The relationship of neuropsychological function to instrumental activities of daily living in mild cognitive impairment. International Journal of Geriatric Psychiatry, 26, 843852. doi: 10.1002/gps.2612.CrossRefGoogle ScholarPubMed
Rousseeuw, P. and Leroy, A. (1987). Robust Regression and Outlier Detection. New York: Wiley.Google Scholar
Sauvaget, C., Yamada, M., Fujiwara, S., Sasaki, H. and Mimori, Y. (2002). Dementia as a predictor of functional disability: a four-year follow-up study. Gerontology, 48, 226233. doi: 10.1159/000058355.Google Scholar
Schmitter-Edgecombe, M., Woo, E. and Greeley, D. R. (2009). Characterizing multiple memory deficits and their relation to everyday functioning in individuals with mild cognitive impairment. Neuropsychology, 23, 168177. doi: 10.1037/a0014186.CrossRefGoogle ScholarPubMed
Sunderland, A., Harris, J. E. and Gleave, J. (1984). Memory failures everyday life following severe head injury. Journal of Clinical Neurology, 6, 127142. doi: 10.1080/01688638408401204.Google Scholar
Tam, C. W., Lam, L. C., Chiu, H. F. and Lui, V. W. (2007). Characteristic profiles of instrumental activities of daily living in Chinese older persons with mild cognitive impairment. American Journal of Alzheimers Disease and Other Dementias, 22, 211217. doi: 10.1177/1533317507301597.Google Scholar
Teng, E., Becker, B. W., Woo, E., Cummings, J. L. and Lu, P. H. (2010a). Subtle deficits in instrumental activities of daily living in subtypes of mild cognitive impairment. Dementia and Geriatric Cognitive Disorders, 30, 189197. doi: 10.1159/000313540.CrossRefGoogle ScholarPubMed
Teng, E., Becker, B. W., Woo, E., Knopman, D. S., Cummings, J. L. and Lu, P. H. (2010b). Utility of the functional activities questionnaire for distinguishing mild cognitive impairment from very mild alzheimer disease. Alzheimer Disease and Associated Disorders, 24, 348353.Google Scholar
Wade, D. T. (2005). Applying the WHO ICF framework to the rehabilitation of patients with cognitive deficits. In Halligan, P. W. and Wade, D. T. (eds.), Effectiveness of Rehabilitation for Cognitive Deficits (pp. 3142). Oxford: Oxford University Press.Google Scholar
Werner, P. and Korczyn, A. (2008). Mild cognitive impairment: conceptual, assessment, ethical, and social issues. Clinical Interventions in Aging, 3, 413420.Google Scholar
Whiteneck, G. G., Charlifue, S. W., Gerhart, K. A., Overholser, J. D. and Richardson, G. N. (1992). Quantifying handicap: a new measure of long-term rehabilitation outcomes. Archives of Physical Medicine and Rehabilitation, 73, 519526.Google Scholar
Winblad, B., et al. (2004). Mild cognitive impairment–beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. Journal of International Medicine, 256, 240246.Google Scholar
Yesavage, J. A. (1988). Geriatric depression scale. Psychopharmacology Bulletin, 24, 709711.Google Scholar