Background: Depression is a potential risk factor for mortality among the aged and it is also associated with other chronic diseases and unhealthy lifestyles that may also affect mortality. The purpose of this study was to investigate the association between depressive symptoms and mortality, controlling for health, nutritional status, and life-style factors.

Methods: A cohort of elderly people (N = 167) was followed-up for ten years. Information on socio-demographic characteristics, medical history, smoking, and alcohol consumption was collected. The primary outcome was all-cause mortality; the secondary outcome was cancer-specific mortality. The Geriatric Depression Scale (GDS-15) was used to assess depression. Using a multivariable Cox proportional hazards regression, we examined the association between depressive symptoms and mortality.

Results: Elderly people with depression (scoring above the depression cut-off of 7) had a 53% increased risk of mortality (relative risk (RR) 1.53; 95%CI: 1.05–2.24) compared to non-depressed subjects. The combination of depressive symptoms with smoking was associated with a particularly higher risk of mortality (RR: 2.61; 95%CI: 1.28–5.31), after controlling for potential confounders.

Conclusions: Depressive symptoms are associated with a significantly increased risk of all-cause mortality. The combination of depressive symptoms and smoking shorten life expectancy among the aged.

Background: The negative image of Alzheimer's disease (AD) in our society has a substantial impact on treating, caring for and integrating those suffering from the disease and their relatives. Little research has been conducted on social perception of AD in the community.

Methods: The aim of this study was to investigate the perception, knowledge, opinions and beliefs about AD in the French population. A cross-sectional telephone survey of 2013 randomly selected community-dwelling people aged 18 years and over was conducted. Multivariate logistic regressions were used for identifying predictors of the personal fear of developing AD, both for the global sample and for different age groups.

Results: Sixty percent of the sample reported personal fear of developing AD. This attitude was strongly related to age, becoming predominant among the elderly. In the middle-aged group, personal fear of developing AD was highest in women with poor self-perceived health and, in particular, those who cared for someone with AD. Being a caregiver or knowing someone with the disease was also strongly associated with fear among younger adults aged 18–34.

Conclusions: These results serve as an incentive for developing special education and prevention programs focused on different age groups and caregivers of AD.

Background: Numerous theoretical models have been developed to explore how caregiving can impact on caregiving outcomes. However, limited attention has been given to the effects of caregivers’ motivations for providing care, the meaning they find in caregiving, and the nature of their relationship with the care-recipient. The current study explored the associations between intrinsic and extrinsic motivations, ability to find meaning in caregiving, and pre-caregiving and current relationship quality, and the way in which these variables interact to influence caregiving outcomes.

Methods: This was a cross-sectional questionnaire study, in which the respondents were 447 caregivers of people with dementia who were in receipt of a specialist nursing service.

Results: The results showed that intrinsic motivations, meaning, and pre-caregiving and current relationship quality were significantly related to each other, while extrinsic motivations were only related to intrinsic motivations and meaning. All these factors were significantly related to caregiving outcomes as measured by caregiver burden, role captivity, and competence.

Conclusions: Based on these findings, it is recommended that interventions aimed at reducing caregiving stress should take into account the impact of the quality of the relationship and the caregivers’ motivations for providing care. More longitudinal research is needed to explore how meanings, motivations, and relationship quality change over the caregiving career.

Background: Although old people may seem less impulsive than adults, numerous experimental studies report that they have inhibitory deficits. Bearing in mind that there is a relationship between inhibition processes and impulsivity, age-related inhibition deficits suggest that older people could be more impulsive than adults.

Methods: The aim of the current study was to compare the functional and dysfunctional impulsivity scores obtained in a sample of elderly people (65 years old and above) with those obtained in previous studies on samples of adolescents and adults. Dickman's Impulsivity Inventory was administered to 190 individuals aged between 65 and 94 years without dementia or cognitive impairment.

Results: Results indicated that the elderly sample showed higher dysfunctional impulsivity levels than the adult samples, which is consistent with the inhibition deficits mentioned above. There were no significant differences in functional impulsivity. Furthermore, old women had higher scores than old men on dysfunctional impulsivity.

Conclusions: This study provides evidence of age-related changes in dysfunctional impulsivity. Functional impulsivity did not show the same pattern as dysfunctional impulsivity, being quite stable across the age span. it seems, then, that impulsivity cannot be considered to decrease with age and dysfunctional impulsivity may even increase.

Background: Early detection and appropriate treatment interventions for depressive symptoms in the elderly are important issues for healthcare systems. However, few studies to date have focused on understanding self-care strategies to manage depressive symptoms among elderly people worldwide. The purpose of this study was to explore self-care management strategies and risk factors for depressive symptoms among elderly outpatients in Taiwan.

Methods: A convenience sample of elderly persons (≥65 years old; N = 1054) was recruited from outpatient clinics of two hospitals in northern Taiwan.

Results: In our sample, the prevalence of depressive tendency was 16.3%. The majority of participants (70.1%) managed depressive symptoms with self-care strategies. The strategy most often used to relieve depressive symptoms was “take a walk.” The main information source for self-care strategies was self-learning. Depressive tendency in this sample was shown by logistic regression analysis to be significantly predicted by gender, marital status, perceived income adequacy, perceived health condition, stroke, and cancer.

Conclusion: Elderly people need to be made more aware of strategies to self-manage depressive symptoms. Healthcare providers can decrease/prevent the first risk factor for depressive symptoms (poor perceived health status) by improving elders’ perceived health and promoting their actual health. The second risk factor (poor perceived income adequacy) can be decreased/prevented by carefully assessing patients’ financial situation during clinic visits and providing suitable referral for further assistance.

Background: White matter hyperintensities (WMH) have frequently been associated with lower executive function performance. Little is known, however, about the effects of hippocampal atrophy on executive control in Alzheimer's disease (AD). The present study focused on the association of hippocampal atrophy with executive function in AD patients and examined whether a threshold effect is present, indicating that a certain amount of brain damage must be present before cognitive function becomes impaired. Finally, we examined the combined effect of hippocampal atrophy and WMH on cognitive task performance.

Methods: We retrospectively collected neuropsychological and neuroimaging data of 94 AD patients. These patients completed tasks of general cognitive function, executive function, memory, and processing speed. With magnetic resonance imaging (MRI), hippocampal atrophy was rated as medial temporal lobe atrophy (MTA) and cerebrovascular disease was rated as WMH using validated visual rating scales.

Results: Medial temporal lobe atrophy (MTA) was associated with lower executive function, general cognitive function, and episodic memory performance. A threshold effect was present, indicating that severe to very severe, but not moderate, MTA was associated with lower executive function. WMH were significantly associated with a single executive test only, whereas the interaction between WMH and MTA was not significantly related to any of the cognitive tasks.

Conclusions: Our findings suggest that AD neuropathology in itself may be responsible for executive dysfunction. Potential explanations for these findings are discussed, focusing on the role of the hippocampus in executive function tests and reduced frontal-posterior connectivity in this patient sample.

Background: The use of informant rating scales in older adults at risk of dementia may assist with early detection and intervention strategies. This study aims to evaluate whether informants rate greater cognitive change in patients with mild cognitive impairment (MCI) compared to cognitively intact individuals, and to determine the relationship between informant ratings of cognitive change and neuropsychological performance.

Methods: One hundred and nine health-seeking older adults underwent clinical and neuropsychological assessments, and informants completed the Cambridge Behavioral Inventory-Revised (CBI-R). Patients were rated according to MCI criteria, including amnestic and non-amnestic subtypes, or as being cognitively intact. CBI-R ratings were evaluated with respect to MCI diagnosis and neuropsychological performance.

Results: Compared to cognitively intact individuals, informants rated patients with MCI as having significantly more change in overall functioning (p < 0.05) as well as in specific domains of memory and orientation (p < 0.01), everyday skills (p < 0.05), and motivation (p < 0.05), even after controlling for depressive symptom severity. In further analyses, the non-amnestic MCI subgroup only had more informant-rated mood changes compared to the amnestic subgroup. In relation to neuropsychological performance, informant ratings were related to poorer visual memory, verbal learning and memory, language, and psychomotor speed, with correlations ranging from –0.19 to –0.43 (p < 0.05).

Conclusions: These findings indicate that informants are sensitive to subtle early cognitive change in individuals with MCI, and that their ratings are related to objectively measured neuropsychological performance. Thus, the CBI-R may be valuable in assisting early screening and intervention processes.

Background: Very few studies from India have studied the phenomenology of delirium. The aim of the present study was to study the phenomenology as measured using the Delirium Rating Scale-Revised-98 (DRS-R98), the associated etiologies and the outcome of delirium among the elderly participants seen by the consultation-liaison psychiatric service in India. In addition, an attempt was made to study the factor structure of symptoms using principal components analysis.

Methods: The case notes of 109 elderly patients referred to psychiatry liaison services were reviewed.

Results: The mean age of the sample was 73.35 years (SD: 7.44; range 65–95 years) and two-thirds of the sample had hospital emergent delirium. The mean DRS-R98 severity score was 18.77 and the DRS-R98 total score was 24.81. In 15 patients the DRS-R98 scores were in the subsyndromal range. Among the various symptoms present, most patients had sleep-wake cycle disturbance, disturbance in orientation, attention and short-term memory impairments, fluctuation of symptoms, temporal onset of symptoms and a physical disorder. Principal components analysis identified three factors which explained 43.5% of variance of symptomatology and it yielded a three-factor structure. Endocrine/metabolic disturbances were the commonest associated etiological category with delirium. The mean hospital stay after being referred to psychiatry referral services was 8.89 days, after which delirium improved in 58.7% of cases. The mortality rate during the inpatient stay was 16.5%.

Conclusions: Results suggest that the symptoms of delirium as assessed by DRS-R98 separate out into a three-factor structure. Delirium is commonly associated with metabolic endocrine disturbances and about one-sixth of the patients die during the short inpatient stay.

Background: The assessment of social anxiety in late life has been examined in few studies (e.g. Gretarsdottir et al., 2004; Ciliberti et al., 2011). The present study describes the creation and initial psychometric evaluation of a new, content valid measure of social anxiety for older adults, the Older Adult Social-Evaluative Situations Questionnaire (OASES).

Methods: Psychometric properties of the OASES were evaluated in a community dwelling sample of older adults (N = 137; 70.8% female). Convergent validity was established by examining the relation between the OASES and the Liebowitz Social Anxiety Scale (LSAS), Social Phobia and Anxiety Inventory (SPAI), and Beck Anxiety Inventory (BAI). Discriminant validity was established by examining the relation between the OASES and measures of depression (Geriatric Depression Scale, GDS), perceived health status (Short Form Health Survey, SF-12), and demographic variables. The validity analyses of the OASES were based on a smaller sample with n values ranging from 98 to 137 depending on missing data on each questionnaire.

Results: Internal consistency, measured by Cronbach's α, for the OASES total score was 0.96. All items on the OASES were endorsed by participants. Convergent validity was demonstrated by medium to large correlations with the SPAI, LSAS, and BAI. Support for discriminant validity was evidenced by small to medium correlations between the OASES and GDS, SF-12, and demographic variables.

Conclusions: Evidence in support of convergent and discriminant validity of the OASES is discussed. Although the results from the present study suggest that this measure may assess anxiety in and avoidance of social situations salient to older adults, future studies are needed to further examine the psychometric properties of the OASES and replicate these results in both clinical and more diverse samples of older adults.

Background: Dementia caregiving has been linked to negative consequences for mental health in caregivers. Although depression seems to be an enduring psychological consequence associated with caregiving, little is known about the longitudinal effects that modulating variables related to coping strategies have on caregiver's changes in depression over time. This study is aimed at investigating whether, in a one-year longitudinal study with 130 dementia caregivers, caregivers’ depression scores co-vary with modulating variables such as self-efficacy for controlling upsetting thoughts, frequency of leisure activities, and cognitive reappraisal, after controlling for gender and caregivers’ stressors (frequency of disruptive behaviors).

Methods: Linear mixed models analysis was used to analyze the associations between time-varying values for caregivers’ stressors and modulating variables in predicting caregivers’ depression.

Results: It was found that increases in caregivers’ self-efficacy, frequency of leisure activities, and cognitive reappraisal significantly predicted decreases in caregivers’ depression over time, even after controlling for gender and frequency of disruptive behaviors. In addition, increases in stressors were significantly related to increases in depression over time.

Conclusions: The inclusion of modulating variables significantly contributed to the explanation of the variance in caregivers’ depression, adding explanatory power to the variables usually included in the stress and coping model (gender and stressors).

Background: The notion of “minimal impairment in instrumental activities of daily living (i-ADL)” is important in the diagnosis of mild cognitive impairment (MCI), but is presently not adequately operationalized. ADL is stratified according to difficulty, complexity, and also to vulnerability to early cognitive changes in a threefold hierarchy: basic activities of daily living (b-ADL), i-ADL, and advanced activities of daily living (a-ADL). This study aims to gain a deeper understanding of the functional decline in the process of MCI.

Methods: In a qualitative design, 37 consecutive patients diagnosed with amnestic (a)-MCI and their proxies were interviewed at two geriatric day hospitals. Constant comparative analysis was used for the analysis.

Results: The a-ADL-concept emerged as important in the diagnosis of MCI. All participants were engaged in a wide range of activities, which could be clustered according to the International Classification of Functioning, Disability and Health (ICF). Participants reported subtle difficulties in performance. A process of functional decline was identified in which adaptation and coping mechanisms interacted with the process of reduced skills, leading to an activity disruption and an insufficiency in functioning.

Conclusion: This study asserts the inclusion of an evaluation of a-ADL in the assessment of older persons. When evaluating ADL at three levels (b-ADL, i-ADL, and a-ADL), all the activities one can perform in daily living are covered.

Background: In an aging population an increasing number of elderly caregivers will be called upon to provide care over a long period, during which time they will be burdened both by caregiving and by the physiological effects of their own aging. Among them there will be more aged male caregivers, who will probably be less prepared than women to become caregivers. The aim of this study was to investigate the relationship between caregivers’ gender, age, family income, living arrangements and social support as independent variables, and depressive symptoms, comorbidities, level of frailty, grip strength, walking speed and social isolation, as dependent variables.

Methods: 176 elderly people (123 women) were selected from a sample of a population-based study on frailty (n = 900), who had cared for a spouse (79.3%) and/or parents (31.4%) in the past five years (mean age = 71.8 ± 4.86 years; mean monthly family income in minimum wages = 4.64 ± 5.14). The study used questionnaires and self-report scales, grip strength and walking speed tests.

Results: 65% of participants evaluated caregiving as being very stressful. Univariate analyses of regression showed low family income as a risk factor for depression; being female and low perceived social support as a risk for comorbidities; being 80 years of age and above for low grip strength; and being male for social isolation indicated by discontinuity of activities and social roles. In multivariate analyses of regression, poverty arose as a risk factor for depression and being female for comorbidities.

Conclusions: Gender roles, age, income and social support interacted with physical and emotional health, and with the continuity of social participation of elderly caregivers. Special attention must be given to male caregivers.

Background: Physical restraint use is common in institutional care for old people and mainly used to prevent falls, despite the fall-preventive effect of physical restraints being questioned in previous research. The aim of the study was to investigate the use of physical restraints in Sweden in 2000 and 2007.

Methods: Data were collected from two comparable census surveys conducted in all institutional care units for old people in 2000 (n = 3,669) and 2007 (n = 2,914). Information on residents’ characteristics and physical restraint use was collected using the Multi-Dimensional Dementia Assessment Scale (MDDAS).

Results: In 2000 16.0% (95% confidence interval (CI) 14.8%–17.2%) of the residents were restrained compared to 18.2% (95% CI 16.8%–19.6%) in 2007 (p = 0.017). Adjusting for residents' characteristics showed that residents in 2007 were more likely to be physically restrained, relative to the residents in 2000 (odds ratio (OR) 1.031, 95% CI 1.005–1.058, p = 0.017). In 2007 the residents had been restrained longer, and a higher proportion were restrained for unknown reasons.

Conclusions: Physical restraint use is still common. Moreover, the findings of this study suggest a small increase (OR 1.031) in the prevalence of physical restraint use from 2000 to 2007 adjusted for residents’ characteristics.

Background: Previous studies using diffusion tensor imaging (DTI) have observed microstructural abnormalities in white matter regions in both Alzheimer's disease and mild cognitive impairment (MCI). The aim of this work was to examine the abnormalities in white matter and subcortical regions of MCI and its subtypes in a large, community-dwelling older aged cohort

Methods: A community-based sample of 396 individuals without dementia underwent medical assessment, neuropsychiatric testing, and neuroimaging. Of these, 158 subjects were classified as MCI and 238 as cognitively normal (controls) based on international MCI consensus criteria. Regional fractional anisotropy (FA) and mean diffusivity (MD) measures were calculated from the DTI and compared between groups. The false discovery rate correction was applied for multiple testing.

Results: Subjects with MCI did not have significant differences in FA compared with controls after correction for multiple testing, but had increased MD in the right putamen, right anterior limb of the internal capsule, genu and splenium of the corpus callosum, right posterior cingulate gyrus, left superior frontal gyrus, and right and left corona radiata. When compared with controls, changes in left anterior cingulate, left superior frontal gyrus, and right corona radiata were associated with amnestic MCI (aMCI), whereas changes in the right putamen, right anterior limb of the internal capsule, and the right corona radiata were associated with non-amnestic MCI (naMCI). On logistic regression, the FA values in the left superior gyrus and MD values in the anterior cingulate distinguished aMCI from naMCI.

Conclusions: MCI is associated with changes in white matter and subcortical regions as seen on DTI. Changes in some anterior brain regions distinguish aMCI from naMCI.

Background: Accuracy of estimation of time-intervals has received marginal attention in psychogeriatrics. We examined presumed differences in this time measure in participants with dementia (PWD) versus participants without dementia (PWoutD), further subdivided into specific diagnoses and performance subgroups. We also studied its demographic, clinical, and cognitive correlates and predictors. A diagnostic role was hypothesized.

Methods: Forty-three individuals (27 PWD: 16 dementia of the Alzheimer's type (DAT), 11 vascular dementia (VaD); 16 PWoutD: 10 major depressive disorder (MDD), 6 normal) were interviewed with the Cambridge Examination for Mental Disorders of the Elderly – Revised (CAMDEX-R) that permits the registration of this time measure. Demographic, clinical, and cognitive data were obtained.

Results: Neither absolute accuracy of estimation of duration of interview nor its transformed logarithm were significantly different between PWD and PWoutD, or between DAT and VaD participants. MDD participants performed significantly poorer than normal and did not differ from PWD, and the PWD relatively better performing subgroup. The logarithm of absolute accuracy of estimation correlated with some clinical and cognitive variables. Only a measure of depression and of impaired judgment could significantly predict it.

Conclusions: The absolute accuracy of estimation of time-intervals did not differ between the major groups and the main diagnoses subgroups. It was associated with a variety of clinical and cognitive measures, and was predicted by the composite constructs of depression and impaired judgment. The diagnostic value of this measure in the psychogeriatric clinic is questionable, and limited to “worried” well individuals.

Background: Cognitive impairment and depression are common and disabling non-motor symptoms of Parkinson's disease (PD). Previous studies have shown associations between them but the nature of the relationship remains unclear. In chronic illness, problem- or task-oriented coping strategies are associated with better outcome but often require higher level cognitive functioning. The present study investigated, in a sample of patients with PD, the relationships between cognitive function, choice of coping strategies, and a broad index of outcome including depression, anxiety, and health-related quality of life (QoL). It was hypothesized that the coping strategy used could mediate the association between cognition and outcome.

Methods: 347 participants completed the Coping Inventory for Stressful Situations, the Hospital Anxiety and Depression Scale, the Parkinson's Disease Questionnaire-8, the Unified Parkinson's Disease Rating Scale, and the Addenbrooke's Cognitive Examination–Revised. Structural Equation Modeling was used to test the hypothesized model of cognition, coping, and outcome based on a direct association between cognition and outcome and an indirect association mediated by coping.

Results: Overall, poorer cognition predicted less use of task-oriented coping, which predicted worse outcome (a latent variable comprised of higher depression and anxiety and lower QoL). The analyses suggested a small indirect effect of cognition on outcome mediated by coping.

Conclusions: The findings suggest that patients who fail to employ task-oriented coping strategies may be at greater risk of depression, anxiety, and poor health-related QoL. Even mild to moderate cognitive impairment may contribute to reduced use of task-oriented coping. Suitably adapted cognitive–behavioral approaches may be useful to enable the use of adaptive coping strategies in such patients.

Background: Chronically ill patients often develop symptoms of depression. They run the risk of sliding into a downward spiral because of the interaction between depression and chronic illness. A minimal psychological intervention (MPI) has been developed to break through the spiral by applying principles of self-management and cognitive behavioral therapy. This study examines the effects of the MPI on self-efficacy, anxiety, daily functioning and social participation.

Methods: A randomized controlled trial compared the MPI with usual care in 361 primary care patients. Nurses visited patients at home over a period of three months. Patients were aged 60 years and older, had minor depression or mild to moderate major depression and either type 2 diabetes mellitus (DM) or chronic obstructive pulmonary disease (COPD). Outcomes were measured at baseline and at one week, three months, and nine months after the intervention period.

Results: At nine months after treatment, the MPI was associated with less anxiety (mean difference 2.5; 95% CI 0.7–4.2) and better self efficacy skills (mean difference 1.8; 95% CI 3.4–0.2), daily functioning (mean difference 1.7; 95% CI 0.6–2.7), and social participation (mean difference 1.3; 95% CI 0.4–2.2). Effect sizes for these outcomes were small to medium (0.29–0.40). Differences were primarily due to a stabilization of outcomes in the intervention group and deterioration in the control group. No major differences were observed between DM and COPD patients.

Conclusions: The intervention appears to be reasonably effective in improving care for chronically ill elderly people. We recommend further evaluation of the MPI, including emphasis on detection and watchful waiting.

Background: Screening tools have been recommended for use in aged care to improve the detection and treatment of depression. This study aimed to evaluate the impact of a program for the routine implementation of the Cornell Scale for Depression in Dementia in Australian facilities, to determine whether use of the instrument by nurses led to further monitoring of depressive symptoms, medical referral, and changes in treatments prescribed for depression.

Methods: A file review was completed for 412 participants out of a total of 867 older people (47.5%) who resided in ten aged care facilities. The review examined Cornell Scale assessment data, medication charts, medical history, nursing progress notes, and resident care plans. Nursing staff who administered the Cornell Scale to each participant were also interviewed, and ten facility managers took part in an interview to determine barriers to the effective implementation of the instrument.

Results: The Cornell Scale had been administered to 46.8% of the sample in the previous 12 months, with 25% of these participants scoring 9–13 and 27% scoring 14 and above. Less than one third of the residents with high scores were monitored by the staff following the assessment. Only 18% of residents with high scores were referred for further assessment of depression, while 10% received a treatment change.

Conclusions: The absence of a protocol for responding to high Cornell Scale scores limited the potential of this program to result in widespread improved treatment of depressed older people. The use of the Cornell Scale by aged care nurses with limited training raised concern.

Background: Knowledge about sleep complaints of caregivers of patients with Alzheimer's disease (AD) and Parkinson's disease (PD) is limited, and we lack information about the relationship between caregivers’ sleep problems and their quality of life (QoL).

Methods: We evaluated subjective sleep quality and its relationship to QoL in a group of 80 caregivers of patients with AD (ADCG, n = 40) and PD (PDCG, n = 40), and in 150 controls. Information about night-time complaints was collected using the Pittsburgh Sleep Quality Index (PSQI). QoL was measured using the McGill QoL Questionnaire.

Results: Eighteen ADCG (45%), 22 PDCG (55%), and 45 (30%) controls reported poor sleep quality. Mean global PSQI score of PDCG (6.25 ± 3.9) was not significantly different from that of ADCG (5.8 ± 3.5; p = 0.67). However, both PDCG and ADCG scored significantly higher than control group (4.3 ± 3.1; p < 0.01). ADCG frequently reported difficulties falling asleep (72.5%) and disturbed sleep (100%). PDCG reported reduced subjective sleep quality (80%) and increased sleep disturbances (100%). Poor sleep quality was associated with depressive symptoms and correlated with QoL in caregivers of both groups, particularly the psychological symptoms domain.

Conclusions: Among caregivers of patients with AD and PD, poor sleep quality is frequent and significantly linked to QoL and depressive symptoms. Identifying the nature of sleep disturbances not only in patients but also in their caregivers is important as appropriate treatment may lead to a better management of the needs of families coping with these patients.

Background: We examined the utility of cognitive evaluation to predict instrumental activities of daily living (IADLs) and decisional ability in Mild Cognitive Impairment (MCI).

Methods: Sixty-seven individuals with single-domain amnestic MCI were administered the Dementia Rating Scale-2 (DRS-2) as well as the Everyday Cognition assessment form to assess functional ability.

Results: The DRS-2 Total Scores and Initiation/Perseveration and Memory subscales were found to be predictive of IADLs, with Total Scores accounting for 19% of the variance in IADL performance on average. In addition, the DRS-2 Initiation/Perseveration and Total Scores were predictive of ability to understand information, and the DRS-2 Conceptualization helped predict ability to communicate with others, both key variables in decision-making ability.

Conclusions: These findings suggest that performance on the DRS-2, and specific subscales related to executive function and memory, is significantly related to IADLs in individuals with MCI. These cognitive measures are also associated with decision-making-related abilities in MCI.