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Self-perceived Difficulties in Everyday Function Precede Cognitive Decline among Older Adults in the ACTIVE Study

Published online by Cambridge University Press:  11 August 2017

Sarah Tomaszewski Farias ,
Tania Giovannetti ,
Brennan R. Payne ,
Michael Marsiske ,
George W. Rebok ,
K. Warner Schaie ,
Kelsey R. Thomas Open the ORCID record for Kelsey R. Thomas [Opens in a new window] ,
Sherry L. Willis ,
Joseph M. Dzierzewski  and
Frederick Unverzagt
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Sarah Tomaszewski Farias*
Affiliation:
Department of Neurology, University of California, Sacramento, California
Tania Giovannetti
Affiliation:
Department of Psychology, Temple University, Philadelphia, Pennsylvania
Brennan R. Payne
Affiliation:
Department of Psychology, University of Utah, Salt Lake City, Utah
Michael Marsiske
Affiliation:
Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida
George W. Rebok
Affiliation:
Department of Mental Health, Johns Hopkins Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
K. Warner Schaie
Affiliation:
Center for Integrated Brain Research (CIBR), Seattle Children’s Research Institute, University of Washington, Seattle, Washington
Kelsey R. Thomas
Affiliation:
VA San Diego Healthcare System and Department of Psychiatry, University of California, San Diego, California
Sherry L. Willis
Affiliation:
Center for Integrated Brain Research (CIBR), Seattle Children’s Research Institute, University of Washington, Seattle, Washington
Joseph M. Dzierzewski
Affiliation:
Departments of Epidemiology and Mental Psychology, Virginia Commonwealth University, Richmond, Virginia
Frederick Unverzagt
Affiliation:
Department of Neurology, Indiana University of Pennsylvania, Indiana, Pennsylvania
Alden L. Gross
Affiliation:
Johns Hopkins Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
*
Correspondence and reprint requests to: Sarah Tomaszewski Farias, University of California, Davis, Department of Neurology 4860 Y Street, suite 3700 Sacramento CA 95817. E-mail: farias@ucdavis.edu
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Abstract

Objectives: Careful characterization of how functional decline co-evolves with cognitive decline in older adults has yet to be well described. Most models of neurodegenerative disease postulate that cognitive decline predates and potentially leads to declines in everyday functional abilities; however, there is mounting evidence that subtle decline in instrumental activities of daily living (IADLs) may be detectable in older individuals who are still cognitively normal. Methods: The present study examines how the relationship between change in cognition and change in IADLs are best characterized among older adults who participated in the ACTIVE trial. Neuropsychological and IADL data were analyzed for 2802 older adults who were cognitively normal at study baseline and followed for up to 10 years. Results: Findings demonstrate that subtle, self-perceived difficulties in performing IADLs preceded and predicted subsequent declines on cognitive tests of memory, reasoning, and speed of processing. Conclusions: Findings are consistent with a growing body of literature suggesting that subjective changes in everyday abilities can be associated with more precipitous decline on objective cognitive measures and the development of mild cognitive impairment and dementia. (JINS, 2018, 24, 104–112)

Keywords

IADLEveryday functionOlder adultMild cognitive impairmentDementiaLongitudinal
Type
Special Section: Lifespan Neuropsychology
Information
Journal of the International Neuropsychological Society , Volume 24 , Issue 1 , January 2018 , pp. 104 - 112
Copyright
Copyright © The International Neuropsychological Society 2017 

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