1
|
Scholz MP, Donders J. Cognitive complaints in older adults: relationships between self and informant report, objective test performance, and symptoms of depression. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2024; 31:263-278. [PMID: 36345862 DOI: 10.1080/13825585.2022.2144617] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 11/01/2022] [Indexed: 11/10/2022]
Abstract
This study explored the relationships between objective measures of cognitive functioning, self and informant reports of cognitive problems in daily life, and depression screening in older adults who had been referred because of reported or suspected cognitive changes. We used archival data from 100, predominantly White (97%), typically educated (M = 13.25 years), older adults (M = 70.38 years) who received an outpatient neuropsychological evaluation. We characterized the cognitive performance using the CVLT-II Total score. We characterized patient and collateral reports using the BRIEF-A MI index, a normed scale of cognitive problems in daily life. We also incorporated a depression screener (PHQ-9) into our analyses. Multiple linear regression analysis revealed that only the informant reported problems in daily life, using the BRIEF-A MI index, was a significant predictor of objective cognitive deficits, as defined by CVLT-II Total scores. Self BRIEF-A MI index scores were not significant predictors of CVLT-II Total performance after we accounted for depression using the patient's PHQ-9 score. Additionally, elevated depression widened the discrepancy between raters, with elevated depression associated with worsening sself-report scores compared to informant-reported scores. As informant-reported problems were the strongest predictor of cognitive deficits, we recommend routine collection of collateral informant reports in the neuropsychological evaluation of older adults referred for cognitive concerns. We also recommend incorporating self-ratings of daily life functioning and screening for depression to contextualize patient complaints and address their concerns, even in the absence of objective cognitive dysfunction.
Collapse
Affiliation(s)
- Michael P Scholz
- Psychology Department, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| | - Jacobus Donders
- Psychology Department, Mary Free Bed Rehabilitation Hospital, Grand Rapids, MI, USA
| |
Collapse
|
2
|
Basta M, John Simos N, Zioga M, Zaganas I, Panagiotakis S, Lionis C, Vgontzas AN. Personalized screening and risk profiles for Mild Cognitive Impairment via a Machine Learning Framework: Implications for general practice. Int J Med Inform 2023; 170:104966. [PMID: 36542901 DOI: 10.1016/j.ijmedinf.2022.104966] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVES Diagnosis of Mild Cognitive Impairment (MCI) requires lengthy diagnostic procedures, typically available at tertiary Health Care Centers (HCC). This prospective study evaluated a flexible Machine Learning (ML) framework toward identifying persons with MCI or dementia based on information that can be readily available in a primary HC setting. METHODS Demographic and clinical data, informant ratings of recent behavioral changes, self-reported anxiety and depression symptoms, subjective cognitive complaints, and Mini Mental State Examination (MMSE) scores were pooled from two aging cohorts from the island of Crete, Greece (N = 763 aged 60-93 years) comprising persons diagnosed with MCI (n = 277) or dementia (n = 153), and cognitively non-impaired persons (CNI, n = 333). A Balanced Random Forest Classifier was used for classification and variable importance-based feature selection in nested cross-validation schemes (CNI vs MCI, CNI vs Dementia, MCI vs Dementia). Global-level model-agnostic analyses identified predictors displaying nonlinear behavior. Local level agnostic analyses pinpointed key predictor variables for a given classification result after statistically controlling for all other predictors in the model. RESULTS Classification of MCI vs CNI was achieved with improved sensitivity (74 %) and comparable specificity (73 %) compared to MMSE alone (37.2 % and 94.3 %, respectively). Additional high-ranking features included age, education, behavioral changes, multicomorbidity and polypharmacy. Higher classification accuracy was achieved for MCI vs Dementia (sensitivity/specificity = 87 %) and CNI vs Dementia (sensitivity/specificity = 94 %) using the same set of variables. Model agnostic analyses revealed notable individual variability in the contribution of specific variables toward a given classification result. CONCLUSIONS Improved capacity to identify elderly with MCI can be achieved by combining demographic and medical information readily available at the PHC setting with MMSE scores, and informant ratings of behavioral changes. Explainability at the patient level may help clinicians identify specific predictor variables and patient scores to a given prediction outcome toward personalized risk assessment.
Collapse
Affiliation(s)
- Maria Basta
- School of Medicine, University of Crete, Heraklion, Crete, Greece
| | | | - Maria Zioga
- School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Ioannis Zaganas
- School of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Simeon Panagiotakis
- Internal Medicine Department, Heraklion University Hospital, Heraklion, Crete, Greece
| | - Christos Lionis
- School of Medicine, University of Crete, Heraklion, Crete, Greece.
| | | |
Collapse
|
3
|
Theory of Mind in Mild Cognitive Impairment - Relationship with Limbic Structures and Behavioural Change. J Int Neuropsychol Soc 2019; 25:1023-1034. [PMID: 31462342 DOI: 10.1017/s1355617719000870] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Older adults presenting with mild cognitive impairment (MCI) have a higher risk of developing dementia and also demonstrate impairments in social cognition. This study sought to establish whether in people with MCI, poorer theory of mind (ToM) was associated with volumetric changes in the amygdala and hippocampus, as well as early changes in behaviour. METHODS One hundred and fourteen people with MCI and fifty-two older adult controls completed the Reading the Mind in the Eyes Test (RMET), while close informants (e.g., spouse/family member/friend/carer) described any current behavioural changes using the Revised Cambridge Behavioural Inventory (CBI-R). A subsample of participants completed structural magnetic resonance imaging (MRI). RESULTS The MCI group showed poorer performance on all neuropsychological tests administered, and moderate reductions on the RMET compared to the control group (d = .44), with greater reduction observed in those with amnestic compared to non-amnestic MCI (p = .03). While a robust correlation was identified between poorer RMET performance and smaller hippocampal volume in the control group (ρ = .53, p = .01), this relationship was not apparent in the MCI group (ρ = .21, p = .11). In the MCI group, poorer RMET performance was associated with poorer everyday skills (ρ = -.26, p = .01) assessed by the CBI-R. CONCLUSIONS Our findings cross-validate previous reports that social cognitive deficits in ToM are a feature of MCI and also suggest that disruptions to broader neural networks are likely to be implicated. Furthermore, ToM deficits in MCI are associated with a decline in everyday skills such as writing or paying bills.
Collapse
|
4
|
Estimating Everyday Neuropsychological Functioning in Multiple Sclerosis: Reliability and Validity of the Greek Multiple Sclerosis Neuropsychological Questionnaire. Mult Scler Int 2018; 2018:6301535. [PMID: 30356376 PMCID: PMC6176322 DOI: 10.1155/2018/6301535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/04/2018] [Accepted: 09/04/2018] [Indexed: 11/18/2022] Open
Abstract
The Multiple Sclerosis Neuropsychological Questionnaire is a brief screening questionnaire for the assessment of everyday neuropsychological competence of patients with Multiple Sclerosis. The aim of the present study was to examine psychometric properties of the Greek version of the instrument. One hundred and three MS patients and 60 informants participated in the present study and completed the questionnaire. From the initial patient sample, 51 participants completed broadly used neuropsychological tests and measures estimating cognitive failures and depression. Moreover, after a six-month interval the MSNQ was administered to 58 patients from the initial sample in order to explore test-retest reliability. Cronbach's α was 0.92 and 0.93 for patient and informant forms, respectively. The patient form was correlated significantly with measures of cognitive failures and depression. Low correlations were found between the informant form and performance on cognitive tests. In regard to the patient form, significant correlation was observed between repeated administrations and, psychometrically, the three-factor structure was preferable than the one-factor structure. The present study confirms the already established pattern of correlations among the two MSNQ forms, neuropsychological test performance and depression measurements. Additional research is needed in order to define a cut-off score for the MSNQ-I providing further information about the diagnostic interpretability of the instrument.
Collapse
|
5
|
Ismail Z, Mortby ME. Cognitive and Neuropsychiatric Screening Tests in Older Adults. MENTAL HEALTH AND ILLNESS WORLDWIDE 2017. [DOI: 10.1007/978-981-10-2414-6_16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
6
|
Szeto JY, Mowszowski L, Gilat M, Walton CC, Naismith SL, Lewis SJ. Mild Cognitive Impairment in Parkinson’s Disease: Impact on Caregiver Outcomes. JOURNAL OF PARKINSONS DISEASE 2016; 6:589-96. [DOI: 10.3233/jpd-160823] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Jennifer Y.Y. Szeto
- Parkinson’s Disease Research Clinic, Brain and Mind Centre, University of Sydney, NSW, Australia
| | - Loren Mowszowski
- Parkinson’s Disease Research Clinic, Brain and Mind Centre, University of Sydney, NSW, Australia
- Healthy Brain Ageing Program, School of Psychology, Brain and Mind Centre, University of Sydney, NSW, Australia
| | - Moran Gilat
- Parkinson’s Disease Research Clinic, Brain and Mind Centre, University of Sydney, NSW, Australia
| | - Courtney C. Walton
- Parkinson’s Disease Research Clinic, Brain and Mind Centre, University of Sydney, NSW, Australia
| | - Sharon L. Naismith
- Parkinson’s Disease Research Clinic, Brain and Mind Centre, University of Sydney, NSW, Australia
- Healthy Brain Ageing Program, School of Psychology, Brain and Mind Centre, University of Sydney, NSW, Australia
| | - Simon J.G. Lewis
- Parkinson’s Disease Research Clinic, Brain and Mind Centre, University of Sydney, NSW, Australia
| |
Collapse
|
7
|
Lindbergh CA, Dishman RK, Miller LS. Functional Disability in Mild Cognitive Impairment: A Systematic Review and Meta-Analysis. Neuropsychol Rev 2016; 26:129-59. [PMID: 27393566 DOI: 10.1007/s11065-016-9321-5] [Citation(s) in RCA: 121] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 05/12/2016] [Indexed: 02/07/2023]
Abstract
Accumulating evidence suggests that the pre-dementia syndrome mild cognitive impairment (MCI) is characterized by decrements in instrumental activities of daily living (IADL). The current review was a quantitative synthesis of the available literature to objectively characterize IADL disability in MCI while clarifying inconsistencies in findings across studies. It was hypothesized that individuals with MCI would display significantly greater functional impairment relative to cognitively intact controls. Candidate moderators specified a priori included functional assessment approach, MCI subtype, depressive symptoms, and language conducted. Online databases (PubMed/MEDLINE and PsycINFO) and reference lists were searched to identify peer-reviewed publications assessing IADL in MCI compared to normal aging. A total of 151 effect sizes derived from 106 studies met inclusionary criteria (N = 62,260). Random effects models yielded a large overall summary effect size (Hedges' g = 0.76, 95 % confidence interval: 0.68 - 0.83, p < .001) confirmed in multi-level analyses adjusted for nesting of effect sizes within studies (g = 0.78, 95 % confidence interval: 0.69 - 0.87). Functional assessment strategy and MCI subtype were significant moderators of effect size, whereas depressive symptoms and language were not. Results convincingly demonstrate that MCI is associated with significant difficulties in the performance of complex everyday tasks. It appears that functional decline, like cognitive decline, exists on a continuum from healthy aging to dementia onset. Implications for clinical practice and research priorities are discussed.
Collapse
Affiliation(s)
- Cutter A Lindbergh
- Department of Psychology, University of Georgia, Athens, GA, 30602, USA.
| | - Rodney K Dishman
- Department of Kinesiology, University of Georgia, Athens, GA, 30602, USA
| | - L Stephen Miller
- Department of Psychology, University of Georgia, Athens, GA, 30602, USA.,Bio-Imaging Research Center, Paul D. Coverdell Center, University of Georgia, Athens, GA, 30602, USA
| |
Collapse
|
8
|
Putcha D, Tremont G. Predictors of independence in instrumental activities of daily living: Amnestic versus nonamnestic MCI. J Clin Exp Neuropsychol 2016; 38:991-1004. [DOI: 10.1080/13803395.2016.1181716] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
9
|
Mcalister C, Schmitter-Edgecombe M, Lamb R. Examination of Variables That May Affect the Relationship Between Cognition and Functional Status in Individuals with Mild Cognitive Impairment: A Meta-Analysis. Arch Clin Neuropsychol 2016; 31:123-47. [PMID: 26743326 DOI: 10.1093/arclin/acv089] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/24/2015] [Indexed: 12/13/2022] Open
Abstract
The objective of this meta-analysis was to improve understanding of the heterogeneity in the relationship between cognition and functional status in individuals with mild cognitive impairment (MCI). Demographic, clinical, and methodological moderators were examined. Cognition explained an average of 23% of the variance in functional outcomes. Executive function measures explained the largest amount of variance (37%), whereas global cognitive status and processing speed measures explained the least (20%). Short- and long-delayed memory measures accounted for more variance (35% and 31%) than immediate memory measures (18%), and the relationship between cognition and functional outcomes was stronger when assessed with informant-report (28%) compared with self-report (21%). Demographics, sample characteristics, and type of everyday functioning measures (i.e., questionnaire, performance-based) explained relatively little variance compared with cognition. Executive functioning, particularly measured by Trails B, was a strong predictor of everyday functioning in individuals with MCI. A large proportion of variance remained unexplained by cognition.
Collapse
Affiliation(s)
| | | | - Richard Lamb
- Department of Teaching and Learning, Washington State University, Pullman, WA, USA
| |
Collapse
|
10
|
Cognitive and Neuropsychiatric Screening Tests in Older Adults. MENTAL HEALTH AND ILLNESS WORLDWIDE 2016. [DOI: 10.1007/978-981-10-0370-7_16-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
|
11
|
Cook DJ, Schmitter-Edgecombe M, Dawadi P. Analyzing Activity Behavior and Movement in a Naturalistic Environment Using Smart Home Techniques. IEEE J Biomed Health Inform 2015; 19:1882-92. [PMID: 26259225 PMCID: PMC4667369 DOI: 10.1109/jbhi.2015.2461659] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
One of the many services that intelligent systems can provide is the ability to analyze the impact of different medical conditions on daily behavior. In this study, we use smart home and wearable sensors to collect data, while ( n = 84) older adults perform complex activities of daily living. We analyze the data using machine learning techniques and reveal that differences between healthy older adults and adults with Parkinson disease not only exist in their activity patterns, but that these differences can be automatically recognized. Our machine learning classifiers reach an accuracy of 0.97 with an area under the ROC curve value of 0.97 in distinguishing these groups. Our permutation-based testing confirms that the sensor-based differences between these groups are statistically significant.
Collapse
Affiliation(s)
- Diane J. Cook
- School of Electrical Engineering & Computer Science, Washington State University, Pullman, WA 99164
| | | | - Prafulla Dawadi
- School of Electrical Engineering & Computer Science, Washington State University, Pullman, WA 99164
| |
Collapse
|
12
|
Paradise M, McCade D, Hickie IB, Diamond K, Lewis SJG, Naismith SL. Caregiver burden in mild cognitive impairment. Aging Ment Health 2015; 19:72-8. [PMID: 24866046 DOI: 10.1080/13607863.2014.915922] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
OBJECTIVES We aimed to compare the rates of burden amongst caregivers of participants with mild cognitive impairment (MCI), compared to a control group. We also aimed to identify factors in both the caregiver and patient that are associated with significant levels of burden. METHOD This was a cross-sectional study. Sixty-four participants with MCI, 36 control-participants and their respective caregivers/informants were recruited to a university research clinic. The proportion of those who showed clinically significant levels of burden was determined by a Zarit Burden Interview score of >21. The associations of burden in MCI-caregivers were calculated in the following categories; participant characteristics (including depressive symptoms, cognition and informant ratings of cognitive and behavioural change); caregiver characteristics; and the caregiving context. Multivariate analyses were performed to examine the relative contribution of individual variables to burden amongst MCI-caregivers. RESULTS We found that 36% of MCI-caregivers reported clinically significant levels of burden, twice that of the control informant group. Participant behavioural problems contribute most to burden, with participant depression and possibly cognition also having a significant association. CONCLUSION Caregiver burden is a considerable problem in MCI and shares some of the same characteristics as caregiver burden in dementia, namely a strong association with challenging behaviours in the patient. This has implications for further research and intervention studies.
Collapse
Affiliation(s)
- Matt Paradise
- a Brain & Mind Research Institute, University of Sydney , Camperdown , Australia
| | | | | | | | | | | |
Collapse
|
13
|
Sanders C, Low C, Schmitter-Edgecombe M. Assessment of planning abilities in individuals with mild cognitive impairment using an open-ended problem-solving task. J Clin Exp Neuropsychol 2014; 36:1084-97. [PMID: 25513952 DOI: 10.1080/13803395.2014.983462] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION There is currently limited research evaluating planning abilities, a core subcomponent of executive functioning, in individuals with mild cognitive impairment (MCI). In the present study, we utilized the "Amap Task," an open-ended problem-solving task, to separately evaluate the formulation and execution components of planning ability in individuals with MCI. METHOD Thirty-seven cognitively healthy older adults and 37 individuals with MCI used a map layout of a university apartment to develop and write out a strategy (formulation stage) to successfully complete a list of tasks (e.g., retrieve and fill a water pitcher before placing it in the refrigerator). Subsequently, participants carried out the tasks in the apartment with the aid of their formulated plan (execution stage). RESULTS MCI participants performed more poorly than older adult (OA) controls during both the formulation and execution stages on measures of task accuracy and task efficiency. However, both groups were able to adjust and improve task accuracy and efficiency from formulation to task execution. Finally, MCI participants took significantly longer to complete the task and adhered less to their formulated plans during task completion. CONCLUSIONS Using an open-ended problem-solving task, the findings revealed that individuals with MCI experienced difficulties with both the formulation and execution components of planning. Like controls, participants with MCI were able to successfully modify their plan online, improving their performance from task formulation to task execution.
Collapse
Affiliation(s)
- Chad Sanders
- a Department of Psychology , Washington State University , Pullman , WA , USA
| | | | | |
Collapse
|
14
|
Schmitter-Edgecombe M, Parsey C, Lamb R. Development and psychometric properties of the instrumental activities of daily living: compensation scale. Arch Clin Neuropsychol 2014; 29:776-92. [PMID: 25344901 DOI: 10.1093/arclin/acu053] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The Instrumental Activities of Daily Living - Compensation (IADL-C) scale was developed to capture early functional difficulties and to quantify compensatory strategy use that may mitigate functional decline in the aging population. The IADL-C was validated in a sample of cognitively healthy older adults (N=184) and individuals with mild cognitive impairment (MCI; N=92) and dementia (N=24). Factor analysis and Rasch item analysis led to the 27-item IADL-C informant questionnaire with four functional domain subscales (money and self-management, home daily living, travel and event memory, and social skills). The subscales demonstrated good internal consistency (Rasch reliability 0.80 to 0.93) and test-retest reliability (Spearman coefficients 0.70 to 0.91). The IADL-C total score and subscales showed convergent validity with other IADL measures, discriminant validity with psychosocial measures, and the ability to discriminate between diagnostic groups. The money and self management subscale showed notable difficulties for individuals with MCI, whereas difficulties with home daily living became more prominent for dementia participants. Compensatory strategy use increased in the MCI group and decreased in the dementia group.
Collapse
Affiliation(s)
| | - Carolyn Parsey
- Department of Psychology, Washington State University, Pullman, WA, USA
| | - Richard Lamb
- Department of Teaching and Learning, Washington State University, Pullman, WA, USA
| |
Collapse
|
15
|
Schmitter-Edgecombe M, Parsey CM. Assessment of functional change and cognitive correlates in the progression from healthy cognitive aging to dementia. Neuropsychology 2014; 28:881-93. [PMID: 24933485 DOI: 10.1037/neu0000109] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE There is currently limited understanding of the course of change in everyday functioning that occurs with normal aging and dementia. To better characterize the nature of this change, we evaluated the types of errors made by participants as they performed everyday tasks in a naturalistic environment. METHOD Participants included cognitively healthy younger adults (YA; n = 55) and older adults (OA; n = 88), and individuals with mild cognitive impairment (MCI: n = 55) and dementia (n = 18). Participants performed 8 scripted everyday activities (e.g., filling a medication dispenser) while under direct observation in a campus apartment. Task performances were coded for the following errors: inefficient actions, omissions, substitutions, and irrelevant actions. RESULTS Performance accuracy decreased with age and level of cognitive impairment. Relative to the YAs, the OA group exhibited more inefficient actions which were linked to performance on neuropsychological measures of executive functioning. Relative to the OAs, the MCI group committed significantly more omission errors which were strongly linked to performance on memory measures. All error types were significantly more prominent in individuals with dementia. Omission errors uniquely predicted everyday functional status as measured by both informant-report and a performance-based measure. CONCLUSIONS These findings suggest that in the progression from healthy aging to MCI, everyday task difficulties may evolve from task inefficiencies to task omission errors, leading to inaccuracies in task completion that are recognized by knowledgeable informants. Continued decline in cognitive functioning then leads to more substantial everyday errors, which compromise ability to live independently.
Collapse
|
16
|
Schmitter-Edgecombe M, Parsey CM. Cognitive correlates of functional abilities in individuals with mild cognitive impairment: comparison of questionnaire, direct observation, and performance-based measures. Clin Neuropsychol 2014; 28:726-46. [PMID: 24766574 DOI: 10.1080/13854046.2014.911964] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The relationship between, and the cognitive correlates of, several proxy measures of functional status were studied in a population with mild cognitive impairment (MCI). Participants were 51 individuals diagnosed with MCI and 51 cognitively healthy older adults (OA). Participants completed performance-based functional status tests and standardized neuropsychological tests, and performed eight activities of daily living (e.g., watered plants, filled medication dispenser) while under direct observation in a campus apartment. An informant interview about everyday functioning was also conducted. Compared to the OA control group, the MCI group performed more poorly on all proxy measures of everyday functioning. The informant report of instrumental activities of daily living (IADL) did not correlate with the two performance-based measures; however, both the informant-report IADL and the performance-based everyday problem-solving test correlated with the direct observation measure. After controlling for age and education, cognitive predictors did not explain a significant amount of variance in the performance-based measures; however, performance on a delayed memory task was a unique predictor for the informant-report IADL, and processing speed predicted unique variance for the direct observation score. These findings indicate that differing methods for evaluating functional status are not assessing completely overlapping aspects of everyday functioning in the MCI population.
Collapse
|