Abstract | BACKGROUND:
Activities of daily living ( ADL) impairment is a hallmark of Alzheimer's disease (AD) dementia, but impairment in instrumental ADL (IADL) has been reported in mild cognitive impairment (MCI). The Structured Interview and Scoring Tool-Massachusetts Alzheimer's Disease Research Center (MADRC)-Informant Report (SIST-MIR) includes 60 graded items that assist in scoring the Clinical Dementia Rating; it assesses the spectrum of cognitive and ADL changes relevant to early AD. Of the 60 SIST-M-IR items, 41 address IADL; we aimed to determine which of these best discriminate individuals with MCI from clinically normal (CN) elderly. METHODS: We assessed 447 subjects participating in the MADRC longitudinal cohort (289 CN, 158 MCI). We performed logistic regression analyses predicting the probability of CN vs. MCI diagnosis using the SIST-M-IR items. Analyses were adjusted for demographic characteristics. RESULTS: We found that 4 SIST-M-IR items best discriminated between CN and MCI subjects (MCI performing worse than CN): "participating in games that involve retrieving words" (p=0.0001), "navigating to unfamiliar areas" (p=0.001), "performing mental tasks involved in a former primary job" (p=0.002), and "fixing things or finishing projects" (p=0.002). CONCLUSIONS: Our results point to the earliest functional changes seen in elderly at risk for AD, which could be captured by a few simple questions. Honing the sensitivity of clinical assessment tools will help clinicians differentiate those individuals with normal aging from those who are developing cognitive impairment.
|
Authors | Amy S Zoller, Ildiko M Gaal, Christine A Royer, Joseph J Locascio, Rebecca E Amariglio, Deborah Blacker, Olivia I Okereke, Keith A Johnson, Reisa A Sperling, Dorene M Rentz, Gad A Marshall |
Journal | Current Alzheimer research
(Curr Alzheimer Res)
Vol. 11
Issue 8
Pg. 785-91
( 2014)
ISSN: 1875-5828 [Electronic] United Arab Emirates |
PMID | 25212917
(Publication Type: Journal Article, Research Support, N.I.H., Extramural)
|
Topics |
- Activities of Daily Living
(psychology)
- Aged
- Aged, 80 and over
- Aging
(physiology)
- Cognitive Dysfunction
(diagnosis, psychology)
- Cohort Studies
- Female
- Humans
- Logistic Models
- Male
- Mental Recall
- Neuropsychological Tests
- Psychiatric Status Rating Scales
- ROC Curve
- Verbal Learning
|