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Impairment in instrumental activities of daily living with high cognitive demand is an early marker of mild cognitive impairment: the Sydney Memory and Ageing Study

Published online by Cambridge University Press:  11 January 2013

S. Reppermund ,
H. Brodaty ,
J. D. Crawford ,
N. A. Kochan ,
B. Draper ,
M. J. Slavin ,
J. N. Trollor  and
P. S. Sachdev
S. Reppermund*
Affiliation:
Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney, Australia
H. Brodaty
Affiliation:
Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney, Australia Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney, Australia Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Sydney, Australia
J. D. Crawford
Affiliation:
Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney, Australia
N. A. Kochan
Affiliation:
Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney, Australia Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
B. Draper
Affiliation:
Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney, Australia Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Sydney, Australia
M. J. Slavin
Affiliation:
Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney, Australia Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney, Australia
J. N. Trollor
Affiliation:
Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney, Australia Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney, Australia
P. S. Sachdev
Affiliation:
Centre for Healthy Brain Ageing, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney, Australia Dementia Collaborative Research Centre, School of Psychiatry, UNSW Medicine, University of New South Wales, Sydney, Australia Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
*
*Address for correspondence: S. Reppermund, Ph.D., University of New South Wales Randwick Campus, Building R1f, Sydney NSW 2052, Australia. (Email: [email protected])
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Abstract

Background

Criteria for mild cognitive impairment (MCI) consider impairment in instrumental activities of daily living (IADL) as exclusionary, but cross-sectional studies suggest that some high-level functional deficits are present in MCI. This longitudinal study examines informant-rated IADL in MCI, compared with cognitively normal (CN) older individuals, and explores whether functional abilities, particularly those with high cognitive demand, are predictors of MCI and dementia over a 2-year period in individuals who were CN at baseline.

Method

A sample of 602 non-demented community dwelling individuals (375 CN and 227 with MCI) aged 70–90 years underwent baseline and 24-month assessments that included cognitive and medical assessments and an interview with a knowledgeable informant on functional abilities with the Bayer Activities of Daily Living Scale.

Results

Significantly more deficits in informant-reported IADL with high cognitive demand were present in MCI compared with CN individuals at baseline and 2-year follow-up. Functional ability in CN individuals at baseline, particularly in activities with high cognitive demand, predicted MCI and dementia at follow-up. Difficulties with highly cognitively demanding activities specifically predicted amnestic MCI but not non-amnestic MCI whereas those with low cognitive demand did not predict MCI or dementia. Age, depressive symptoms, cardiovascular risk factors and the sex of the informant did not contribute to the prediction.

Conclusions

IADL are affected in individuals with MCI, and IADL with a high cognitive demand show impairment predating the diagnosis of MCI. Subtle cognitive impairment is therefore likely to be a major hidden burden in society.

Keywords

Dementiainstrumental activities of daily living (IADL)mild cognitive impairment (MCI)
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 11 , November 2013 , pp. 2437 - 2445
Copyright
Copyright © Cambridge University Press 2013 

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References

Anderson, TM, Sachdev, PS, Brodaty, H, Trollor, JN, Andrews, G (2007). Effects of sociodemographic and health variables on Mini-Mental State Exam scores in older Australians. American Journal of Geriatric Psychiatry 15, 467–476.CrossRefGoogle ScholarPubMed
APA (1994). Diagnostic and Statistical Manual of Mental Health Disorders, 4th edn, revised. American Psychiatric Association: Washington, DC.Google Scholar
Bangen, KJ, Jak, AJ, Schiehser, DM, Delano-Wood, L, Tuminello, E, Han, SD, Delis, DC, Bondi, MW (2010). Complex activities of daily living vary by mild cognitive impairment subtype. Journal of the International Neuropsychological Society 16, 630–639.CrossRefGoogle ScholarPubMed
Barnes, DE, Alexopoulos, GS, Lopez, OL, Williamson, JD, Yaffe, K (2006). Depressive symptoms, vascular disease, and mild cognitive impairment: findings from the cardiovascular health study. Archives of General Psychiatry 63, 273–280.CrossRefGoogle ScholarPubMed
Benton, AL (1967). Problems of test construction in the field of aphasia. Cortex 3, 32–58.CrossRefGoogle Scholar
Benton Sivan, AB, Spreen, O (1996). Der Benton Test (The Benton Test). Huber: Bern.Google Scholar
Blom, G (1958). Statistical Estimates and Transformed Beta Variables. John Wiley and Sons: New York.Google Scholar
Brown, PJ, Devanand, DP, Liu, X, Caccappolo, E (2011). Functional impairment in elderly patients with mild cognitive impairment and mild Alzheimer disease. Archives of General Psychiatry 68, 617–626.CrossRefGoogle ScholarPubMed
D'Agostino, RB Sr, Vasan, RS, Pencina, MJ, Wolf, PA, Cobain, M, Massaro, JM, Kannel, WB (2008). General cardiovascular risk profile for use in primary care: the Framingham Heart Study. Circulation 117, 743–753.CrossRefGoogle ScholarPubMed
De Vriendt, P, Gorus, E, Cornelis, E, Velghe, A, Petrovic, M, Mets, T (2012). The process of decline in advanced activities of daily living: a qualitative explorative study in mild cognitive impairment. International Psychogeriatrics 24, 974–986.CrossRefGoogle ScholarPubMed
Di Carlo, A, Lamassa, M, Baldereschi, M, Inzitari, M, Scafato, E, Farchi, G, Inzitari, D (2007). CIND and MCI in the Italian elderly – frequency, vascular risk factors, progression to dementia. Neurology 68, 1909–1916.CrossRefGoogle ScholarPubMed
Erzigkeit, H, Lehfeld, H, Pena-Casanova, J, Bieber, F, Yekrangi-Hartmann, C, Rupp, M, Rappard, F, Arnold, K, Hindmarch, I (2001). The Bayer-Activities of Daily Living Scale (B-ADL): results from a validation study in three European countries. Dementia and Geriatric Cognitive Disorders 12, 348–358.CrossRefGoogle ScholarPubMed
Farias, ST, Mungas, D, Jagust, W (2005). Degree of discrepancy between self and other-reported everyday functioning by cognitive status: dementia, mild cognitive impairment, and healthy elders. International Journal of Geriatric Psychiatry 20, 827–834.CrossRefGoogle ScholarPubMed
Fastenau, PS, Denburg, NL, Mauer, BA (1998). Parallel short forms for the Boston Naming Test: psychometric properties and norms for older adults. Journal of Clinical and Experimental Neuropsychology 20, 828–834.CrossRefGoogle ScholarPubMed
Folstein, MF, Folstein, SE, McHugh, PR (1975). ‘Mini-mental state’: practical method for grading cognitive state of patients for the clinician. Journal of Psychiatric Research 12, 189–198.CrossRefGoogle ScholarPubMed
Gold, DA (2011). An examination of instrumental activities of daily living assessment in older adults and mild cognitive impairment. Journal of Clinical and Experimental Neuropsychology 34, 11–34.CrossRefGoogle ScholarPubMed
Gorelick, PB, Scuteri, A, Black, SE, Decarli, C, Greenberg, SM, Iadecola, C, Launer, LJ, Laurent, S, Lopez, OL, Nyenhuis, D, Petersen, RC, Schneider, JA, Tzourio, C, Arnett, DK, Bennett, DA, Chui, HC, Higashida, RT, Lindquist, R, Nilsson, PM, Roman, GC, Sellke, FW, Seshadri, S (2011). Vascular contributions to cognitive impairment and dementia: a statement for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 42, 2672–2713.CrossRefGoogle ScholarPubMed
Hindmarch, I, Lehfeld, H, de Jongh, P, Erzigkeit, H (1998). The Bayer Activities of Daily Living Scale (B-ADL). Dementia and Geriatric Cognitive Disorders 9 (Suppl. 2), 20–26.CrossRefGoogle ScholarPubMed
Jungwirth, S, Zehetmayer, S, Hinterberger, M, Tragl, KH, Fischer, P (2012). The validity of amnestic MCI and non-amnestic MCI at age 75 in the prediction of Alzheimer's dementia and vascular dementia. International Psychogeriatrics 24, 959–966.CrossRefGoogle ScholarPubMed
Kaplan, E, Goodglass, H, Weintraub, S (2001). The Boston Naming Test. Lippincott Williams & Wilkins: Philadelphia.Google Scholar
Luck, T, Luppa, M, Angermeyer, MC, Villringer, A, Konig, HH, Riedel-Heller, SG (2011). Impact of impairment in instrumental activities of daily living and mild cognitive impairment on time to incident dementia: results of the Leipzig Longitudinal Study of the Aged. Psychological Medicine 41, 1087–1097.CrossRefGoogle ScholarPubMed
Luis, CA, Loewenstein, DA, Acevedo, A, Barker, WW, Duara, R (2003). Mild cognitive impairment – directions for future research. Neurology 61, 438–444.CrossRefGoogle ScholarPubMed
Modrego, PJ, Ferrández, J (2004). Depression in patients with mild cognitive impairment increases the risk of developing dementia of Alzheimer type: a prospective cohort study. Archives of Neurology 61, 1290–1293.CrossRefGoogle ScholarPubMed
Nelson, HE, Willison, J (1991). National Adult Reading Test (NART): Test Manual, 2nd edn. NFER Nelson: Windsor.Google Scholar
Pérès, K, Chrysostome, V, Fabrigoule, C, Orgogozo, JM, Dartigues, JF, Barberger-Gateau, P (2006). Restriction in complex activities of daily living in MCI – impact on outcome. Neurology 67, 461–466.CrossRefGoogle ScholarPubMed
Perneczky, R, Pohl, C, Sorg, C, Hartmann, J, Komossa, K, Alexopoulos, P, Wagenpfeil, S, Kurz, A (2006). Complex activities of daily living in mild cognitive impairment: conceptual and diagnostic issues. Age and Ageing 35, 240–245.CrossRefGoogle ScholarPubMed
Petersen, RC (2004). Mild cognitive impairment as a diagnostic entity. Journal of Internal Medicine 256, 183–194.CrossRefGoogle ScholarPubMed
Petersen, RC, Smith, GE, Waring, SC, Ivnik, RJ, Tangalos, EG, Kokmen, E (1999). Mild cognitive impairment – clinical characterization and outcome. Archives of Neurology 56, 303–308.CrossRefGoogle ScholarPubMed
Purser, JL, Fillenbaum, GG, Pieper, CF, Wallace, RB (2005). Mild cognitive impairment and 10-year trajectories of disability in the Iowa Established Populations for Epidemiologic Studies of the Elderly cohort. Journal of the American Geriatrics Society 53, 1966–1972.CrossRefGoogle ScholarPubMed
Reitan, RM, Wolfson, D (1985). The Halstead-Reitan Neuropsychological Test Battery: Theory and Clinical Interpretation. Neuropsychological Press: Tucson, AZ.Google Scholar
Reppermund, S, Brodaty, H, Crawford, JD, Kochan, NA, Slavin, MJ, Trollor, JN, Draper, B, Sachdev, PS (2011 a). The relationship of current depressive symptoms and past depression with cognitive impairment and instrumental activities of daily living in an elderly population: the Sydney Memory and Ageing Study. Journal of Psychiatric Research 45, 1600–1607.CrossRefGoogle Scholar
Reppermund, S, Sachdev, PS, Crawford, J, Kochan, NA, Slavin, MJ, Kang, K, Trollor, JN, Draper, B, Brodaty, H (2011 b). The relationship of neuropsychological function to instrumental activities of daily living in mild cognitive impairment. International Journal of Geriatric Psychiatry 26, 843–852.CrossRefGoogle ScholarPubMed
Rey, A (1964). L'Examen Clinique en Psychologie (Clinical Examination in Psychology). Presses Universitaires de France: Paris.Google Scholar
Sachdev, PS, Brodaty, H, Reppermund, S, Kochan, NA, Trollor, JN, Draper, B, Slavin, MJ, Crawford, J, Kang, K, Broe, GA, Mather, KA, Lux, O (2010). Memory and Ageing Study Team. The Sydney Memory and Ageing Study (MAS): methodology and baseline medical and neuropsychiatric characteristics of an elderly epidemiological non-demented cohort of Australians aged 70–90 years. International Psychogeriatrics 22, 1248–1264.CrossRefGoogle Scholar
Sheik, JI, Yesavage, JA (1986). Geriatric Depression Scale (GDS). Recent evidence and development of a shorter version. In Clinical Gerontology: A Guide to Assessment and Intervention (ed. Brink, T. L.), pp. 165–173. The Haworth Press: New York.Google Scholar
Spreen, O, Benton, AL (1969). Neurosensory Center Comprehensive Examination for Aphasis: Manual of Instructions (NCCEA). University of Victoria: Victoria, BC.Google Scholar
Tuokko, H, Morris, C, Ebert, P (2005). Mild cognitive impairment and everyday functioning in older adults. Neurocase 11, 40–47.CrossRefGoogle ScholarPubMed
Wadley, VG, Crowe, M, Marsiske, M, Cook, SE, Unverzagt, FW, Rosenberg, AL, Rexroth, D (2007). Changes in everyday function in individuals with psychometrically defined mild cognitive impairment in the Advanced Cognitive Training for Independent and Vital Elderly Study. Journal of the American Geriatric Society 55, 1192–1198.CrossRefGoogle ScholarPubMed
Wechsler, D (1981). Wechsler Adult Intelligence Scale – Revised. Psychological Corporation: New York.Google Scholar
Wechsler, D (1997 a). Wechsler Memory Scale, 3rd edn. Harcourt Brace & Company: San Antonio.Google Scholar
Wechsler, D (1997 b). Wechsler Adult Intelligence Scale, 3rd edn. Psychological Corporation: San Antonio.Google Scholar
Wilms, HU, Riedel-Heller, SG, Angermeyer, MC (2007). Limitations in activities of daily living and instrumental activities of daily living capacity in a representative sample: disentangling dementia- and mobility-related effects. Comprehensive Psychiatry 48, 95–101.CrossRefGoogle Scholar
Winblad, B, Palmer, K, Kivipelto, M, Jelic, V, Fratiglioni, L, Wahlund, LO, Nordberg, A, Backman, L, Albert, M, Almkvist, O, Arai, H, Basun, H, Blennow, K, de Leon, M, DeCarli, C, Erkinjuntti, T, Giacobini, E, Graff, C, Hardy, J, Jack, C, Jorm, A, Ritchie, K, van Duijn, C, Visser, P, Petersen, RC (2004). Mild cognitive impairment – beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. Journal of Internal Medicine 256, 240–246.CrossRefGoogle Scholar
Yesavage, JA, Brink, TL, Rose, TL, Lum, O, Huang, V, Adey, M, Leirer, VO (1982). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research 17, 37–49.CrossRefGoogle Scholar