Functional deficits in patients with mild cognitive impairment
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- 12 March 2002
- journal article
- Published by Wolters Kluwer Health in Neurology
- Vol. 58 (5) , 758-764
- https://doi.org/10.1212/wnl.58.5.758
Abstract
Objective: To evaluate the predictive utility of self-reported and informant-reported functional deficits in patients with mild cognitive impairment (MCI) for the follow-up diagnosis of probable AD. Methods: The Pfeffer Functional Activities Questionnaire (FAQ) and Lawton Instrumental Activities of Daily Living (IADL) Scale were administered at baseline. Patients were followed at 6-month intervals, and matched normal control subjects (NC) were followed annually. Results: Self-reported deficits were higher for patients with MCI than for NC. At baseline, self- and informant-reported functional deficits were significantly greater for patients who converted to AD on follow-up evaluation than for patients who did not convert, even after controlling for age, education, and modified Mini-Mental State Examination scores. While converters showed significantly more informant- than self-reported deficits at baseline, nonconverters showed the reverse pattern. Survival analyses further revealed that informant-reported deficits (but not self-reported deficits) and a discrepancy score indicating greater informant- than self-reported functional deficits significantly predicted the development of AD. The discrepancy index showed high specificity and sensitivity for progression to AD within 2 years. Conclusions: These findings indicate that in patients with MCI, the patient’s lack of awareness of functional deficits identified by informants strongly predicts a future diagnosis of AD. If replicated, these findings suggest that clinicians evaluating MCI patients should obtain both self-reports and informant reports of functional deficits to help in prediction of long-term outcome.Keywords
This publication has 28 references indexed in Scilit:
- Olfactory Deficits in Patients With Mild Cognitive Impairment Predict Alzheimer’s Disease at Follow-UpAmerican Journal of Psychiatry, 2000
- Functional Disability in Alzheimer's DiseaseInternational Psychogeriatrics, 1997
- The Puzzle of Functional Status in Mild and Moderate Alzheimer's Disease: Self-Report, Family Report, and Performance-Based AssessmentThe Gerontologist, 1995
- Memory Self-Report in Alzheimer's Disease and in Age-Associated Memory ImpairmentJournal of Geriatric Psychiatry and Neurology, 1994
- Impaired Insight in Alzheimer's DiseaseJournal of Geriatric Psychiatry and Neurology, 1991
- Assessment of Functional Changes in Alzheimer's DiseaseNeuroepidemiology, 1990
- Insight for impairment in independent living skills in Alzheimer's disease and multi-infarct dementiaJournal of Clinical and Experimental Neuropsychology, 1990
- Clinical diagnosis of Alzheimer's diseaseNeurology, 1984
- A New Clinical Scale for the Staging of DementiaThe British Journal of Psychiatry, 1982
- Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily LivingThe Gerontologist, 1969