Can Performance on Daily Activities Discriminate Between Older Adults with Normal Cognitive Function and Those with Mild Cognitive Impairment?

Objectives To examine whether preclinical disability in performance of cognitively focused instrumental activity of daily living (C‐IADL) tasks can discriminate between older adults with normal cognitive function and those with mild cognitive impairment (MCI) and, secondarily, to determine the two t...

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Published in:Journal of the American Geriatrics Society (JAGS) Vol. 62; no. 7; pp. 1347 - 1352
Main Authors: Rodakowski, Juleen, Skidmore, Elizabeth R., Reynolds III, Charles F., Dew, Mary Amanda, Butters, Meryl A., Holm, Margo B., Lopez, Oscar L., Rogers, Joan C.
Format: Journal Article
Language:English
Published: Hoboken, NJ Blackwell Publishing Ltd 01-07-2014
Wiley-Blackwell
Wiley Subscription Services, Inc
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Summary:Objectives To examine whether preclinical disability in performance of cognitively focused instrumental activity of daily living (C‐IADL) tasks can discriminate between older adults with normal cognitive function and those with mild cognitive impairment (MCI) and, secondarily, to determine the two tasks with the strongest psychometric properties and assess their discriminative ability so as to generate diagnosis‐relevant information about cognitive changes associated with MCI and mild neurocognitive disorder according to Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, criteria. Design Secondary analyses of cross‐sectional data from a cohort of individuals diagnosed with normal cognitive function or MCI. Setting Pittsburgh, Pennsylvania. Participants Older adults with remitted major depression (N = 157). Measurements Diagnosis of cognitive status was made at the Alzheimer's Disease Research Center, University of Pittsburgh. Performance on eight C‐IADLs was measured using the criterion‐referenced, observation‐based Performance Assessment of Self‐Care Skills (PASS). Results Ninety‐six older adults with normal cognitive function (mean age 72.5 ± 5.9) and 61 with MCI (mean age 75.5 ± 6.3) participated. The eight C‐IADLs demonstrated 81% accuracy in discriminating cognitive status (area under the receiver operating characteristic curve (AUC) = 0.81, P < .001). Two tasks (shopping and checkbook balancing) were the most discriminating (AUC = 0.80, P < .001); they demonstrated similar ability as all eight C‐IADLs in determining cognitive status. Assessing performance on these two C‐IADLs takes 10 to 15 minutes. Conclusion This is the first demonstration of the discriminative ability of preclinical disability to distinguish older adults with MCI from cognitively normal older adults. These findings highlight potential tasks that, when measured using the observation‐based PASS, demonstrate greater effort for individuals with MCI. These tasks may be considered when attempting to diagnose MCI or mild neurocognitive disorder in clinical practice and research.
Bibliography:National Institute of Nursing Research - No. NR010904
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ArticleID:JGS12878
Commonwealth of Pennsylvania
University of Pittsburgh Office of Research
National Institute on Aging
University of Pittsburgh Medical Center Rehabilitation Institute
National Center for Minority Health Disparities
RTI International
American Foundation for Suicide Prevention
MediPAC
National Institute of Mental Health - No. R01 MH072947; No. MH080240
National Center for Medical and Rehabilitation Research - No. HD055931
Patient Centered Outcomes Research Institute
University of Pittsburgh Medical Center Endowed Chair in Geriatric Psychiatry
National Palliative Care Research Center
John A. Hartford Foundation
National Heart Lung and Blood Institute
National Institutes of Health NIH - No. P30 MH090333; No. R01MH043823; No. R01 MH072947; No. T32 MH019986; No. P50AG05133; No. R01 HD074693; No. R03 HD073770
istex:7778CB213CB8502D8E48B174C4779347EF0AB0E3
National Institute on Disability and Rehabilitation Research
Centers for Medicare and Medicaid Services
National Institute of Disability and Rehabilitation Research - No. H133B090024; No. H133A080053
Clinical and Translational Science Institute Grants - No. UL1RR024153; No. UL1TR000005
ObjectType-Article-1
SourceType-Scholarly Journals-1
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ISSN:0002-8614
1532-5415
DOI:10.1111/jgs.12878