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Functional evaluation distinguishes MCI patients from healthy elderly people — The ADCS/MCI/ADL scale

  • JNHA: Clinical Trials and Aging
  • Published:
The journal of nutrition, health & aging

Abstract

Patients with MCI may present minor impairments in activities of daily living (ADL). The main objective of this work was to evaluate the ability of two versions of the Alzheimer's Disease Cooperative Study / Activities of Daily Living scale adapted for MCI patients (ADCS/MCI/ADL18 and ADCS/MCI/ADL24) to distinguish patients with MCI from healthy control subjects. Participants were 60 years or older and community dwelling: 31 control subjects, 30 aMCI patients and 33 AD patients. A protocol of neuropsychological tests, global evaluation scales, functional scales, and depressive symptoms assessment was used. Activities of balancing the cheque book, using a telephone, going shopping, taking medication regularly, finding objects, talking about current events, watching television, initiating complex activities, keeping appointments or meetings, reading, getting around outside the home and driving a car were impaired in aMCI patients. The ADCS/MCI/ADL24 scale was better than the ADCS/MCI/ADL18 scale in distinguishing aMCI patients from healthy controls (sensitivity=0.87, specificity=0.87, ROC c=0.887, cut-off point=52/53). The detection of initial functional changes with appropriate scales may contribute to the early diagnosis of MCI and the development of targeted interventions to improve everyday function or prolong independence.

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References

  1. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. The index of ADL: a standardized measure of biological and psychological function. JAMA 1963; 185: 914–919.

    CAS  PubMed  Google Scholar 

  2. Lawton MP, Brody EM. Assessment of older people: Self-maintaining and instrumental activities of daily living. Gerontologist 1969;9: 179–186.

    CAS  PubMed  Google Scholar 

  3. Nygåd L. Instrumental activities of daily living: a stepping-stone towards Alzheimer's disease diagnosis in subjects with mild cognitive impairment? Acta Neurol Scand Suppl 2003; 107: 42–46.

    Google Scholar 

  4. Albert SM, Tabert MH, Dienstag A, Pelton G, Devanand D. The impact of mild cognitive impairment on functional abilities in the elderly. Curr Psychiatry Rep 2002; 4: 64–68.

    Article  PubMed  Google Scholar 

  5. Peres K, Chrysostome V, Fabrigoule C, Orgogozo JM, Dartigues JF, Barberger-Gateau P. Restriction in complex activities of daily living in MCI: impact on outcome. Neurology 2006; 67: 461–466.

    Article  CAS  PubMed  Google Scholar 

  6. Perneczky R, Pohl C, Sorg C, Hartmann J, Komossa K, Alexopoulos P, Wagenpfeil S, Kurz A. Complex Activities of Daily Living in MCI: Conceptual and Diagnostic issues. Age Ageing 2006; 35: 240–245.

    Article  PubMed  Google Scholar 

  7. Perneczky R, Pohl C, Sorg C, Hartmann J, Tosic N, Grimmer T, Heitele S, Kurz A. Impairment of activities of daily living requiring memory or complex reasoning as part of the MCI syndrome. Int J Geriatr Psychiatry 2006; 21: 158–162.

    Article  PubMed  Google Scholar 

  8. Petersen RC, Smith GE, Waring SC, Ivnik RJ, Tangalos EG, Kokmen E. Mild Cognitive Impairment: clinical characterization and outcome. Arch Neurol 1999; 56: 303–308.

    Article  CAS  PubMed  Google Scholar 

  9. Petersen RC, Doody R, Kurz A, Mohs RC, Morris JC, Rabins PV, Ritchie K, Rossor M, Thal L, Winblad B. Current concepts in mild cognitive impairment. Arch Neurol 2001; 58: 1985–1992.

    Article  CAS  PubMed  Google Scholar 

  10. Cromwell DA, Eagar K, Poulos RG. The performance of instrumental activities of daily living scale in screening for cognitive impairment in elderly community residents. J Clin Epidemiol 2003; 56: 131–137.

    Article  PubMed  Google Scholar 

  11. Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L, Wahlund LO, Nordberg A, Bäckman 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. Mild cognitive impairment: beyond controversies, towards a consensus. J Intern Med 2004; 256: 240–246.

    Article  CAS  PubMed  Google Scholar 

  12. Portet F, Ousset PJ, Visser PJ, Frisoni GB, Nobili F, Scheltens P, Vellas B, Touchon J; MCI working group of the European Consortium on Alzheimer's Disease (EADC). MCI in medical practice: a critical review of the concept and new diagnostic procedure. Report of the Mild Cognitive Impairment Working Group of the EADC. J Neurol Neurosurg Psychiatry 2006; 77: 714–718.

    Article  CAS  PubMed  Google Scholar 

  13. Artero S, Touchon J, Ritchie K. Disability and mild cognitive impairment: a longitudinal population-based study. Int J Geriatr Psychiatry 2001; 16: 1092–1097.

    Article  CAS  PubMed  Google Scholar 

  14. Mariani E, Monastero R, Mecocci P. Mild Cognitive Impairment: a systematic review. J Alzheimers Dis 2007; 12: 23–35.

    PubMed  Google Scholar 

  15. Luis CA., Loewenstein DA, Acevedo A, Barker WW, Duara R. Mild Cognitive Impairment: directions for future research. Neurology 2003; 61: 438–444.

    CAS  PubMed  Google Scholar 

  16. Petersen RC, Stevens JC, Ganguli M. Practice Parameter: early detection of dementia: MCI (an evidence based review). Neurology 2001; 56: 1133–1142.

    CAS  PubMed  Google Scholar 

  17. Galasko D, Bennett D, Sano M, Ernesto C, Thomas R, Grundman M, Ferris S. An Inventory to assess activities of daily living for clinical trials in Alzheimer's Disease. The Alzheimer's disease cooperative study. Alzheimer Dis Assoc Disord 1997; 11(Suppl. 2): 33–39.

    Article  Google Scholar 

  18. Grundman M, Petersen RC, Ferris SH, Thomas RG, Aisen PS, Bennett DA, Foster NL, Jack CR Jr, Galasko DR, Doody R, Kaye J, Sano M, Mohs R, Gauthier S, Kim HT, Jin S, Schultz AN, Schafer K, Mulnard R, van Dyck CH, Mintzer J, Zamrini EY, Cahn-Weiner D, Thal LJ; Alzheimer's Disease Cooperative Study. MCI can be distinguished from AD and Normal Aging for clinical trials. Arch Neurol 2004; 61: 59–66.

    Article  PubMed  Google Scholar 

  19. Li M, Ng TP, Kua EH, Ko SM. Brief informant screening test for MCI and early AD. Dement Geriatr Cogn Disord 2006; 21: 392–402.

    Article  CAS  PubMed  Google Scholar 

  20. Pantoni L, Basile AM, Pracucci G, Asplund K, Bogousslavsky J, Chabriat H, Erkinjuntti T, Fazekas F, Ferro JM, Hennerici M, O'brien J, Scheltens P, Visser MC, Wahlund LO, Waldemar G, Wallin A, Inzitari D; on behalf of the Ladis study group. Impact of age related cerebral white matter changes on the transition to disability—The Ladis Study: Rationale, design and methodology. Neuroepidemiology 2005; 24: 51–62.

    Article  PubMed  Google Scholar 

  21. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. Fourth Edition — text review (DSM IV — TR). Washington, DC: American Psychiatric Press. 2002.

    Google Scholar 

  22. Knopman DS, DeKosky ST, Cummings JL, Chui H, Corey-Bloom J, Relkin N, Small GW, Miller B, Stevens JC. Practice parameter: Diagnosis of dementia (an evidencebased review). Neurology 2001; 56: 1143–1153.

    CAS  PubMed  Google Scholar 

  23. Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12: 189–198.

    Article  CAS  PubMed  Google Scholar 

  24. Guerreiro M., Silva AP, Botelho MA. Adaptação à população portuguesa da tradução do “Mini Mental State Examination” (MMSE) [Adaptation to the Portuguese population of the “MiniMental State Examination” (MMSE)]. Rev Port Neurol 1994; 1:9

    Google Scholar 

  25. Uhlmann RF, Larson EB. Effect of education on the mini-mental state examination as a screening test for dementia. J Am Geriatr Soc 1991; 39: 876–880.

    CAS  PubMed  Google Scholar 

  26. Ostrosky-Solis F, López-Arango G, Ardila A. Sensitivity and specificity of the Mini-Mental state examination in a Spanish-speaking population. Appl Neuropsychol 2000; 7: 25–31.

    Article  CAS  PubMed  Google Scholar 

  27. Wechsler D. Manuel de l'échelle clinique de mémoire. Centre de Psychologie Appliquée. Paris. 1969.

    Google Scholar 

  28. Garcia C. Alzheimer's disease: Difficulties in clinical diagnosis. PhD Dissertation, Faculty of Medicine, University of Lisbon, Portugal. 1984.

    Google Scholar 

  29. Palmer K., Fratiglioni L, Winblad B. What is mild cognitive impairment? Variations in definitions and evolution of nondemented persons with cognitive impairment. Acta Neurol Scand 2003; 179: 14–20.

    Article  Google Scholar 

  30. Blanchet S, McCormick L, Belleville S, Gély-Nargeot M-C, Joanette Y. Les troubles cognitifs légers de la personne agée: revue critique, Rev Neurol (Paris) 2002; 158: 29–40.

    CAS  Google Scholar 

  31. Yesavage JA, Brink TL, Rose TL, Lum O, Huang V, Adey M, Leirer VO. Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 1983; 17: 37–49.

    Article  CAS  Google Scholar 

  32. De Mendonça A, Guerreiro M. Escalas e Testes na Demência [Scales and Tests in Dementia] (2nd Ed). Lisbon, Portugal: Grupo de Estudos de Envelhecimento Cerebral e Demências. 2008.

    Google Scholar 

  33. Morris JC. The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology 1993; 43: 2412–2414.

    CAS  PubMed  Google Scholar 

  34. Blessed G, Tomlinson BE, Roth M. The association between quantitative measures of dementia and senile change in the cerebral gray matter of elderly subjects. Br J Psychiatry 1968; 114: 797–811.

    Article  CAS  PubMed  Google Scholar 

  35. Tabert MH, Albert SM, Borukhova-Milov L, Camacho Y, Pelton G, Liu X, Stern Y, Devanand DP. Functional deficits in patients with mild cognitive impairment: prediction of AD. Neurology 2002; 58: 758–764.

    CAS  PubMed  Google Scholar 

  36. Maroco J. Análise EstatÍstica com utilização do SPSS [Statistical analysis using SPSS] (3rd Ed). Lisbon, Portugal: Silabo. 2007.

    Google Scholar 

  37. Hanly JA, McNeill BJ. A Method of Comparing the Under Receiver Operating Characteristic Curves Derived from the same cases. Radiology 1983; 148: 839–843.

    Google Scholar 

  38. Tam CW, Lam LC, Chiu HF, Lui VW. Characteristic profiles of IADL in chinese older persons with MCI. Am J Alzheimers Dis Other Dement 2007; 22: 211–217.

    Article  Google Scholar 

  39. Njegovan V, Man-Son-Hing M., Mitchell SL, Molnar FJ. The hierarchy of functional loss associated with cognitive decline in older persons. J Gerontol A Biol Sci Med Sci 2001; 56: 638–643.

    Google Scholar 

  40. Barberger-Gateau P, Commenges D, Gagnon M, Letenneur L, Sauvel C, Dartigues JF. Instrumental activities of daily living as a screening tool for cognitive impairment and dementia in elderly community dwellers. J Am Geriatr Soc 1992; 40: 1129–1134.

    CAS  PubMed  Google Scholar 

  41. Barberger-Gateau P, Fabrigoule C, Helmer C, Rouch I, Dartigues JF. Functional impairment in instrumental activities of daily living: an early clinical sign of dementia? J Am Geriatr Soc 1999; 47: 456–462.

    CAS  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Dementia Clinics, Institute of Molecular Medicine and Faculty of Medicine of Lisbon, Lisbon, Portugal

    H. Pedrosa, M. Guerreiro & Alexandre de Mendonça

  2. Neurology Clinics, Hospital of Santo André, Leiria, Portugal

    A. De Sa

  3. Laboratory of Language, Institute of Molecular Medicine and Faculty of Medicine of Lisbon, Lisbon, Portugal

    M. Guerreiro

  4. Superior Institute of Applied Psychology, Lisbon, Portugal

    J. Maroco

  5. Psychological Assessment Service, Faculty of Psychology and Educational Sciences of the University of Coimbra, Coimbra, Portugal

    M. R. Simoes

  6. Department of Neurosciences, University of California, San Diego, US

    D. Galasko

  7. Laboratory of Neurosciences, Institute of Molecular Medicine and Faculty of Medicine of Lisbon, Lisbon, Portugal

    Alexandre de Mendonça

  8. Laboratory of Neurosciences, Institute of Molecular Medicine, Av Prof Egas Moniz, 1649-028, Lisbon, Portugal

    Alexandre de Mendonça

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  1. H. Pedrosa
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  2. A. De Sa
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  3. M. Guerreiro
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  4. J. Maroco
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  5. M. R. Simoes
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  6. D. Galasko
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  7. Alexandre de Mendonça
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Correspondence to Alexandre de Mendonça.

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Pedrosa, H., De Sa, A., Guerreiro, M. et al. Functional evaluation distinguishes MCI patients from healthy elderly people — The ADCS/MCI/ADL scale. J Nutr Health Aging 14, 703–709 (2010). https://doi.org/10.1007/s12603-010-0102-1

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  • DOI: https://doi.org/10.1007/s12603-010-0102-1

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