Functional impairment in instrumental activities of daily living: an early clinical sign of dementia?
OBJECTIVE
To estimate the predictive value of four IADLs on 3- and 5-year incident dementia.


METHODS
Prospective cohort study.


METHODS
A community survey in 37 randomly selected parishes.


METHODS
A random sample of French community dwellers aged 65 and older included in the PAQUID study followed-up at 3 (1582 subjects) and 5 years (1283 subjects).


METHODS
Incidence of dementia at 3 and 5 years, diagnosed by two-step screening: (1) MMS and DSM-III-R; (2) diagnosis of dementia confirmed by a neurologist.


RESULTS
A score summing up the number of dependencies at baseline on four IADLs is a predictor of 3-year but not of 5-year incident dementia. Increase in the level of dependence between baseline and 3-year follow-up is associated with an increased risk of incident dementia at 5-year follow-up.


CONCLUSIONS
These four IADLs can help to identify older subjects at high risk of dementia who should then undergo neuropsychological testing.
Barberger-Gateau
P
P
INSERM U330, Université Victor Segalen Bordeaux2, France.
Fabrigoule
C
C
Helmer
C
C
Rouch
I
I
Dartigues
J F
JF
D000203:Activities of Daily Living; D000368:Aged; D003704:Dementia / Q000209:etiology*; D015577:Geriatric Assessment; D006801:Humans; D015994:Incidence; D016015:Logistic Models; D008403:Mass Screening; D008609:Mental Status Schedule; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011446:Prospective Studies; D015203:Reproducibility of Results; D012307:Risk Factors; D011795:Surveys and Questionnaires