Functional significance of mild cognitive impairment in elderly patients without a dementia diagnosis.
The authors investigated differences in functional ability among three groups of subjects who were not diagnosed with dementia: normal control (NC) subjects (n=35); Clinical Dementia Rating Scale (CDRS) score of 0 (minimal impairment; n=26); and CDRS 0. 5 (questionable dementia; n=42). CDRS 0 and 0. 5 patients reported significantly poorer functioning than NCs in household and other activities, but CDRS 0 and CDRS 0. 5 groups did not differ in self-reported functioning. It is likely that CDRS 0. 5 patients overestimated their functional abilities. Correlations between self- and informant reports of functional status were significantly lower in the CDRS 0. 5 group than in the CDRS 0 group, an important finding for clinical management because patients with questionable dementia may actually be more impaired than they admit. Informants' reports or standardized performance-based assessment should be considered in the clinical evaluation of such patients.
Albert
S M
SM
Gertrude H. Sergievsky Center, Columbia University, College of Physicians and Surgeons, New York, NY 10032, USA. sma10@columbia.edu
Michaels
K
K
Padilla
M
M
Pelton
G
G
Bell
K
K
Marder
K
K
Stern
Y
Y
Devanand
D P
DP
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000175:diagnosis*; D003704:Dementia / Q000175:diagnosis*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D015588:Observer Variation; D011569:Psychiatric Status Rating Scales; D012650:Self Disclosure