title: Cross-domain variability of cognitive performance in very old nursing home residents and community dwellers: relationship to functional status.
abstract: BACKGROUND
  Recent evidence suggests that cross-domain variability in cognition may be related to subsequent cognitive decline beyond mean performance levels in cognitive tasks.
  
  
  OBJECTIVE
  To examine age-related changes in cross-domain variability across cognitive task performance in very old nursing home residents in contrast to community-dwelling older adults. To explore the relationship between cross-domain variability in cognition and functional disability in very old age.
  
  
  METHODS
  204 very old (82.00+/-8.51 years) residents from the Jewish Home and Hospital, Bronx, N.Y., and 376 community-dwelling older adults of similar age (86.75+/-5.84 years) were tested on a cognitive battery. Cross-domain variability scores were computed across the cognitive tasks. Functional disability measures were derived from the CDR (Clinical Dementia Rating) Scale.
  
  
  RESULTS
  Whereas oldest old community-dwelling adults showed a decrease in variability across domains with age, variability increased with age in nursing home residents, irrespective of the level of cognitive performance. Cross-domain variability was associated with functional disability beyond the effects of age, gender, education, dementia status, residential status, and level of cognitive performance.
  
  
  CONCLUSIONS
  Findings suggest that cross-domain variability in cognition is related to functional decline with age. Cross-domain variability in cognition may be a prominent predictor for the development of functional decline in very old adults.
authors.affiliation: Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029-6574, USA. Michael.Rapp@mssm.edu
authors.forename: Michael A
authors.initials: MA
authors.lastname: Rapp
authors.forename: Michael
authors.initials: M
authors.lastname: Schnaider-Beeri
authors.forename: Mary
authors.initials: M
authors.lastname: Sano
authors.forename: Jeremy M
authors.initials: JM
authors.lastname: Silverman
authors.forename: Vahram
authors.initials: V
authors.lastname: Haroutunian
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003071:Cognition / Q000502:physiology*; D005260:Female; D006304:Health Status; D006761:Hospitals; D006801:Humans; D008019:Life Style; D008297:Male; D015999:Multivariate Analysis; D009483:Neuropsychological Tests; D009735:Nursing Homes