Cross-domain variability of cognitive performance in very old nursing home residents and community dwellers: relationship to functional status.
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.
Rapp
Michael A
MA
Department of Psychiatry, Mount Sinai School of Medicine, New York, NY 10029-6574, USA. Michael.Rapp@mssm.edu
Schnaider-Beeri
Michael
M
Sano
Mary
M
Silverman
Jeremy M
JM
Haroutunian
Vahram
V
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