Mild cognitive impairment and everyday function: evidence of reduced speed in performing instrumental activities of daily living.
OBJECTIVE
Mild cognitive impairment (MCI) may involve subtle functional losses that are not detected with typical self- or informant-report assessments of daily function. Information about the nature of functional difficulties in MCI can be used to augment common clinical assessment procedures, and aspects of function that are affected in MCI can serve as meaningful endpoints for intervention trials.


METHODS
Cross-sectional case and comparison group study.


METHODS
University medical center.


METHODS
Fifty participants with MCI and 59 cognitively normal participants.


METHODS
The authors compared the groups on dimensions of both speed and accuracy in performing instrumental activities of daily living (IADLs), using a standardized Timed IADL measure that evaluates five functional domains commonly encountered in everyday life (telephone use, locating nutrition information on food labels, financial abilities, grocery shopping, medication management).


RESULTS
Across Timed IADL domains, MCI participants demonstrated accuracy comparable with cognitively normal participants but took significantly longer to complete the functional activities, controlling for depressive symptoms (p< 0.001). Slower performance was demonstrated in each discrete domain except financial abilities.


CONCLUSIONS
These results suggest that slower speed of task performance is an important component and perhaps an early marker of functional change in MCI that would not be detected using traditional measurements of daily function. Future research should address the question of whether performance-based functional measures, as well as simple queries regarding whether functional activities take longer than usual to complete, may improve the prediction of future cognitive decline and disease progression among those individuals in whom MCI represents impending dementia.
Wadley
Virginia G
VG
Department of Medicine and Alzheimer's Disease Research Center, University of Alabama at Birmingham, Birmingham, AL 35294-2041, USA. vwadley@uab.edu
Okonkwo
Ozioma
O
Crowe
Michael
M
Ross-Meadows
Lesley A
LA
D000203:Activities of Daily Living; D000368:Aged; D001076:Aptitude; D003071:Cognition; D003072:Cognition Disorders / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D009068:Movement; D009483:Neuropsychological Tests; D012044:Regression Analysis; D013647:Task Performance and Analysis