Clinical correlates of functional performance in community-dwelling Chinese older persons with mild cognitive impairment.
BACKGROUND
Increasing evidence suggests that functional impairment can be detected in older persons with mild cognitive impairment (MCI). This study explores the functional profiles and the clinical correlates of a population-based sample of Chinese older persons with MCI in Hong Kong.


METHODS
A random sample of 765 Chinese elderly subjects without dementia was recruited, of which 389 were elderly normal controls (Clinical Dementia Rating = 0), and 376 had questionable dementia (CDR = 0.5). The latter were categorized into an MCI group (n = 291) and a very mild dementia (VMD) group (n = 85). Their functional performances were measured and compared with the normal controls (NC). Multiple regression analyses investigated the associations between functional scores (Disability Assessment in Dementia) and clinical correlates (cognitive test scores, neuropsychiatric symptoms and motor signs) in the NC subjects and cognitively impaired subjects.


RESULTS
Subjects with MCI had intermediate functional performance between the NC and those with VMD. Regression analyses revealed that lower scores of cognitive tests (delayed recall and categorical verbal fluency tests), apathy, aberrant motor symptoms and parkinsonism features were associated with lower functional scores in clinically non-demented subjects. Functional scores had no correlation with age, education and medical illness burden.


CONCLUSIONS
Neuropsychiatric symptoms and parkinsonism features were associated with functional impairment in the clinically non-demented elderly in the community. Assessment of these should be incorporated in the evaluation of older persons for early cognitive impairment.
Tam
Cindy W C
CW
Department of Psychiatry, Tai Po Hospital, Hong Kong SAR.
Lam
Linda C W
LC
Lui
Victor W C
VW
Chan
W C
WC
Chan
Sandra S M
SS
Chiu
Helen F K
HF
Chan
W M
WM
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000367:Age Factors; D000368:Aged / Q000706:statistics & numerical data*; D044466:Asian People / Q000523:psychology / Q000706:statistics & numerical data*; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D035061:Control Groups; D003625:Data Collection / Q000706:statistics & numerical data*; D003704:Dementia / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D004185:Disability Evaluation; D005260:Female; D015577:Geriatric Assessment / Q000706:statistics & numerical data; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D020734:Parkinsonian Disorders / Q000175:diagnosis / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012494:Sampling Studies; D012720:Severity of Illness Index