title: Profiles of functional deficits in mild cognitive impairment and dementia: benefits from objective measurement.
abstract: The magnitude of functional impairment that may indicate the threshold between MCI and incipient Alzheimer's disease (AD) has not been clearly defined. The objective was to examine the pattern of functional impairment in the continuum MCI-AD. Eighty-nine older adults (32 cognitively unimpaired, 31 MCI, and 26 AD patients) were examined with the Brazilian version of the Direct Assessment of Functional Status (DAFS-BR) at a university-based memory clinic. MCI patients were sub-divided according to the progression to AD upon follow-up, and had baseline cognitive, functional and biological variables analyzed. MCI patients displayed mild deficits in functional abilities, with intermediate scores as compared to controls and AD. The DAFS-BR items that differentiated MCI from controls involved the ability to deal with finances and shopping skills. At baseline, scores obtained by MCI patients who converted to AD were not significantly different from scores of nonconverters. The magnitude of functional deficits was associated with AD-like pathological findings in the CSF. In conclusion, MCI patients present with early functional changes in complex, instrumental abilities that require the integrity of memory and executive functions. The objective measurement of the functional state may help identify older adults with increased risk of developing dementia in the MCI-AD continuum.
authors.affiliation: Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil.
authors.forename: Fernanda Speggiorin
authors.initials: FS
authors.lastname: Pereira
authors.forename: Mônica Sanches
authors.initials: MS
authors.lastname: Yassuda
authors.forename: Alexandra Martini
authors.initials: AM
authors.lastname: Oliveira
authors.forename: Breno Satler
authors.initials: BS
authors.lastname: Diniz
authors.forename: Márcia
authors.initials: M
authors.lastname: Radanovic
authors.forename: Leda Leme
authors.initials: LL
authors.lastname: Talib
authors.forename: Wagner Farid
authors.initials: WF
authors.lastname: Gattaz
authors.forename: Orestes Vicente
authors.initials: OV
authors.lastname: Forlenza
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D015415:Biomarkers; D003072:Cognition Disorders / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000453:epidemiology; D003704:Dementia / Q000134:cerebrospinal fluid / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers