Neuropsychological screening performance and the association with activities of daily living and instrumental activities of daily living in dementia: baseline and 18- to 24-month follow-up.
OBJECTIVE
The use of neuropsychological assessment beyond diagnosis is related partly to the extent to which it can indicate everyday function. This study investigates whether the associations between neuropsychological functioning, activities of daily living (ADL) and instrumental activities of daily living (IADL) change over an 18- to 24-month follow-up, exploring whether these change with dementia progression.


METHODS
Thirty-four patients with probable Alzheimer's disease were assessed at baseline and again after between 18 and 24 months. Neuropsychological function was assessed using the revised Cambridge Cognitive Examination, which includes in it the Mini mental state examination and an executive functions scale. ADL and IADL were also measured, together with background neuropsychiatric features by using the Neuropsychiatric Inventory.


RESULTS
Pearson correlations between the measures of daily functioning and cognitive abilities and neuropsychiatric symptoms showed that initially neuropsychological test results tended to correlate with IADL rather than ADL measures. Neuropsychiatric symptoms were not correlated whether IADL or ADL. At follow-up, none of the neuropsychological function measures correlated with IADL or ADL, but neuropsychiatric symptoms were correlated with IADL.


CONCLUSIONS
At baseline, neuropsychological function is associated with IADL but not ADL. At follow-up, the association between neuropsychological function and IADL diminishes, and associations between neuropsychiatric disturbances and IADL emerge.
Wolfson Neurorehabilitation Centre, St Georges' Healthcare NHS Trust, London, UK. Linda.Monaci@stgeorges.nhs.uk
Linda
L
Monaci
Robin G
RG
Morris
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000503:physiopathology / Q000523:psychology*; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D015577:Geriatric Assessment / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales