title: Activities of Daily Living and Depressive Symptoms in Patients with Subjective Cognitive Decline, Mild Cognitive Impairment, and Alzheimer's Disease.
abstract: BACKGROUND
  Subjective cognitive decline (SCD) may be an early indicator for an increased risk of dementia. The exact definition of SCD remains unclear and has recently become a major research interest.
  
  
  OBJECTIVE
  To determine impairments in activities of daily living (ADL) and depressive symptoms in elderly individuals with SCD, mild cognitive impairment (MCI), and Alzheimer's disease (AD).
  
  
  METHODS
  We included 752 consecutive patients suffering from SCD, non-amnestic (naMCI) or amnestic MCI (aMCI), AD, and 343 healthy controls into this prospective cohort study. A neuropsychological test battery, B-ADL and BDI-II was performed.
  
  
  RESULTS
  SCD patients showed a decreased performance in ADL compared to controls. Performance in ADL declined concurrently with cognitive abilities along the controls-SCD-naMCI-aMCI-AD continuum. Individuals with cognitive complains, no matter if SCD, MCI, or AD patients, reported more often depressive symptoms compared to healthy controls without complaints. Within all five cognitive subgroups, patients with depressive symptoms reported more difficulties in ADL in comparison to patients without depressive symptoms. Adjusting for depressive symptoms, there was no significant group difference between the control versus the SCD group (OR 1.1, CI 0.6-1.7).
  
  
  CONCLUSIONS
  SCD is a heterogeneous clinical condition. Specific features such as slightly impaired ADL and depressive symptoms are associated with SCD. Clinical markers may serve as an indicator for preclinical AD and in combination with biomarkers guide to an early diagnosis of a progressive neurodegenerative disease.
authors.affiliation: Department of Clinical Neurology, Medical University of Vienna, Vienna, Austria.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Stogmann
authors.affiliation: Department of Clinical Neurology, Medical University of Vienna, Vienna, Austria.
authors.forename: Doris
authors.initials: D
authors.lastname: Moser
authors.affiliation: Department of Clinical Neurology, Medical University of Vienna, Vienna, Austria.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Klug
authors.affiliation: Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria.
authors.forename: Andreas
authors.initials: A
authors.lastname: Gleiss
authors.affiliation: Department of Clinical Neurology, Medical University of Vienna, Vienna, Austria.
authors.forename: Eduard
authors.initials: E
authors.lastname: Auff
authors.affiliation: Department of Clinical Neurology, Medical University of Vienna, Vienna, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Dal-Bianco
authors.affiliation: Department of Clinical Neurology, Medical University of Vienna, Vienna, Austria.
authors.forename: Gisela
authors.initials: G
authors.lastname: Pusswald
authors.affiliation: Department of Clinical Neurology, Medical University of Vienna, Vienna, Austria.
authors.forename: Johann
authors.initials: J
authors.lastname: Lehrner
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000544:Alzheimer Disease / Q000150:complications*; D060825:Cognitive Dysfunction / Q000150:complications*; D003863:Depression / Q000150:complications*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D016017:Odds Ratio; D010465:Perception; D011446:Prospective Studies
keywords: Activities of daily living; Alzheimer’s Disease; depressive symptoms; mild cognitive impairment subtypes; subjective cognitive decline