title: Daily Function as Predictor of Dementia in Cognitive Impairment, No Dementia (CIND) and Mild Cognitive Impairment (MCI): An 8-Year Follow-Up in the ILSA Study.
abstract: Preclinical cognitive changes may predict an increased risk of dementia, allowing selection of subgroups as possible targets for preventive or therapeutic interventions.
  
  
  
  To evaluate the predictive effect of daily functioning and motor performance (MP) on the progression to dementia in normal cognition, cognitive impairment, no dementia (CIND), and mild cognitive impairment (MCI).
  
  
  
  The Italian Longitudinal Study on Aging is a large population-based survey on age-related diseases of the cardiovascular and nervous systems. After the baseline assessment, to detect prevalent cases of cognitive impairment and dementia, participants were re-examined at 4-year and 8-year follow-ups. Functional independence was evaluated using the Index of Activities of Daily Living (ADL) and the Instrumental Activities of Daily Living (IADL) Scale. A six-test battery was used to assess MP.
  
  
  
  Overall, 2,386 individuals were included, for a total of 16,545 person-years. Eight-year incidence of dementia (per 1,000 person-years) was 12.69 in total sample, 9.86 in subjects with normal cognition at baseline, 22.99 in CIND, and 21.43 in MCI. Progression to dementia was significantly higher with increasing baseline ADL and IADL impairment, and with a worse MP. In Cox regression analyses controlled for demographics and major age-related conditions, increased IADL impairment was the stronger predictor of progression to dementia (p < 0.001), with HR ranging from 2.16 (95% CI, 0.82-5.70) to 9.57 (95% CI, 3.40-26.91) in subjects with MCI at baseline.
  
  
  
  Inclusion of IADL in the MCI construct significantly improves the prediction of dementia. Individuation of different transition rates is required to plan cost-effective interventions.
authors.affiliation: Institute of Neuroscience, Italian National Research Council, Florence, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Di Carlo
authors.affiliation: Institute of Neuroscience, Italian National Research Council, Florence, Italy.
authors.forename: Marzia
authors.initials: M
authors.lastname: Baldereschi
authors.affiliation: Department of NEUROFARBA, Neuroscience Section, University of Florence, Florence, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Lamassa
authors.affiliation: Department of NEUROFARBA, Neuroscience Section, University of Florence, Florence, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Bovis
authors.affiliation: Hospital Sociosanitari Pere Virgili, Barcelona, Spain.
authors.forename: Marco
authors.initials: M
authors.lastname: Inzitari
authors.affiliation: Geriatric Medicine-Memory Unit, Rare DiseaseCentre, Department of Interdisciplinary Medicine, University of Bari Aldo Moro, Bari, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Solfrizzi
authors.affiliation: Neurodegenerative Disease Unit, Department of Basic Medicine, Neuroscience, and Sense Organs, University of Bari Aldo Moro, Bari, Italy.|Geriatric Unit & Laboratory of Gerontology and Geriatrics, Department of Medical Sciences, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Panza
authors.affiliation: Population Health and Health Determinants Unit, National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS), Rome, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Galluzzo
authors.affiliation: Population Health and Health Determinants Unit, National Centre for Epidemiology, Surveillance and Health Promotion (CNESPS), Istituto Superiore di Sanità (ISS), Rome, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Scafato
authors.affiliation: Institute of Neuroscience, Italian National Research Council, Florence, Italy.|Department of NEUROFARBA, Neuroscience Section, University of Florence, Florence, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Inzitari
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D015331:Cohort Studies; D018672:Community Health Planning; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D000073216:Mental Status and Dementia Tests; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D013997:Time Factors
keywords: Dementia; instrumental activities of daily living; longitudinal studies; mild cognitive impairment; motor performance