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Clinical correlates of functional performance in community-dwelling Chinese older persons with mild cognitive impairment

Published online by Cambridge University Press:  23 May 2008

Cindy W. C. Tam
Affiliation:
Department of Psychiatry, Tai Po Hospital, Hong Kong SAR
Linda C. W. Lam*
Affiliation:
Department of Psychiatry, the Chinese University of Hong Kong, Shatin, Hong Kong SAR
Victor W. C. Lui
Affiliation:
Department of Psychiatry, Tai Po Hospital, Hong Kong SAR
W. C. Chan
Affiliation:
Castle Peak Hospital, Tuen Mum, Hong Kong SAR
Sandra S. M. Chan
Affiliation:
Department of Psychiatry, the Chinese University of Hong Kong, Shatin, Hong Kong SAR
Helen F. K. Chiu
Affiliation:
Department of Psychiatry, the Chinese University of Hong Kong, Shatin, Hong Kong SAR
W. M. Chan
Affiliation:
Elderly Health Service, Department of Health, Hong Kong SAR
*
Correspondence should be addressed to: Linda C. W. Lam, Department of Psychiatry, G/F, Multi-centre, Tai Po Hospital, Tai Po, NT, Hong Kong SAR. Phone: +852 26076026, Fax: +852 26671255. Email: cwlam@cuhk.edu.hk.

Abstract

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.

Conclusion: 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.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2008

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