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Functional impairment as a defining feature of: amnestic MCI cognitive, emotional, and demographic correlates

Published online by Cambridge University Press:  19 April 2012

Igor Bombin
Affiliation:
Reintegra Foundation, Oviedo, Spain Department of Psychology, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, University of Oviedo, Oviedo, Spain
Sandra Santiago-Ramajo
Affiliation:
Department of Personality Evaluation and Treatment Psychology, University of Granada, Granada, Spain
Maite Garolera
Affiliation:
Grup de Recerca Consolidat de Neuropsicologia (SRG0941), University of Barcelona, Spain
Eva M. Vega-González
Affiliation:
Reintegra Foundation, Oviedo, Spain
Noemí Cerulla
Affiliation:
Neuropsychology Unit Hospital de Terrassa-Consorci Sanitari de Terrassa, Barcelona, Spain Sant Jordi Day Hospital for Cognitive impairment-Consorci Sanitari de Terrassa, Barcelona, Spain
Alfonso Caracuel
Affiliation:
Department of Personality Evaluation and Treatment Psychology, University of Granada, Granada, Spain
Alicia Cifuentes
Affiliation:
Reintegra Foundation, Oviedo, Spain
M. Teresa Bascarán
Affiliation:
Department of Medicine, Psychiatry Area, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, University of Oviedo, Oviedo, Spain
Julio Bobes
Affiliation:
Department of Medicine, Psychiatry Area, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, University of Oviedo, Oviedo, Spain
Corresponding
E-mail address:

Abstract

Background: Early definitions of mild cognitive impairment (MCI) excluded the presence of functional impairment, with preservation of a person's ability to perform activities of daily living (ADL) as a diagnostic criterion. However, recent studies have reported varying degrees of functional impairment associated with MCI. Hence, we aimed to test the potential functional impairment associated with MCI and its predictors.

Methods: Sixty-nine healthy elderly subjects, 115 amnestic single-domain MCI subjects (a-MCI), and 111 amnestic multi-domain MCI subjects (md-MCI) were assessed using a battery of neuropsychological tests including measures of attention, memory, working memory, executive functions, language, and depression. Additionally, functional ability was assessed by both qualitative (WHO-DAS II) and quantitative (CHART) instruments. Cognitive and functional performance was compared between groups, and regression analyses were performed to identify predictors of functional ability.

Results: The md-MCI group was more impaired than the a-MCI group, and both were more impaired than healthy subjects in all cognitive measures, in total CHART score, CHART cognitive and mobility subscores, and WHO-DAS II communication and participation subscales. For the rest of the functional measures, the md-MCI group was more impaired than healthy controls. Prediction of functional ability by cognitive measures was limited to md-MCI subjects and was higher for the CHART than for the WHO-DAS II. The WHO-DAS II was largely influenced by depressive symptoms.

Conclusions: Functional impairment is a defining feature of MCI and is partially dependent on the degree of cognitive impairment. Quantitative measures of functional ability seem more sensitive to functional impairment in MCI than qualitative measures, which seem to be more related to depression.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2012

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