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Subtle changes in daily functioning predict conversion from normal to mild cognitive impairment or dementia: an analysis of the NACC database

Published online by Cambridge University Press:  08 August 2016

Milap A. Nowrangi ,
Paul B. Rosenberg  and
Jeannie-Marie S. Leoutsakos
Milap A. Nowrangi*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Paul B. Rosenberg*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Jeannie-Marie S. Leoutsakos*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
*
Correspondence should be addressed to: Milap A. Nowrangi, M.D., Paul B. Rosenberg, M.D., and Jeannie-Marie Leoutsakos, Ph.D., Department of Psychiatry, Johns Hopkins Bayview Medical Center, 5300 Alpha Commons Drive, 4th Floor, Baltimore, MD 21224. Office: 410-550-2294; Fax: 410-550-1407. Emails: mnowran1@jhmi.edu., prosenb9@jhmi.edu, jeannie-marie@jhu.edu.
Correspondence should be addressed to: Milap A. Nowrangi, M.D., Paul B. Rosenberg, M.D., and Jeannie-Marie Leoutsakos, Ph.D., Department of Psychiatry, Johns Hopkins Bayview Medical Center, 5300 Alpha Commons Drive, 4th Floor, Baltimore, MD 21224. Office: 410-550-2294; Fax: 410-550-1407. Emails: mnowran1@jhmi.edu., prosenb9@jhmi.edu, jeannie-marie@jhu.edu.
Correspondence should be addressed to: Milap A. Nowrangi, M.D., Paul B. Rosenberg, M.D., and Jeannie-Marie Leoutsakos, Ph.D., Department of Psychiatry, Johns Hopkins Bayview Medical Center, 5300 Alpha Commons Drive, 4th Floor, Baltimore, MD 21224. Office: 410-550-2294; Fax: 410-550-1407. Emails: mnowran1@jhmi.edu., prosenb9@jhmi.edu, jeannie-marie@jhu.edu.
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Abstract

Background:

There are relatively small but observable changes in functional ability in those without Mild cognitive impairment (MCI) or dementia. The present study seeks to understand whether these individuals go on to develop MCI or dementia by assessing the association between baseline Functional Activities Questionnaire (FAQ) and conversion independent and after adjustment for cognitive tests.

Methods:

The NACC database was used to conduct the analysis of which 7,625 participants were initially identified as having more than one visit and who were cognitively normal at their first visit. Cox proportional hazards were used to fit three models that controlled for executive and non-executive cognitive domains. A similar model was used to assess the effect of FAQ subcategories on conversion.

Results:

Of these individuals, 1,328 converted to either MCI or dementia by visit 10. Converters had a total visit 1 FAQ score significantly higher than non-converters indicating more functional impairment at baseline. After adjustment for cognitive tests, the association between visit 1 FAQ and subsequent conversion was not attenuated. Doing taxes, remembering dates, and traveling were individually identified as significant predictors of conversion.

Conclusions:

The FAQ can be used as an indirect measure of functional ability and is associated with conversion to MCI or dementia. There is a selective and significant association between changes in financial ability and conversion that is in accordance with other research of financial capacity.

Keywords

Alzheimer's diseaseMCIactivities of daily livingfunctioning
Type
Research Article
Information
International Psychogeriatrics , Volume 28 , Issue 12 , December 2016 , pp. 2009 - 2018
Copyright
Copyright © International Psychogeriatric Association 2016 

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References

Abikoff, H. et al. (1987). Logical memory subtest of the wechsler memory scale: age and education norms and alternate-form reliability of two scoring systems. Journal of Clinical and Experimental Neuropsychology, 9, 435–448.CrossRefGoogle ScholarPubMed
Albert, M. S. et al. (2011). The diagnosis of mild cognitive impairment due to Alzheimer's disease: recommendations from the national institute on aging-Alzheimer's association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 7, 270–279.Google Scholar
Alzheimer's, A. (2014). 2014 Alzheimer's disease facts and figures. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 10, e47–e92.Google Scholar
Artero, S. et al. (2008). Risk profiles for mild cognitive impairment and progression to dementia are gender specific. Journal of Neurology, Neurosurgery, and Psychiatry, 79, 979–984.CrossRefGoogle ScholarPubMed
Bangen, K. J. et al. (2010). Complex activities of daily living vary by mild cognitive impairment subtype. Journal of the International Neuropsychological Society: JINS, 16, 630–639.CrossRefGoogle ScholarPubMed
Barberger-Gateau, P., Dartigues, J. F. and Letenneur, L. (1993). Four instrumental activities of daily living score as a predictor of one-year incident dementia. Age and Ageing, 22, 457–463.Google Scholar
Beekly, D. L. et al. (2004). The national Alzheimer's coordinating center (NACC) database: an Alzheimer disease database. Alzheimer Disease and Associated Disorders, 18, 270–277.Google Scholar
Beekly, D. L. et al. (2007). The national Alzheimer's coordinating center (NACC) database: the uniform data set. Alzheimer Disease and Associated Disorders, 21, 249–258.Google Scholar
Bookheimer, S. Y. et al. (2000). Patterns of brain activation in people at risk for Alzheimer's disease. The New England Journal of Medicine, 343, 450–456.Google Scholar
Braak, H. and Braak, E. (1995). Staging of Alzheimer's disease-related neurofibrillary changes. Neurobiology of Aging, 16, 271–278; discussion 278–284.Google Scholar
Bruscoli, M. and Lovestone, S. (2004). Is MCI really just early dementia? A systematic review of conversion studies. International Psychogeriatrics/IPA, 16, 129–140.CrossRefGoogle ScholarPubMed
Burton, C. L., Strauss, E., Hultsch, D. F. and Hunter, M. A. (2006). Cognitive functioning and everyday problem solving in older adults. The Clinical Neuropsychologist, 20, 432–452.CrossRefGoogle ScholarPubMed
Caselli, R. J. et al. (2014). The neuropsychology of normal aging and preclinical Alzheimer's disease. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 10, 84–92.Google Scholar
Chaytor, N. and Schmitter-Edgecombe, M. (2003). The ecological validity of neuropsychological tests: a review of the literature on everyday cognitive skills. Neuropsychology Review, 13, 181–197.Google Scholar
DeCarli, C. (2003). Mild cognitive impairment: prevalence, prognosis, aetiology, and treatment. The Lancet Neurology, 2, 15–21.Google Scholar
Delis, D. C., Kramer, J. H., Kaplan, E. and Holdnack, J. (2004). Reliability and validity of the delis-kaplan executive function system: an update. Journal of the International Neuropsychological Society, 10, 301–303.CrossRefGoogle ScholarPubMed
Di Carlo, A. et al. (2007). CIND and MCI in the Italian elderly: frequency, vascular risk factors, progression to dementia. Neurology, 68, 1909–1916.CrossRefGoogle ScholarPubMed
Duda, B., Puente, A. N. and Miller, L. S. (2014). Cognitive reserve moderates relation between global cognition and functional status in older adults. Journal of Clinical and Experimental Neuropsychology, 36, 368–378.Google Scholar
Farias, S. T., Harrell, E., Neumann, C. and Houtz, A. (2003). The relationship between neuropsychological performance and daily functioning in individuals with Alzheimer's disease: ecological validity of neuropsychological tests. Archives of Clinical Neuropsychology: The Official Journal of the National Academy of Neuropsychologists, 18, 655–672.CrossRefGoogle ScholarPubMed
Farias, S. T., Mungas, D., Reed, B. R., Harvey, D., Cahn-Weiner, D. and Decarli, C. (2006). MCI is associated with deficits in everyday functioning. Alzheimer Disease and Associated Disorders, 20, 217–223.Google Scholar
Fischer, P. et al. (2007). Conversion from subtypes of mild cognitive impairment to Alzheimer dementia. Neurology, 68, 288–291.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Harada, C. N., Natelson Love, M. C. and Triebel, K. L. (2013). Normal cognitive aging. Clinics in Geriatric Medicine, 29, 737–752.CrossRefGoogle ScholarPubMed
Homack, S., Lee, D. and Riccio, C. A. (2005). Test review: Delis-Kaplan executive function system. Journal of Clinical and Experimental Neuropsychology, 27, 599–609.Google Scholar
Hughes, T. F., Chang, C. C., Bilt, J. V., Snitz, B. E. and Ganguli, M. (2012). Mild cognitive deficits and everyday functioning among older adults in the community: the monongahela-youghiogheny healthy aging team study. The American Journal of Geriatric Psychiatry, 20, 836–844.Google Scholar
Jefferson, A. L. et al. (2008). Characterization of activities of daily living in individuals with mild cognitive impairment. The American Journal of Geriatric Psychiatry, 16, 375–383.Google Scholar
Jensen, A. R. and Figueroa, R. A. (1975). Forward and backward digit span interaction with race and IQ: predictions from Jensen's theory. Journal of Educational Psychology, 67, 882–893.CrossRefGoogle ScholarPubMed
Kaplan, E., Goodglass, H. and Weintraub, S. (1983). The Boston Naming Test. Philadelphia, PA: Lea & Febiger.Google Scholar
Kawas, C. H. et al. (2003). Visual memory predicts Alzheimer's disease more than a decade before diagnosis. Neurology, 60, 1089–1093.Google Scholar
Kryscio, R. J., Schmitt, F. A., Salazar, J. C., Mendiondo, M. S. and Markesbery, W. R. (2006). Risk factors for transitions from normal to mild cognitive impairment and dementia. Neurology, 66, 828–832.Google Scholar
LaBarge, E., Edwards, D. and Knesevich, J. W. (1986). Performance of normal elderly on the Boston naming test. Brain and Language, 27, 380–384.CrossRefGoogle ScholarPubMed
Lezak, M. D. (2004c). Verbal functions and language skills. In Lezak, M. D. (ed.), Neuropsychological Assessment (pp. 647–693). Oxford: Oxford University Press.Google Scholar
Marchesi, V. T. (2012). Alzheimer's disease 2012: the great amyloid gamble. The American Journal of Pathology 180, 1762–1767.CrossRefGoogle ScholarPubMed
Mariani, E. et al. (2008). Influence of comorbidity and cognitive status on instrumental activities of daily living in amnestic mild cognitive impairment: results from the ReGAl project. International Journal of Geriatric Psychiatry, 23, 523–530.CrossRefGoogle ScholarPubMed
Marshall, G. A. et al. For The Alzheimer's Disease Neuroimaging, I. (2014). Everyday cognition scale items that best discriminate between and predict progression from clinically normal to mild cognitive impairment. Current Alzheimer Research, 11, 853–861.Google Scholar
Marson, D. C. et al. (2000). Assessing financial capacity in patients with Alzheimer disease: a conceptual model and prototype instrument. Archives of Neurology, 57, 877–884.CrossRefGoogle ScholarPubMed
Marson, D. C. et al. (2009). Clinical interview assessment of financial capacity in older adults with mild cognitive impairment and Alzheimer's disease. Journal of the American Geriatrics Society, 57, 806–814.CrossRefGoogle ScholarPubMed
McKhann, G. M. (2011). Changing concepts of Alzheimer disease. JAMA, 305, 2458–2459.Google Scholar
Monsell, S. E. et al. (2014). Neuropsychological changes in asymptomatic persons with Alzheimer disease neuropathology. Neurology, 83, 434–440.Google Scholar
Morris, J. C. ed. (2008). National Alzheimer's Coordinating Center: NACC Uniform Data Set (UDS) Coding Guidebook for Initial Visit Packet. Washington University: ADC Clinical Task Force.Google Scholar
Morris, J. C. et al. (2006). The uniform data set (UDS): clinical and cognitive variables and descriptive data from Alzheimer disease centers. Alzheimer Disease and Associated Disorders, 20, 210–216.Google Scholar
Nowrangi, M. A., Rao, V. and Lyketsos, C. G. (2011). Epidemiology, assessment, and treatment of dementia. The Psychiatric Clinics of North America, 34, 275–294, vii.CrossRefGoogle ScholarPubMed
Okonkwo, O. C. et al. (2008). Cognitive models of medical decision-making capacity in patients with mild cognitive impairment. Journal of the International Neuropsychological Society, 14, 297–308.CrossRefGoogle ScholarPubMed
Oulhaj, A., Wilcock, G. K., Smith, A. D. and de Jager, C. A. (2009). Predicting the time of conversion to MCI in the elderly: role of verbal expression and learning. Neurology, 73, 1436–1442.Google Scholar
Panza, F. et al. (2005). Current epidemiology of mild cognitive impairment and other predementia syndromes. The American Journal of Geriatric Psychiatry, 13, 633–644.Google Scholar
Pereira, F. S. et al. (2010). Profiles of functional deficits in mild cognitive impairment and dementia: benefits from objective measurement. Journal of the International Neuropsychological Society, 16, 297–305.Google Scholar
Peres, K., Chrysostome, V., Fabrigoule, C., Orgogozo, J. M., Dartigues, J. F. and Barberger-Gateau, P. (2006). Restriction in complex activities of daily living in MCI: impact on outcome. Neurology, 67, 461–466.Google Scholar
Perneczky, R. et al. (2006). Complex activities of daily living in mild cognitive impairment: conceptual and diagnostic issues. Age and Ageing, 35, 240–245.Google Scholar
Petersen, R. C. et al. (2001). Current concepts in mild cognitive impairment. Archives of Neurology, 58, 1985–1992.Google Scholar
Petersen, R. C. et al. (2009). Mild cognitive impairment: ten years later. Archives of Neurology, 66, 1447–1455.Google Scholar
Pfeffer, R. I., Kurosaki, T. T., Harrah, C. H. Jr., Chance, J. M. and Filos, S. (1982). Measurement of functional activities in older adults in the community. Journal of Gerontology, 37, 323–329.Google Scholar
Pinto, C. and Subramanyam, A. A. (2009). Mild cognitive impairment: the dilemma. Indian Journal of Psychiatry, 51 (Suppl. 1), S44–S51.Google Scholar
Reinvang, I., Grambaite, R. and Espeseth, T. (2012). Executive dysfunction in MCI: subtype or early symptom. International Journal of Alzheimer's Disease, 2012, 936272.Google Scholar
Reitan, R. M. (1955). The relation of the trail making test to organic brain damage. Journal of Consulting Psychology, 19, 393–394.CrossRefGoogle ScholarPubMed
Reppermund, S. et al. (2011). The relationship of neuropsychological function to instrumental activities of daily living in mild cognitive impairment. International Journal of Geriatric Psychiatry, 26, 843–852.CrossRefGoogle ScholarPubMed
Reppermund, S. et al. (2013). Impairment in instrumental activities of daily living with high cognitive demand is an early marker of mild cognitive impairment: the Sydney memory and ageing study. Psychological Medicine, 43, 2437–2445.Google Scholar
Royall, D. R., Lauterbach, E. C., Kaufer, D., Malloy, P., Coburn, K. L. and Black, K. J. (2007). The cognitive correlates of functional status: a review from the committee on research of the American neuropsychiatric association. Journal of Neuropsychiatry Clinical Neurosciences, 19, 249–265.Google Scholar
Royall, D. R., Palmer, R., Chiodo, L. K. and Polk, M. J. (2005). Normal rates of cognitive change in successful aging: the freedom house study. Journal of the International Neuropsychological Society, 11, 899–909.Google Scholar
Royall, D. R. et al. (2002). Executive control function: a review of its promise and challenges for clinical research. A report from the committee on research of the American neuropsychiatric association. Journal of Neuropsychiatry Clinical Neurosciences, 14, 377–405.Google Scholar
Salthouse, C. D., Reynolds, F., Tam, J. M., Josephson, L. and Mahmood, U. (2010). When does age-related cognitive decline begin? Neurobiology of Aging, 30, 507–514.Google Scholar
Satterthwaite, F. E. (1946). An approximate distribution of estimates of variance components. Biometrics, 2, 110–114.Google Scholar
Shankle, W. R. et al. (2013). Relating memory to functional performance in normal aging to dementia using hierarchical Bayesian cognitive processing models. Alzheimer Disease and Associated Disorders, 27, 16–22.Google Scholar
Sperling, R. A. et al. (2013). Amyloid deposition detected with florbetapir F 18 ((18)F-AV-45) is related to lower episodic memory performance in clinically normal older individuals. Neurobiology of Aging, 34, 822–831.Google Scholar
Stoeckel, L. E. et al. (2013). MRI volume of the medial frontal cortex predicts financial capacity in patients with mild Alzheimer's disease. Brain Imaging and Behavior, 7, 282–292.CrossRefGoogle ScholarPubMed
Tabert, M. H. et al. (2002). Functional deficits in patients with mild cognitive impairment: prediction of AD. Neurology, 58, 758–764.Google Scholar
Tuokko, H., Morris, C. and Ebert, P. (2005). Mild cognitive impairment and everyday functioning in older adults. Neurocase, 11, 40–47.Google Scholar
Vallotti, B. et al. (2001). Determinants of functional status in Alzheimer's disease and vascular dementia. Archives of Gerontology and Geriatrics Supplement, 7, 419–428.Google Scholar
Visser, P. J., Kester, A., Jolles, J. and Verhey, F. (2006). Ten-year risk of dementia in subjects with mild cognitive impairment. Neurology, 67, 1201–1207.CrossRefGoogle ScholarPubMed
Wadley, V. G. et al. (2007). Changes in everyday function in individuals with psychometrically defined mild cognitive impairment in the advanced cognitive training for independent and vital elderly study. Journal of the American Geriatrics Society, 55, 1192–1198.Google Scholar
Wechsler, D. (1939). The Measurement of Adult Intelligence. Baltimore, MD: Williams & Witkins.Google Scholar
Weintraub, S. et al. (2009). The Alzheimer's disease centers' uniform data set (UDS): the neuropsychologic test battery. Alzheimer Disease and Associated Disorders, 23, 91–101.Google Scholar
Yesavage, J. A. (1988). Geriatric depression scale. Psychopharmacology Bulletin, 24, 709–711.Google Scholar