Instrumental activities of daily living are impaired in Parkinson’s disease patients with mild cognitive impairment.

2014 ◽  
Vol 28 (2) ◽  
pp. 229-237 ◽  
Author(s):  
Eva Pirogovsky ◽  
Dawn M. Schiehser ◽  
Kristalyn M. Obtera ◽  
Mathes M. Burke ◽  
Stephanie L. Lessig ◽  
...  
2019 ◽  
Vol 26 (4) ◽  
pp. 430-440
Author(s):  
Patricia Sulzer ◽  
Alena Bäumer ◽  
Huong Giang Hoang ◽  
Sara Becker ◽  
Hannah Dorothea Lönneker ◽  
...  

AbstractObjectives:Parkinson’s disease (PD) patients with mild cognitive impairment (PD-MCI) have an increased risk of developing dementia (PDD). As activities of daily living (ADL) impairment is mandatory for the diagnosis of PDD, assessing early signs of instrumental ADL (iADL) dysfunction, especially in PD-MCI, is essential. In PD, self- and caregiver-reported iADL performance is often confounded by motor dysfunction and mood. Objective and time-efficient performance-based measurements are needed to screen for cognitive-related iADL dysfunction. We evaluated the Erlangen Test of Activities of Daily Living in Mild Dementia and Mild Cognitive Impairment (ETAM) in PD and determined its value for characterizing a subgroup of PD-MCI patients with mild performance-based iADL impairment.Methods:Twenty-one cognitively normal PD patients (PD-NC), 24 PD-MCI patients, and 18 healthy controls (HC) were analyzed. Assessments included the ETAM, a comprehensive neuropsychological test battery, iADL, mood, and motor measurements.Results:PD-MCI patients scored significantly lower on the ETAM total score compared to PD-NC patients (p = .002), whereas HC and PD-NC patients did not statistically differ. No HC scored lower than 27 points (diagnostic cutoff for mild iADL impairment); only PD-MCI patients scored below this cutoff (29.2%) suggesting the ETAM is able to characterize a PD-MCI subgroup with early iADL impairment. PD-MCI patients below the cutoff were more impaired in the attention domain (p = .04).Conclusions:The ETAM is a potentially valuable clinical assessment, able to detect first signs of iADL dysfunction in PD-MCI. Further studies in larger cohorts are needed to evaluate the prognostic ability for predicting PDD.


2019 ◽  
Vol 19 (7) ◽  
pp. 1022-1031 ◽  
Author(s):  
Paula D. Cebrián ◽  
Omar Cauli

Background: Many neurological disorders lead to institutionalization and can be accompanied in their advanced stages by functional impairment, and progressive loss of mobility, and cognitive alterations. Objective: We analyzed the relationship between functional impairment and cognitive performance and its related subdomains in individuals with Parkinson’s disease, Alzheimer’s disease accompanied by motor dysfunction, and with other neurological disorders characterized by both motor and cognitive problems. Methods: All participants lived in nursing homes (Valencia, Spain) and underwent cognitive evaluation with the Mini-Mental State Examination; functional assessment of independence in activities of daily living using the Barthel score and Katz index; and assessment of mobility with the elderly mobility scale. Results: The mean age of the subjects was 82.8 ± 0.6 years, 47% of the sample included individuals with Parkinson’s disease, and 48 % of the sample presented severe cognitive impairment. Direct significant relationships were found between the level of cognitive impairment and functional capacity (p < 0.01) and mobility (p < 0.05). Among the different domains, memory impairment was not associated with altered activities of daily living or mobility. The functional impairment and the risk of severe cognitive impairment were significantly (p<0.05) higher in female compared to male patients. Among comorbidities, overweight/obesity and diabetes were significantly (p < 0.05) associated with poor cognitive performance in those individuals with mild/moderate cognitive impairment. Conclusion: In institutionalized individuals with movement disorders there is an association between functional and cognitive impairment. Reduction of over-weight and proper control of diabetes may represent novel targets for improving cognitive function at such early stages.


2018 ◽  
Vol 12 (2) ◽  
pp. 165-172 ◽  
Author(s):  
Ana Iza Gomes da Penha Sobral ◽  
Cláudia Marina Tavares de Araújo ◽  
Marcos Felipe Falcão Sobral

Abstract Mild Cognitive Impairment is characterized as an intermediate form between age-related change and dementia. For the elderly, autonomy and independence are related to the ability to remain active in conducting their social activities and, for this to occur, communication is fundamental in this process. Objective: To assess the association between communication and the abilities of elderly people with mild cognitive impairment to perform instrumental activities of daily living. Methods: A cross-sectional, quantitative, analytical, correlational study was conducted at the Open University of the Third Age (UnATI), a program of the Federal University of Pernambuco. This study included 92 people, comprising 46 elderly with mild cognitive impairment and a caregiver or family member who met the inclusion criteria. The elderly were asked to complete a sociodemographic questionnaire and Lawton-Brody’s Instrumental Activities of Daily Living Scale. The caregivers were asked to complete the Functional Assessment of Communication Skills. The following variables were studied: social communication skills and instrumental activities of daily living. Data were stored in an Excel® 2007 spreadsheet, and the Pearson correlation test was used for the statistical analysis. Results: There were statistically significant correlations in four domains of social communication: referring to family members by name (p=0.0033); requesting information about people or events (p=0.0355); understanding conversations in a noisy environment (p=0.0448); and understanding what they watch on television or listen to on the radio (p=0.0127). Conclusion: Changes in the communication of elderly people with mild cognitive impairment interfere with their ability to perform instrumental activities autonomously and independently.


2021 ◽  
Vol 23 (3) ◽  
pp. 297-310
Author(s):  
Sujin Eom ◽  
Ju-Young Ha

Purpose: The purpose of this study was to identify factors affecting reversion to normal cognition and progression to dementia from mild cognitive impairment (MCI) after 2 years.Methods: We analyzed data from the 6th and 7th “Korean Longitudinal Study of Ageing (KLoSA)”. A total of 773 participants aged 65 years and above classified as having MCI according to the Korean Mini-Mental State Examination in the 6th survey were included in the study. Data were analyzed by SPSS 26.0 software using x2 test, t-test, Mann-Whitney test and logistic regression analysis.Results: Of all the participants, 30.5% reverted to normal cognition, 48.5% remained with MCI, and 21.0% progressed to dementia. Factors such as young age (odds ratio [OR]=0.96, 95% confidence interval [CI]: 0.94~0.99), the absence of diabetes (OR=1.49, 95% CI: 1.01~2.19), and frequent neighbor networks “at least once or twice a month” (OR=2.35, 95% CI: 1.26~4.37), and “at least once a week” (OR=1.63, 95% CI: 1.03~2.56) compared to “never or less than 6 times a year” significantly associated with reversion to normal cognition. Meanwhile, factors such as old age (OR=1.09, 95% CI: 1.05~1.12), low level of perceived socioeconomic status (reference. above middle) (OR=1.59, 95% CI: 1.05~2.41), low levels of instrumental activities of daily living (OR=1.17, 95% CI: 1.05~1.32), and a small number of social activities (OR=0.70, 95% CI: 0.51~0.96) significantly associated with dementia progression.Conclusion: The study indicates the necessity of follow-up research for developing interventions that could aid individuals in reverting to normal cognitive function by managing diabetes or encouraging interaction with neighbors and preventing the progression to dementia by improving Instrumental Activities of Daily Living levels or encouraging participation in social activities.


2014 ◽  
Vol 39 (1-2) ◽  
pp. 12-24 ◽  
Author(s):  
Julia J. Hsiao ◽  
Po H. Lu ◽  
Joshua D. Grill ◽  
Edmond Teng

Background: Previous cross-sectional studies suggest that assessments of instrumental activities of daily living (IADLs) may be useful for operationalizing the differences in functional deficits seen in mild cognitive impairment (MCI) and dementia. However, their utility for longitudinal changes in IADLs in the transition between MCI and dementia remains unclear. Methods: We analyzed longitudinal IADL data with the Functional Activities Questionnaire (FAQ) in stable (MCI-S; n = 1,318) or progressive (MCI-P; n = 1,108) MCI patients. Results: Larger increases in FAQ scores were seen in the MCI-P group across a 14.5-month interval, but overlapping distributions in the two groups yielded poorer discriminatory power than prior cross-sectional reports. Conclusion: Our findings emphasize the difficulties in operationalizing the criterion of ‘essentially intact' IADLs in MCI, which may complicate the interpretation of disease progression in MCI treatment trials. © 2014 S. Karger AG, Basel


2013 ◽  
Vol 35 (9) ◽  
pp. 926-933 ◽  
Author(s):  
Eva Pirogovsky ◽  
Mercedes Martinez-Hannon ◽  
Dawn M. Schiehser ◽  
Stephanie L. Lessig ◽  
David D. Song ◽  
...  

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