Relationship between instrumental activities of daily living performance and incidence of mild cognitive impairment among older adults: A 48-month follow-up study
Relationship between instrumental activities of daily living performance and incidence of mild cognitive impairment among older adults: A 48-month follow-up study
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DOI：
10.1016/j.archger.2020.104034
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发表时间：
2020-05-01
影响因子：
4
通讯作者：
Shimada, Hiroyuki
中科院分区：
文献类型：
--
作者：
Makino, Keitaro;Lee, Sangyoon;Shimada, Hiroyuki
早期预防轻度认知障碍MCI至关重要，因为MCI患者进展为痴呆的风险很高。本研究的目的是研究日常生活IADL的工具性活动的性能和未来的MCI发病率在日本社区居住的老年人之间的关系。共有1595名基线时无认知障碍的个体参加了这项前瞻性队列研究，随访期为48个月。在基线时评估以下IADL的表现：处理现金和银行业务，购买必需品，乘坐公共汽车/火车外出，使用地图前往不熟悉的地方，以及操作视频/DVD播放器。在基线和随访时，使用国家老年医学和老年学中心功能评估工具和简易精神状态检查进行客观认知筛查;确定48个月内新的MCI发病率。在所有参与者中，922人（57.8%）在基线时至少有一项IADL受限。在随访期间，179名（11.2%）参与者经历了从正常认知到MCI的转变。基线时未参与“使用公共汽车/火车外出”或“使用地图前往不熟悉的地方”的参与者比参与此类活动的参与者显示出更高的MCI发病风险。户外IADL的限制与MCI的发作有关。有这种局限性的人需要监测，因为这些局限性是认知能力下降和MCI的强有力指标。
Early prevention of mild cognitive impairment MCI is crucial because individuals with MCI are at high risk for progression to dementia. The purpose of the present study was to examine the relationship between the performance of instrumental activities of daily living IADL and future incidence of MCI among community-dwelling older adults in Japan. A total of 1595 individuals without cognitive impairment at baseline participated in this prospective cohort study with a 48-month follow-up period. Performance on the following IADL was assessed at baseline: handling cash and banking, shopping for necessities, going out using buses/trains, using maps to travel to unfamiliar places, and operating video/DVD players. Objective cognitive screening using the National Center for Geriatrics and Gerontology-Functional Assessment Tool and Mini-Mental State Examination was conducted at baseline and follow-up; new MCI incidence over the 48 months was determined. Of all participants, 922 (57.8 %) had a limitation in at least one IADL at baseline. During the follow-up period, 179 (11.2 %) participants experienced a transition from normal cognition to MCI. Participants who had not engaged in "going out using buses/trains" or "using maps to travel to unfamiliar places" at baseline showed a significantly higher risk of MCI incidence than those who had engaged in such activities. Limitations in outdoor IADL were associated with MCI onset. Individuals with such limitations need to be monitored, as these limitations are strong indicators of cognitive decline and MCI.