Mild cognitive impairment and everyday function: Evidence of reduced speed in performing instrumental activities of daily living
Mild cognitive impairment and everyday function: Evidence of reduced speed in performing instrumental activities of daily living
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DOI：
10.1097/jgp.0b013e31816b7303
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发表时间：
2008-05-01
影响因子：
7.2
通讯作者：
Ross-Meadows, Lesley A.
中科院分区：
文献类型：
--
作者：
Wadley, Virginia G.;Okonkwo, Ozioma;Ross-Meadows, Lesley A.
目标：轻度认知障碍（MCI）可能涉及微妙的功能丧失，这些功能丧失无法通过典型的自我或信息报告的日常功能评估检测到。有关MCI中功能困难性质的信息可用于增强常见的临床评估程序，MCI中受影响的功能方面可作为干预试验的有意义终点。设计：横断面病例对照组研究。地点：大学医学中心。参与者：50名MCI参与者和59名认知正常参与者。测量值：作者比较了两组在执行工具性日常生活活动（IADL）方面的速度和准确性，使用标准化的定时IADL测量，评估日常生活中常见的五个功能领域（电话使用，在食品标签上定位营养信息，财务能力，杂货店购物，药物管理）。结果如下：在定时IADL领域，MCI参与者表现出与认知正常参与者相当的准确性，但需要更长的时间来完成功能活动，控制抑郁症状（p < 0.001）。除财务能力外，在每个离散域中表现较慢。结论：这些结果表明，较慢的速度的任务性能是一个重要的组成部分，也许是MCI的功能变化的早期标志，不会被检测到使用传统的日常功能测量。未来的研究应该解决这样一个问题，即基于表现的功能测量，以及关于功能活动是否需要比平时更长的时间才能完成的简单查询，可能会改善MCI代表即将发生痴呆的个体对未来认知能力下降和疾病进展的预测。
Objective: Mild cognitive impairment ( MCI) may involve subtle functional losses that are not detected with typical self-or informant-report assessments of daily function. Information about the nature of functional difficulties in MCI can be used to augment common clinical assessment procedures, and aspects of function that are affected in MCI can serve as meaningful endpoints for intervention trials. Design: Cross-sectional case and comparison group study. Setting: University medical center. Participants: Fifty participants with MCI and 59 cognitively normal participants. Measurements: The authors compared the groups on dimensions of both speed and accuracy in performing instrumental activities of daily living ( IADLs), using a standardized Timed IADL measure that evaluates five functional domains commonly encountered in everyday life ( telephone use, locating nutrition information on food labels, financial abilities, grocery shopping, medication management). Results: Across Timed IADL domains, MCI participants demonstrated accuracy comparable with cognitively normal participants but took significantly longer to complete the functional activities, controlling for depressive symptoms ( p < 0.001). Slower performance was demonstrated in each discrete domain except financial abilities. Conclusion: These results suggest that slower speed of task performance is an important component and perhaps an early marker of functional change in MCI that would not be detected using traditional measurements of daily function. Future research should address the question of whether performance-based functional measures, as well as simple queries regarding whether functional activities take longer than usual to complete, may improve the prediction of future cognitive decline and disease progression among those individuals in whom MCI represents impending dementia.