Functional impairment in instrumental activities of daily living: An early clinical sign of dementia?
Functional impairment in instrumental activities of daily living: An early clinical sign of dementia?
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DOI：
10.1111/j.1532-5415.1999.tb07239.x
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发表时间：
1999-04-01
影响因子：
6.3
通讯作者：
Dartigues, JF
中科院分区：
文献类型：
--
作者：
Barberger-Gateau, P;Fabrigoule, C;Dartigues, JF
目的：评估 4 个 IADL 对 3 年和 5 年痴呆症的预测价值。设计：前瞻性队列研究。背景：在 37 个随机选择的教区进行社区调查。受试者：PAQUID 研究中随机抽取 65 岁及以上的法国社区居民样本，进行 3 年（1582 名受试者）和 5 年（1283 名受试者）随访。主要结果测量：3 岁和 5 岁时痴呆症的发病率，通过两步筛查诊断：(1) MMS 和 DSM-III-R； (2) 经神经科医生证实的痴呆诊断。结果：总结基线时对 4 个 IADL 的依赖性数量的分数是 3 年痴呆的预测因子，但不能预测 5 年痴呆的预测因子。基线和 3 年随访之间依赖性水平的增加与 5 年随访时发生痴呆的风险增加相关。 结论：这四个 IADL 可以帮助识别患有痴呆高风险的老年受试者，然后对他们进行神经心理学测试。
OBJECTIVE: To estimate the predictive value of four IADLs on 3- and 5-year incident dementia.DESIGN: Prospective cohort study.SETTING: A community survey in 37 randomly selected parishes.SUBJECTS: A random sample of French community dwellers aged 65 and older included in the PAQUID study followed-up at 3 (1582 subjects) and 5 years (1283 subjects).MAIN OUTCOME MEASURES: Incidence of dementia at 3 and 5 years, diagnosed by two-step screening: (1) MMS and DSM-III-R; (2) diagnosis of dementia confirmed by a neurologist.RESULTS: A score summing up the number of dependencies at baseline on four IADLs is a predictor of 3-year but not of 5-year incident dementia. Increase in the level of dependence between baseline and 3-year follow-up is associated with an increased risk of incident dementia at 5-year follow-up.CONCLUSION: These four IADLs can help to identify older subjects at high risk of dementia who should then undergo neuropsychological testing.