EVERYDAY FUNCTIONAL PERFORMANCE IN MCI

很少有人直接评估轻度认知障碍（MCI）的认知变化对日常任务表现的影响。由于他们发展为痴呆症的风险很高，MCI患者在有效和独立地在社会中运作所需的能力下降的风险也很高。他们可能会经历功能技能的丧失，这种丧失介于正常衰老引起的细微衰退和阿尔茨海默病等痴呆症引起的明显缺陷之间。MCI概念化的一个关键问题是，记忆和其他认知能力的变化如何影响2到4年期间的日常任务表现——对许多人来说，这段时间将标志着从MCI到痴呆症的过渡。更清楚地了解认知能力与现实世界任务表现之间的关系，不仅可以提供MCI功能变化的潜在机制信息，还可以找到目标区域

Little has been done to directly evaluate the impact of cognitive changes in Mild Cognitive Impairment (MCI) on the performance of everyday tasks. By virtue of their high risk for progression to dementia, individuals with MCI also are at high risk for decline in the abilities needed to function effectively and independently in society. They are likely to experience a loss of functional skills that lies somewhere between the subtle decrements associated with normal aging and the frank deficits associated with a dementia such as Alzheimer's disease. A critical question in the conceptualization of MCI is how changes in memory and other cognitive abilities influence the performance of everyday tasks over a 2 to 4 year period of time--a period that for many individuals will mark the transition from MCI to dementia. A clearer understanding of the relationship between cognitive abilities and real world task performance will not only provide information about potential mechanisms for functional change in MCI but also will target areas for future multi-component intervention studies. The objectives of the proposed research are to examine the relationships between specific cognitive abilities and a spectrum of real world tasks that are strongly tied to autonomous functioning, quality of life, health, and avoidance of adverse outcomes such as hospitalization and mortality, and to evaluate how these relationships change over time among individuals with MCI relative to normal controls. These objectives will be achieved by comparing over time the functional abilities of a well-characterized, clinic-based sample of 75 to 90 individuals with MCI to those of an equally well- characterized, clinic-based sample of 75 to 90 age-matched, cognitively normal individuals. Specific aims are to: (1) compare the performance of individuals diagnosed with MCI to that of age- and education-matched normal controls on a variety of indices of everyday function, with primary emphasis on driving and financial skills; (2) compare longitudinal changes in functional performance in individuals with MCI to longitudinal changes in controls with annual assessments over intervals of 2 to 4 years; (3) examine cognitive predictors of functional performance and functional change over time in individuals with MCI and in normal controls; and (4) explore the hierarchy of functional change in MCI by examining decrements in functional abilities compared to those of normal controls and by comparing the magnitude of loss in each functional domain to losses across the range of functional abilities under evaluation, both at baseline and over time.