Daily Functioning, Cognition, and Caregiver Burden in MCI Patients

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DESCRIPTION (provided by applicant): Individuals at the very early stages of dementia (most often Alzheimer's disease) are referred to as having mild cognitive impairment (MCI). However, concrete clinical diagnostic criteria have not yet been established because cognitive and daily functional impairments are not yet well characterized in individuals with MCI. The current research criteria states that individuals with MCI must exhibit memory impairment beyond that of normal aging and maintain relatively preserved daily functional abilities (Petersen, 2004). Yet, recent research indicates that MCI patients are likely to experience subtle functional impairments (Farias et al., 2009; Pernesczky et al., 2006a). The problem is that most of the studies assessing daily functioning have used either cognitive rating forms or self- or informant-rated instrumental activities of daily living which can lead to biased results (Albert et al., 1999; Wadley et al., 2003; Razani et al., 2007). Additionally, very little attention has been paid to caregiver's of MCI individuals, given that there is an assumption that individuals with MCI do not require assistance in their daily activities. Thus, the aims of the present study are. 1) to characterize daily functioning in MCI individuals using a performance-based measure and to examine how neuropsychological impairment affects functional ability in MCI patients relative to those with diagnosed dementia, 2) to characterize how neuropsychological and functional impairments affect caregivers of MCI individuals, and 3) to assess whether the rate of cognitive decline can predict the rate of functional decline in MCI individuals and the rate of increased burden for their caregivers. Forty individuals with MCI (using the current research diagnostic criteria for MCI) will be recruited and administered a clinical neuropsychological test battery that includes tests of memory, attention, abstract reasoning, and information processing speed, as well as a performance-based functional task. The performance of the MCI individuals will be compared to a database of individuals with dementia (Alzhiemer's disease, Frontotemporal dementia, and Vascular dementia) and normal controls. Additionally, next-of-kin caregivers will be administered a set of questionnaires in order to assess the level of burden and psychological distress experienced. Patients and caregivers will be administered tests at baseline and 1-year follow-up periods. The functional abilities of the groups will be compared, the degree to which neuropsychological test scores predict daily functioning will be examined, and finally decline in cognitive and functional abilities over a 1-year period will be assessed. The results will better characterize degree, type and severity of deficits experienced by MCI individuals and their caregivers, which will assist with refining the diagnostic criteria for MCI and lead to better treatment planning for patients and their families. PUBLIC HEALTH RELEVANCE: Currently, there are no formal clinical diagnostic criteria for individuals experiencing mild cognitive impairment and very little is known about the daily functional abilities of such individuals. Also, little is known about the burden of care experienced by their next-of-kin. Gaining this information can assist with refining diagnostic criteria and aid with treatment planning.