Jefferson Angela L, Byerly Laura K, Vanderhill Susan, Lambe Susan, Wong Sarah, Ozonoff Al, Karlawish Jason H
Department of Neurology, Alzheimer's Disease Center, Boston University School of Medicine, Boston, MA 02118-2526, USA.
Am J Geriatr Psychiatry. 2008 May;16(5):375-83. doi: 10.1097/JGP.0b013e318162f197. Epub 2008 Mar 10.
To determine whether participants with mild cognitive impairment (MCI) differ from cognitively normal (NC) older adults on traditional and novel informant-based measures of activities of daily living (ADL) and to identify cognitive correlates of ADLs among participants with MCI.
Cross-sectional.
University medical setting.
Seventy-seven participants (NC: N = 39; MCI: N = 38), 60 to 90 years old (73.5 +/- 6.6 years; 53% female).
Neuropsychological and ADL measures.
Neuropsychological tests were administered to NC and MCI participants. Informants completed the Lawton and Brody Instrumental Activities of Daily Living and Physical Self-Maintenance Scale, including instrumental (IADL) and basic ADL (BADL) scales, as well as the Functional Capacities for Activities of Daily Living (FC-ADL), an error-based ADL measure.
No statistically or clinically significant between-group differences emerged for the BADL or IADL subscales. However, a robust difference was noted for the FC-ADL scale (MCI errors > NC errors; F((1,75))= 13.6, p <0.001; d = 0.84). Among MCI participants, correlations revealed that a measure of verbal learning was the only neuropsychological correlate of FC-ADL total score (r = -0.39, df = 36, p = 0.007). No neuropsychological measures were significantly associated with the IADL or BADL subscale score.
Traditional measures assessing global ADLs may not be sensitive to early functional changes related to MCI; however, error-based measures may capture the subtle evolving functional decline associated with MCI. Among MCI participants, early functional difficulties are associated with verbal learning performance, possibly secondary to the hallmark cognitive impairment associated with this cohort.
确定轻度认知障碍（MCI）参与者与认知正常（NC）的老年人在基于传统和新型 informant 的日常生活活动（ADL）测量指标上是否存在差异，并识别 MCI 参与者中 ADL 的认知相关因素。
横断面研究。
大学医学环境。
77 名参与者（NC：N = 39；MCI：N = 38），年龄在 60 至 90 岁之间（73.5±6.6 岁；53%为女性）。
神经心理学和 ADL 测量指标。
对 NC 和 MCI 参与者进行神经心理学测试。Informant 完成了 Lawton 和 Brody 日常生活工具性活动量表以及身体自我维持量表，包括工具性（IADL）和基本 ADL（BADL）量表，以及日常生活活动功能能力（FC - ADL），这是一种基于错误的 ADL 测量指标。
BADL 或 IADL 子量表在组间未出现统计学或临床显著差异。然而，FC - ADL 量表存在显著差异（MCI 错误数>NC 错误数；F((1,75)) = 13.6，p <0.001；d = 0.84）。在 MCI 参与者中，相关性显示言语学习测量指标是 FC - ADL 总分唯一的神经心理学相关因素（r = -0.39，df = 36，p = 0.007）。没有神经心理学测量指标与 IADL 或 BADL 子量表得分显著相关。
评估整体 ADL 的传统测量指标可能对与 MCI 相关的早期功能变化不敏感；然而，基于错误的测量指标可能捕捉到与 MCI 相关的细微渐进性功能衰退。在 MCI 参与者中，早期功能困难与言语学习表现相关，这可能继发于该队列相关的标志性认知障碍。
