Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil.
J Int Neuropsychol Soc. 2010 Mar;16(2):297-305. doi: 10.1017/S1355617709991330.
The magnitude of functional impairment that may indicate the threshold between MCI and incipient Alzheimer's disease (AD) has not been clearly defined. The objective was to examine the pattern of functional impairment in the continuum MCI-AD. Eighty-nine older adults (32 cognitively unimpaired, 31 MCI, and 26 AD patients) were examined with the Brazilian version of the Direct Assessment of Functional Status (DAFS-BR) at a university-based memory clinic. MCI patients were sub-divided according to the progression to AD upon follow-up, and had baseline cognitive, functional and biological variables analyzed. MCI patients displayed mild deficits in functional abilities, with intermediate scores as compared to controls and AD. The DAFS-BR items that differentiated MCI from controls involved the ability to deal with finances and shopping skills. At baseline, scores obtained by MCI patients who converted to AD were not significantly different from scores of nonconverters. The magnitude of functional deficits was associated with AD-like pathological findings in the CSF. In conclusion, MCI patients present with early functional changes in complex, instrumental abilities that require the integrity of memory and executive functions. The objective measurement of the functional state may help identify older adults with increased risk of developing dementia in the MCI-AD continuum.
表明轻度认知障碍 (MCI) 与早期阿尔茨海默病 (AD) 之间阈值的功能障碍程度尚未明确界定。本研究旨在探讨 MCI-AD 连续体中功能障碍的模式。89 名老年人（32 名认知正常、31 名 MCI 和 26 名 AD 患者）在一所大学记忆诊所接受了巴西版直接功能评估 (DAFS-BR) 的检查。根据随访期间向 AD 的进展情况，将 MCI 患者进一步细分，并对基线认知、功能和生物学变量进行了分析。与对照组和 AD 组相比，MCI 患者的功能能力仅轻度受损，但得分处于中间水平。将 MCI 与对照组区分开来的 DAFS-BR 项目涉及处理财务和购物技能的能力。在基线时，转化为 AD 的 MCI 患者的得分与未转化患者的得分无显著差异。功能缺陷的程度与 CSF 中类似 AD 的病理发现有关。总之，MCI 患者在记忆和执行功能完整的情况下，表现出复杂、工具性的早期功能变化。对功能状态的客观测量可能有助于识别在 MCI-AD 连续体中痴呆风险增加的老年人。
