Beaver Jenna, Wilson Kaci B, Schmitter-Edgecombe Maureen
a Department of Psychology , Washington State University , Pullman , USA.
Neuropsychol Rehabil. 2019 Jun;29(5):804-820. doi: 10.1080/09602011.2017.1337039. Epub 2017 Jun 14.
Functional ability declines with age and cognitive impairment. This study investigated errors of omission made by community-dwelling older adults completing everyday tasks in a naturalistic setting.
Sixty-five cognitively healthy older adults (HOA), 19 individuals with single domain mild cognitive impairment (sdMCI), 33 individuals with multi-domain MCI (mdMCI), and 13 individuals with dementia completed measures of memory, processing speed, working memory, and executive functioning, as well as eight different activities of daily living in a naturalistic environment. Task steps were divided into preparatory, action-oriented, and concluding steps.
For action-oriented steps, the number of omission errors increased with level of cognitive impairment beyond sdMCI (i.e., HOA = sdMCI < mdMCI < dementia). In contrast, for preparatory and concluding steps, the dementia group committed more omission errors than the HOA, sdMCI, and mdMCI groups, which did not differ.
The results suggest that the more complex and integrative action-oriented steps may be the first type of everyday task step to be affected in the process of cognitive decline, with preparatory and concluding steps being preserved longer and only showing decline in later stages of impairment (i.e., dementia). Individuals with sdMCI may use other intact abilities to compensate for task omission errors.
功能能力会随着年龄增长和认知障碍而下降。本研究调查了在自然环境中完成日常任务的社区老年成年人所犯的遗漏错误。
65名认知健康的老年人(HOA)、19名单一领域轻度认知障碍(sdMCI)患者、33名多领域MCI(mdMCI)患者以及13名痴呆患者完成了记忆、处理速度、工作记忆和执行功能的测量,以及在自然环境中的八项不同日常生活活动。任务步骤分为准备步骤、行动导向步骤和结束步骤。
对于行动导向步骤,遗漏错误的数量随着认知障碍程度超过sdMCI而增加(即HOA = sdMCI < mdMCI < 痴呆)。相比之下,对于准备步骤和结束步骤,痴呆组比HOA组、sdMCI组和mdMCI组犯了更多的遗漏错误,而后三组之间没有差异。
结果表明,更复杂且综合的行动导向步骤可能是认知衰退过程中首先受到影响的日常任务步骤类型,准备步骤和结束步骤保留时间更长,仅在损伤后期(即痴呆)才出现下降。sdMCI患者可能会利用其他未受损的能力来弥补任务遗漏错误。