Lassen-Greene Caroline L, Steward Kayla, Okonkwo Ozioma, Porter Ellen, Crowe Michael, Vance David E, Griffith H Randall, Ball Karlene, Marson Daniel C, Wadley Virginia G
1 Department of Psychology, University of Alabama at Birmingham (UAB), Birmingham, AL, USA.
2 Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA.
J Geriatr Psychiatry Neurol. 2017 Jul;30(4):220-227. doi: 10.1177/0891988717711807.
Research estimates that a significant percentage of individuals with mild cognitive impairment (MCI) experience functional difficulties. In addition to reduced accuracy on measures of everyday function, cross-sectional research has demonstrated that speed of performing instrumental activities of daily living (IADLs) is slowed in individuals with MCI. The present study investigated whether baseline and longitudinal changes in speed and accuracy of IADL performance differed between persons with MCI and cognitively normal peers.
Linear mixed models were used to estimate the group differences in longitudinal performance on measures of IADLs.
Assessments were conducted at university and medical research centers.
The sample consisted of 80 participants with MCI and 80 control participants who were enrolled in the Alzheimer's Disease Research Center's Measuring Independent Living in the Elderly Study.
Instrumental activities of daily living speed and accuracy were directly assessed using selected domains of the Financial Capacity Instrument, the Timed IADL assessment, and driving-related assessments (Useful Field of View, Road Sign Test).
Individuals with MCI performed worse on speed and accuracy measures of IADLs in comparison to cognitively normal peers and demonstrated significantly steeper rates of decline over three years in either speed or accuracy in all domains assessed.
Both speed and accuracy of performance on measures of IADL are valuable indices for early detection of functional change in MCI. The performance pattern may reflect a trade-off between speed and accuracy that can guide clinical recommendations for maintaining patient independence.
研究估计，相当大比例的轻度认知障碍（MCI）患者存在功能困难。除了日常功能测量的准确性降低外，横断面研究表明，MCI患者进行日常生活工具性活动（IADL）的速度减慢。本研究调查了MCI患者与认知正常的同龄人在IADL表现的速度和准确性方面的基线和纵向变化是否存在差异。
采用线性混合模型估计IADL测量指标纵向表现的组间差异。
在大学和医学研究中心进行评估。
样本包括80名MCI参与者和80名对照参与者，他们均参与了阿尔茨海默病研究中心的老年人独立生活测量研究。
使用财务能力工具的选定领域、定时IADL评估和与驾驶相关的评估（有用视野、路标测试）直接评估日常生活工具性活动的速度和准确性。
与认知正常的同龄人相比，MCI患者在IADL的速度和准确性测量方面表现更差，并且在所有评估领域中，三年来速度或准确性的下降速度明显更快。
IADL测量指标的表现速度和准确性都是早期检测MCI功能变化的有价值指标。表现模式可能反映了速度和准确性之间的权衡，这可以指导维持患者独立性的临床建议。
