Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy.
IRCCS S.D.N., Naples, Italy.
Neurol Sci. 2021 May;42(5):1773-1783. doi: 10.1007/s10072-021-05142-0. Epub 2021 Mar 18.
Activities of daily living (ADL) are fundamental skills required to independently care for oneself and are categorized in basic (BADLs) and instrumental (IADLs) activities of daily living. ADL evaluation is of paramount importance in clinical practice to discriminate between healthy individuals (HC) and patients with mild cognitive impairment (MCI) or Alzheimer's disease (AD). However, it is unclear whether and to what extent BADL and IADL deficits occur in MCI, when compared with AD. Therefore, the present study aimed at comparing performance on both BADLs and IADLs in HC, MCI, and AD.
Three electronic databases were consulted for studies comparing total BADLs/IADLs, and single BADLs/IADLs in AD, MCI, and HC (comparisons: AD versus MCI, AD versus HC, MCI versus HC). Ninety-six studies were included in the meta-analysis with random effect models (Hedges' g). Meta-regression was performed to evaluate the effect of clinical variables on ESs.
AD group had more difficulties in BADLs and IADLs than HC and MCI groups; people with MCI showed more difficulties in both IADLs and BADLs than HC. The meta-regression analysis revealed that the percentage of males in the samples was a significant predictor of the ES in the meta-analysis comparing total BADL scores between MCI and HC; in the comparison between AD and HC, age at evaluation predicted the ES on some single IADLs: preparing food, handling medication, and finances.
In MCI, it should be considered not only a decline of IADLs but also subtle decline of BADL abilities.
日常生活活动（ADL）是独立照顾自己所需的基本技能，分为基本日常生活活动（BADLs）和工具性日常生活活动（IADLs）。ADL 评估在临床实践中至关重要，可用于区分健康个体（HC）与轻度认知障碍（MCI）或阿尔茨海默病（AD）患者。然而，尚不清楚与 AD 相比，MCI 是否以及在何种程度上存在 BADL 和 IADL 缺陷。因此，本研究旨在比较 HC、MCI 和 AD 患者在 BADL 和 IADL 方面的表现。
通过电子数据库检索比较 AD、MCI 和 HC 之间总 BADLs/IADLs 和单个 BADLs/IADLs 的研究（比较：AD 与 MCI、AD 与 HC、MCI 与 HC）。使用随机效应模型（Hedges' g）进行荟萃分析，纳入 96 项研究。进行荟萃回归分析以评估临床变量对 ES 的影响。
AD 组在 BADLs 和 IADLs 方面比 HC 和 MCI 组更困难；MCI 患者在 IADLs 和 BADLs 方面均比 HC 患者更困难。荟萃回归分析显示，样本中男性的比例是 MCI 和 HC 之间总 BADL 评分比较中 ES 的显著预测因素；在 AD 和 HC 之间的比较中，评估时的年龄预测了一些单项 IADLs（如准备食物、处理药物和管理财务）的 ES。
在 MCI 中，不仅应考虑 IADLs 的下降，还应考虑 BADL 能力的细微下降。
