Sergeyev Nicole, Paré Nadia, Rahman Aneela, Krishnan Anjali, Warren David E, Wolterstoff Trevor, Wilhelm Anna, Aflagah Erica, Rabin Laura
Department of Psychology, Brooklyn College, City University of New York, New York, NY, USA.
Gaylord Specialty Hospital, Wallingford, CT, USA.
Appl Neuropsychol Adult. 2024 Nov 6:1-13. doi: 10.1080/23279095.2024.2419932.
Measures of complex functional decision-making capacity can greatly aid in assessing mild cognitive impairment (MCI) and facilitating early intervention in dementia care. We examined the ability of the Assessment of Functional Capacity Interview (AFCI) to detect functional differences among older adults who were cognitively unimpaired (CU), or who presented with subjective cognitive decline (SCD) or MCI. A sample of 97 older adults (CU; n = 30, Mage = 74.64 ± 7.42 years; SCD; n = 34, Mage = 72.56 ± 6.43 years; MCI; n = 33, Mage = 78.28 ± 7.55 years) underwent neuropsychological testing and responded to the Financial Capacity Instrument (FCI-SF). Informants completed the Assessment of Functional Capacity (AFCI), an instrument of functional decision-making capacity, and responded to the Social Vulnerability Scale (SVS15) and Amsterdam Instrumental Activity of Daily Living (A-IADL-Q-SV), a measure of functional status, for comparison. According to informant-reported responses, the CU group had significantly lower AFCI total (and domain) scores, (2) = 27.59, <.001, relative to MCI. Additionally, the CU group had significantly lower AFCI scores in the domain relative to the SCD group, (2) = 14.06, <.05. In the overall sample, AFCI total scores were associated with FCI-SF, SVS15, and A-IADL-Q-SV scores and cognitive measures. Our results demonstrate that the AFCI is sensitive to impairment in safety, social, financial, and medical functioning in MCI and is associated with measures of cognitive functioning and social vulnerability in older adults. Incorporating this instrument as a supplement to cognitive screening instruments may aid in the prevention of hazardous decision-making in older adults.
复杂功能决策能力的测量方法有助于评估轻度认知障碍（MCI）并促进痴呆症护理的早期干预。我们研究了功能能力评估访谈（AFCI）检测认知未受损（CU）、主观认知下降（SCD）或MCI的老年人之间功能差异的能力。97名老年人（CU组；n = 30，年龄中位数Mage = 74.64 ± 7.42岁；SCD组；n = 34，Mage = 72.56 ± 6.43岁；MCI组；n = 33，Mage = 78.28 ± 7.55岁）接受了神经心理学测试，并对财务能力工具（FCI-SF）做出反应。 informant完成了功能能力评估（AFCI），这是一种功能决策能力工具，并对社会脆弱性量表（SVS15）和阿姆斯特丹日常生活工具性活动（A-IADL-Q-SV）（一种功能状态测量工具）做出反应，以进行比较。根据 informant报告的回答，与MCI组相比，CU组的AFCI总分（和各领域得分）显著更低，χ²(2) = 27.59，p <.001。此外，与SCD组相比，CU组在该领域的AFCI得分显著更低，χ²(2) = 14.06，p <.05。在整个样本中，AFCI总分与FCI-SF、SVS15和A-IADL-Q-SV得分以及认知测量指标相关。我们的结果表明，AFCI对MCI患者在安全、社交、财务和医疗功能方面的损害敏感，并且与老年人的认知功能和社会脆弱性测量指标相关。将该工具作为认知筛查工具的补充可能有助于预防老年人做出危险决策。
