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Profiles of functional deficits in mild cognitive impairment and dementia: benefits from objective measurement

Fernanda Speggiorin Pereira1, Mônica Sanches Yassuda, Alexandra Martini Oliveira

  • 1Laboratory of Neuroscience (LIM-27), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, São Paulo, Brazil.

Journal of the International Neuropsychological Society : JINS
|February 24, 2010
PubMed

Insights

Early functional deficits in complex tasks like finances and shopping may signal progression from mild cognitive impairment (MCI) to Alzheimer's disease (AD). Objective functional assessment aids in identifying individuals at higher risk for dementia.

Area of Science:

  • Neuroscience
  • Gerontology
  • Clinical Psychology

Background:

  • The precise functional impairment threshold distinguishing mild cognitive impairment (MCI) from incipient Alzheimer's disease (AD) remains undefined.
  • Understanding functional changes is crucial for early detection and intervention in the MCI-AD continuum.

Purpose of the Study:

  • To investigate the pattern of functional impairment across the spectrum from cognitive normality to MCI and AD.
  • To identify specific functional deficits indicative of progression within the MCI-AD continuum.

Main Methods:

  • Eighty-nine older adults (cognitively unimpaired, MCI, AD) were assessed using the Brazilian Direct Assessment of Functional Status (DAFS-BR).
  • MCI patients were analyzed based on progression to AD upon follow-up, examining baseline cognitive, functional, and biological data.
  • Cerebrospinal fluid (CSF) biomarkers associated with AD pathology were analyzed.

Main Results:

  • MCI patients exhibited mild functional deficits, with scores intermediate between controls and AD patients.
  • Key DAFS-BR items differentiating MCI from controls included financial management and shopping skills.
  • Baseline functional scores did not significantly differ between MCI patients who converted to AD and those who did not.
  • The extent of functional deficits correlated with AD-like pathological findings in CSF.

Conclusions:

  • MCI is characterized by early impairments in complex instrumental activities reliant on memory and executive functions.
  • Objective functional status measurement can help identify individuals at increased risk of developing dementia.
  • These findings support the utility of functional assessments in the MCI-AD continuum for risk stratification.

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