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Application of Granger Causality Analysis of the Directed Functional Connection in Alzheimer's Disease and Mild Cognitive Impairment
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Functional impairment as a defining feature of: amnestic MCI cognitive, emotional, and demographic correlates

Igor Bombin1, Sandra Santiago-Ramajo, Maite Garolera

  • 1Reintegra Foundation, Oviedo, Spain. ibombin@reintegra-dca.es

International Psychogeriatrics
|June 22, 2012
PubMed
Abstract

Insights

Functional impairment is a key feature of mild cognitive impairment (MCI), worsening with cognitive decline. Quantitative assessments are more sensitive to this impairment than qualitative ones, which are influenced by depression.

Area of Science:

  • Gerontology
  • Neuroscience
  • Psychiatry

Background:

  • Mild cognitive impairment (MCI) definitions historically excluded functional impairment.
  • Recent research indicates varying degrees of functional impairment in MCI patients.
  • This study investigates functional impairment in MCI and its predictors.

Purpose of the Study:

  • To assess functional impairment in individuals with amnestic single-domain MCI (a-MCI) and amnestic multi-domain MCI (md-MCI).
  • To identify predictors of functional ability in MCI.
  • To compare the sensitivity of qualitative and quantitative functional assessment tools.

Main Methods:

  • Compared 69 healthy controls, 115 a-MCI, and 111 md-MCI subjects using neuropsychological tests.
  • Assessed functional ability with qualitative (WHO-DAS II) and quantitative (CHART) instruments.
  • Utilized regression analyses to determine predictors of functional ability.

Main Results:

  • md-MCI subjects showed greater cognitive and functional impairment than a-MCI subjects and controls.
  • Quantitative CHART scores and WHO-DAS II communication/participation subscales were significantly lower in MCI groups.
  • Cognitive measures predicted functional ability only in md-MCI, with CHART being more sensitive than WHO-DAS II; depression influenced WHO-DAS II.
  • md-MCI group showed more impairment than controls on remaining functional measures.

Conclusions:

  • Functional impairment is integral to MCI, linked to the severity of cognitive deficits.
  • Quantitative functional measures (CHART) appear more sensitive to MCI-related functional decline than qualitative measures (WHO-DAS II).
  • Depression significantly impacts qualitative assessments of functional ability in MCI.

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