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Longitudinal changes in functional disability in Alzheimer's disease patients
H Michael Arrighi1, Isabelle Gélinas, Trent P McLaughlin
1Janssen Alzheimer Immunotherapy Research & Development, LLC, South San Francisco, California 94080, USA. marrighi@janimm.com
International Psychogeriatrics
|February 15, 2013
Summary
Alzheimer's disease patients experience progressive loss of daily living activities tied to cognitive decline. This functional impairment follows a hierarchy, impacting instrumental tasks before basic ones.
Area of Science:
- Neurology
- Gerontology
- Cognitive Science
Background:
- Functional impairment, marked by reduced activities of daily living (ADL), is a key symptom of Alzheimer's disease (AD).
- Understanding the relationship between cognitive decline and ADL loss is crucial for patient care and disease management.
Purpose of the Study:
- To characterize the progressive loss of specific ADL capabilities in relation to cognitive decline in Alzheimer's disease patients.
- To describe the hierarchical nature of functional impairment in AD.
Main Methods:
- Utilized data from the ELN-AIP-901 observational study involving participants with AD, mild cognitive impairment, and cognitive normality.
- Employed the Mini-Mental Status Exam (MMSE) and Disability Assessment for Dementia (DAD) for evaluations every six months over two years.
- Applied hierarchical regression to analyze annual changes in MMSE and DAD scores, controlling for baseline diagnosis.
Main Results:
- A significant association was found between cognitive changes (MMSE) and functional decline (DAD) in AD patients over two years.
- Specific ADL subdomains, including finance, medication management, and outings, showed earlier impairment.
- A clear hierarchy of functional impairment was observed, with instrumental ADL typically affected before basic ADL.
Conclusions:
- Activities of daily living decline progressively and hierarchically with cognitive deterioration in Alzheimer's disease.
- Significant individual variability exists in the rate of decline and the specific order of functional impairment.
- Cognitive ability is a key determinant of functional capacity in Alzheimer's disease patients.
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