Functional impairment in mild cognitive impairment evidenced using performance-based measurement.

Area of Science:

• Gerontology
• Neuroscience
• Rehabilitation Science

Background:

• Older adults (OAs) with mild cognitive impairment (MCI) are often presumed to maintain activities of daily living (ADLs).
• Emerging research indicates potential difficulties in ADLs, particularly instrumental ADLs (IADLs), among OAs with MCI.
• Current ADL assessments predominantly rely on self- or collateral reports, overlooking the enhanced accuracy and sensitivity of performance-based measures.

Purpose of the Study:

• To compare ADL and IADL performance between community-dwelling OAs with and without MCI.
• To evaluate the efficacy of performance-based measures versus self- and collateral report questionnaires in detecting functional deficits in OAs with MCI.

Main Methods:

• A comparative study involving community-dwelling OAs with (n=20) and without MCI (n=30).
• Functional abilities were assessed using the Older American Resources and Services Activities of Daily Living Scale (OARS) for self- and collateral reports.
• Performance-based assessment was conducted using the Direct Assessment of Functional Status-Revised (DAFS-R).

Main Results:

• OAs with MCI demonstrated significantly decreased ADLs and IADLs on the performance-based DAFS-R compared to cognitively intact OAs.
• No significant differences in ADLs or IADLs were detected between the groups when using the OARS self-report or collateral report questionnaires.
• Performance-based testing identified functional deficits in OAs with MCI that were missed by traditional questionnaires.

Conclusions:

• OAs with MCI exhibit diminished capacity to perform instrumental activities of daily living.
• Standard self- and collateral report questionnaires may fail to detect these functional impairments.
• Performance-based assessments are crucial for accurately identifying IADL deficits in older adults with mild cognitive impairment.